Patient Preference and Adherence (Feb 2024)
Evaluating the Feasibility of a Community Pharmacy-Delivered Behaviour Change Intervention to Reduce Reliever Reliance in Asthma
Abstract
Holly Foot,1,2 Kebede Beyene,3 Rob Horne,4 James Fingleton,5,6 Jeff Harrison,1 Amy Hai Yan Chan1,4 1School of Pharmacy, The University of Auckland, Auckland, New Zealand; 2School of Pharmacy, The University of Queensland, Woolloongabba, QLD, Australia; 3Department of Pharmaceutical and Administrative Sciences, University of Health Sciences and Pharmacy, St Louis, MO, Unites States; 4Centre of Behavioural Medicine, School of Pharmacy, University College London, London, UK; 5Capital and Coast District Health Board, Wellington, New Zealand; 6Medical Research Institute of New Zealand, Wellington, New ZealandCorrespondence: Amy Hai Yan Chan, School of Pharmacy, The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand, Tel +6493737599, Email [email protected]: The aim of this study was to evaluate the feasibility of a community pharmacy-delivered intervention to shift patients’ beliefs about short-acting beta2 agonists (SABA) in asthma management. The study targeted individual beliefs about SABA and assessed actual SABA use, focusing on reducing SABA use as well as adherence to inhaled corticosteroids (ICS) as a preventive measure.Patients and Methods: This non-randomized, before-and-after feasibility study enrolled participants with asthma from four community pharmacies in Auckland, New Zealand. Eligible participants were aged 18 years and above and were prescribed a SABA for their asthma. The intervention included the SABA reliance questionnaire to determine the degree of SABA reliance, verbal discussions with pharmacists personalised according to the degree of SABA reliance identified, and referral to general practitioners as appropriate.Results: Of the 44 patients who consented into the study, 19 were in the control group and 16 in the intervention group. Recruitment and retention were modest, with 10 control and five intervention participants completing the 90-day follow-up. Although not statistically significant, preliminary results indicated reduced SABA reliance and increased ICS adherence in the intervention group, and reduced SABA refill. Feedback showed that 78% of intervention participants found the information easy to understand, and 56% expressed intent to consult their general practitioners. Pharmacy staff found the intervention feasible but noted time constraints as a barrier to intervention delivery.Conclusion: The study demonstrates that a community pharmacy-delivered intervention is feasible and acceptable to both patients and pharmacists. While preliminary results show a positive effect on reducing SABA reliance and improvement of ICS adherence, the results were not statistically significant due to the small numbers recruited. This suggests a larger randomised trial is indicated. This intervention holds promise for addressing the over-reliance on SABA in asthma management and improving adherence to preventive therapies.Keywords: adherence, SABA, SRQ, feasibility, pharmacist, asthma
