The Coulee Region Community Pharmacy Asthma Intervention study.

OBJECTIVE: To determine whether community pharmacist-initiated interventions containing a recommendation to adjust prescribed asthma therapy are more helpful to prescribers than similar communications without such a recommendation.

DESIGN: Prospective, multicenter, quasi-experimental design with posttest.

SETTING: Wisconsin and Minnesota.

PATIENTS AND PARTICIPANTS: 33 community and clinic pharmacies throughout the Coulee Region of Wisconsin and Minnesota enrolled eligible patients from October 1, 2004, to January 31, 2005. Patients were between 12 and 60 years of age, had used three or more short-acting beta-agonist (SABA) canisters with-in the previous 90 days, and did not meet any exclusion criteria.

INTERVENTIONS: Based on an evaluation of each patient's inhaler technique and adherence to controller medications, pharmacists sent to the prescriber a fax containing a recommendation (for patients with proper technique and appropriate adherence to prescribed controller medications) or information (for those who had any combination of inappropriate inhaler technique or inappropriate adherence).

MAIN OUTCOME MEASURE: Health care professionals' yes-or-no response to the question, "Do you find this form helpful for making clinical decisions?"

RESULTS: Pharmacists offered to enroll 235 patients who were identified as meeting preliminary inclusion criteria. Of those, 112 people met exclusion criteria, 28 were not interested in their pharmacists' involvement, 13 stated that they did not have time to participate, 11 took the forms home but did not return them, and 11 other patients were excluded by the pharmacists for other reasons. The remaining 60 patients were in enrolled in the study, 60 faxes were sent from 16 pharmacies, and 40 of those were analyzed further. For 24 recommendation faxes sent, prescribers rated 15 as helpful (62.5%) and 4 as not helpful (16.7%). Of 16 informational faxes sent, 10 were marked helpful (62.5%) and 2 were marked not helpful (12.5%).

CONCLUSION: Recommendation and informational faxes were overall helpful to health care professionals in making clinical decisions. Respondents found the two types of faxed interventions as equally helpful, suggesting that pharmaceutical care initiated by community pharmacists is helpful to prescribers.