An evaluation of a community pharmacy-based rural asthma management service

Objective: To compare the effect of a pharmacist-delivered rural asthma management service (RAMS) on health outcomes for People with asthma in a rural/ regional area with 'standard care' delivered through community pharmacies. Design: A parallel group controlled repeated measures study. Setting: Community pharmacies in Central West New South Wales. Intervention: Standardised protocols and resources based on national asthma management guidelines, delivered by specially trained community pharmacists. Patients visited the pharmacy at baseline and 1, 3 and 6 months after baseline in the intervention group and at baseline plus 6 months after baseline in the control group. Participants: The intervention pharmacists (n = 12) were trained to deliver the RAMS model, while control pharmacists (n = 8) provided standard asthma care to their recruited patients. Fifty-one and 39 patients were recruited by intervention and control pharmacists. Main outcome measure: Asthma severity score which was a composite score based on recency, frequency and severity of asthma symptoms, and asthma history. Results: Data compared at the final visit between groups indicated that the RAMS patient group demonstrated a significant reduction in the asthma severity scores (7.9 +/- 2.6 versus 10.4 +/- 2.6, P < 0.001); a reduction in the risk of non-adherence to medication scores (1.6 +/- 0.7 versus 2.3 +/- 1.1, P < 0.001); and an increase in the proportion of Patients owning a written action plan (50% versus 23%, P = 0.04). Conclusions: These results indicated that the community pharmacy-based RAMS model can improve asthma outcomes for patients in rural settings, and similar models for asthma and other chronic diseases should be tested rigorously and adopted in rural primary care practice.