Physician-Pharmacist Collaboration Keeps Asthma Patients Out of Hospitals

In a study that will be presented next month at the American College of Clinical Pharmacy Annual Meeting in Austin, Texas, implementing physician-pharmacist collaborative management (PPCM) methods reduced asthma-related emergency department visits.

Researchers from the University of Iowa College of Pharmacy observed patients enrolled in the Collaboration Among Pharmacists and Physicians to Improve Blood Pressure Now (CAPTION) trial, which aimed to monitor changes in blood pressure levels following the implementation of PPCM. The 5-year CAPTION trial examined 32 primary care clinics, each of which enrolled approximately 10 to 15 patients aged 12 years or older with persistent asthma.

“Asthma in the primary care setting has not received a lot of attention recently with PPCM models,” Tyler Harris Gums, PharmD, corresponding author of the study, told Pharmacy Times in an exclusive interview. “We wanted to explore the pharmacist impact in diseases outside of hypertension and other chronic cardiovascular disease states.”

Among the observed outcomes were the sum of asthma-related emergency department visits and hospitalizations, Asthma Control Test (ACT) scores, Asthma Quality of Life Questionnaire by Marks (AQLQ-M) scores, and asthma medication changes.

Because roughly one-third of the patients had controlled asthma at baseline, additional intention-to-treat analysis was performed to examine the effects of PPCM. The number of emergency department visits and/or hospitalizations decreased by 43.2% during PPCM, but returned to baseline levels once the intervention was terminated.

Following the 9-month PPCM intervention, mean ACT scores increased from the pre-PPCM period. Compared to the post-PPCM period, no significant change was found between the baseline numbers and the post-intervention period, which demonstrated a sustained effect of PPCM, the study authors suggested.

The researchers also noted a significant improvement in AQLQ-M scores during PPCM compared to the pre- and post-intervention periods.

“We were pleasantly surprised by how significant pharmacists were in the care of asthmatics,” Dr. Gums said of the results. “With a large percentage of CAPTION’s patients controlled at baseline, we were concerned any effect would be difficult to see.”

The researchers noted their results align with previous studies focused on PPCM, which similarly proved that the intervention reduces emergency department visits.

“Pharmacists can be a great asset in controlling this chronic disease at the primary care level,” Dr. Gums concluded in the email. “A collaborative team approach has proven worthwhile and, with good execution, can help manage patients’ asthma.”