Abstract
Background Paediatric asthma is a public health burden in Australia despite the availability of national asthma guidelines. Community pharmacy interventions focusing on paediatric asthma are scarce. Practitioner Asthma Communication and Education (PACE) is an evidence-based program, developed in the USA for general practice physicians, aimed at addressing the issues of poor clinician-patient communication in the management of paediatric asthma. This program has been shown to improve paediatric asthma management practices of general practitioners in the USA and Australia. The development of a PACE program for community pharmacists will fill a void in the current armamentarium for pharmacist-patient care. Objectives To adapt the educational program, PACE, to the community pharmacy setting. To test the feasibility of the new program for pharmacy and to explore its potential impact on pharmacists’ communication skills and asthma related practices. Setting Community pharmacies located within the Sydney metropolitan. Method The PACE framework was reviewed by the research team and amended in order to ensure its relevance within the pharmacy context, thereby developing PACE for Pharmacy. Forty-four pharmacists were recruited and trained in small groups in the PACE for Pharmacy workshops. Pharmacists’ satisfaction and acceptability of the workshops, confidence in using communication strategies pre- and post-workshop and self-reported behaviour change post workshop were evaluated. Main Outcome Measure Pharmacist self-reported changes in communication and teaching behaviours during a paediatric asthma consultation. Results All 44 pharmacists attended both workshops, completed pre- and post-workshop questionnaires and provided feedback on the workshops (100 % retention). The participants reported a high level of satisfaction and valued the interactive nature of the workshops. Following the PACE for Pharmacy program, pharmacists reported significantly higher levels in using the communication strategies, confidence in their application and their helpfulness. Pharmacists checked for written asthma self-management plan possession and inhaler device technique more regularly, and provided verbal instructions more frequently to paediatric asthma patients/carers at the initiation of a new medication. Conclusion This study provides preliminary evidence that the PACE program can be translated into community pharmacy. PACE for Pharmacy positively affected self-reported communication and education behaviours of pharmacists. The high response rate shows that pharmacists are eager to expand on their clinical role in primary healthcare.
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References
Australia NAC. Asthma management handbook 2006. Melbourne: National Asthma Council Australia Ltd; 2006, ISBN-10: 1-876122-07-2.
Shah S, Roydhouse JK, Sawyer SM. Asthma education in primary healthcare settings. Curr Opin Pediatr. 2008;20(6):705–10.
Gibson PG, Powell HG, Coughlan J, Wilson AJ, Abramson M, Haywood P, et al. Self-management education and regular practitioner review for adults with asthma. Cochrane Database Syst Rev. 2003(1):CD001117.
Shah S, Sawyer SM, Toelle BG, Mellis CM, Peat JK, Lagleva M, et al. Improving paediatric asthma outcomes in primary health care: a randomised controlled trial. Med J Aust. 2011;195(7):405–9.
Grover C, Armour C, Asperen PPV, Moles R, Saini B. Medication use in children with asthma: not a child size problem. J Asthma. 2011;48(10):1085–103.
Drakeford PA, Davis AM, Van Asperen PP. Evaluation of a paediatric asthma education package for health professionals. J Paediatr Child Health. 2007;43(5):342–52.
Szefler SJ. Advances in pediatric asthma in 2010: addressing the major issues. J Allergy Clin Immunol. 2011;127(1):102–15.
Haby MM, Powell CVE, Oberklaid F, Waters EB, Robertson CF. Asthma in children: gaps between current management and best practice. J Paediatr Child Health. 2002;38(3):284–9.
Chong JJ, Davidsson A, Moles R, Saini B. What affects asthma medicine use in children? Australian asthma educator perspectives. J Asthma. 2009;46(5):437–44.
Bandura A. Social foundations of thought and action: a social cognitive theory. Englewood Cliffs: Prentice-Hall Inc.; 1986, ISBN-10: 013815614X.
Clark NM, Valerio MA. The role of behavioural theories in educational interventions for paediatric asthma. Paediatr Respir Rev. 2003;4(4):325–33.
Clark NM, Gong M, Schork MA, Evans D, Roloff D, Hurwitz M, et al. Impact of education for physicians on patient outcomes. Pediatrics. 1998;101(5):831–6.
Cabana MD, Slish KK, Evans D, Mellins RB, Brown RW, Lin X, et al. Impact of physician asthma care education on patient outcomes. Pediatrics. 2006;117(6):2149–57.
Shah S, Toelle BG, Sawyer SM, Roydhouse JK, Edwards P, Usherwood T, et al. Feasibility study of a communication and education asthma intervention for general practitioners in Australia. Aust J Prim Health. 2010;16(1):75–80.
Mehuys E, Van Bortel L, De Bolle L, Van Tongelen I, Annemans L, Remon JP, et al. Effectiveness of pharmacist intervention for asthma control improvement. Eur Respir J. 2008;31(4):790–9.
Armour C, Bosnic-Anticevich S, Brillant M, Burton D, Emmerton L, Krass I, et al. Pharmacy Asthma Care Program (PACP) improves outcomes for patients in the community. Thorax. 2007;62(6):496–502.
Saini B, Krass I, Armour C. Development, implementation, and evaluation of a community pharmacy-based asthma care model. Ann Pharmacother. 2004;38(11):1954–60.
Dolovich L, Sabharwal M, Agro K, Foster G, Lee A, McCarthy L, et al. The effect of pharmacist education on asthma treatment plans for simulated patients. Pharm World Sci. 2007;29(3):228–39.
Smith L, Bosnic-Anticevich SZ, Mitchell B, Saini B, Krass I, Armour C. Treating asthma with a self-management model of illness behaviour in an Australian community pharmacy setting. Soc Sci Med. 2007;64(7):1501–11.
Saini B, LeMay K, Emmerton L, Krass I, Smith L, Bosnic-Anticevich S, et al. Asthma disease management-Australian pharmacists’ interventions improve patients’ asthma knowledge and this is sustained. Patient Educ Couns. 2011;83(3):295–302.
Barbanel D, Eldridge S, Griffiths C. Can a self-management programme delivered by a community pharmacist improve asthma control? A randomised trial. Thorax. 2003;58(10):851–4.
Basheti IA, Reddel HK, Armour CL, Bosnic-Anticevich SZ. Improved asthma outcomes with a simple inhaler technique intervention by community pharmacists. J Allergy Clin Immunol. 2007;119(6):1537–8.
Bosnic-Anticevich SZ, Sinha H, So S, Reddel HK. Metered-dose inhaler technique: the effect of two educational interventions delivered in community pharmacy over time. J Asthma. 2010;47(3):251–6.
Giraud V, Allaert F-A, Roche N. Inhaler technique and asthma: feasability and acceptability of training by pharmacists. Respir Med. 2011;105(12):1815–22.
Liu Y, Nevins JC, Carruthers KM, Doucette WR, McDonough RP, Pan X. Osteoporosis risk screening for women in a community pharmacy. J Am Pharm Assoc. 2007;47(4):521–6.
Heilmann RM, Friesleben CR, Billups SJ. Impact of a pharmacist-directed intervention in postmenopausal women after fracture. AJHP. 2012;69(6):504–9.
Shah S. PACE Australia manual. Sydney: University of Sydney; 2011, ISBN: 1-74080-128.
Basheti IA, Armour CL, Reddel HK, Bosnic-Anticevich SZ. Long-term maintenance of pharmacists’ inhaler technique demonstration skills. Am J Pharm Educ. 2009;73(2):32.
Bratton SL, Cabana MD, Brown RW, White DF, Wang Y, Lang SW, et al. Asthma educational seminar targeting Medicaid providers. Respir Care. 2006;51(1):49–55.
Bosnic-Anticevich SZ, Stuart M, Mackson J, Cvetkovski B, Sainsbury E, Armour C, et al. Development and evaluation of an innovative model of inter-professional education focused on asthma medication use. BMC Med Educ. 2014;14:72.
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A. Elaro is the recipient of scholarships from the Australian Postgraduate Award (APA).
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Elaro, A., Shah, S., Pomare, L.N. et al. PACE: Pharmacists use the power of communication in paediatric asthma. Int J Clin Pharm 36, 976–985 (2014). https://doi.org/10.1007/s11096-014-9984-z
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DOI: https://doi.org/10.1007/s11096-014-9984-z