The effect of pharmacist education on asthma treatment plans for simulated patients
- 284 Downloads
Objective To determine if an educational program designed for community pharmacists to help patients self manage their asthma could improve pharmacists abilities to facilitate asthma treatment plans. Setting Hamilton and Toronto, Ontario, Canada. Method A randomized controlled trial involving volunteer community pharmacists who received either an asthma education program (AEP; intervention group) or a delayed AEP (control group). The AEP consisted of a one-day workshop and two follow-up telephone calls. Teaching methods progressed from a didactic approach to self-directed learning and role playing with simulated patients (SPs). The primary outcome was measured by SPs who conducted unannounced pharmacy visits. Main Outcomes Measures The number of appropriate (defined a priori) action plans facilitated by the pharmacist was the primary outcome. Facilitated was defined as the pharmacist recommending a specific plan, taking responsibility for telephoning the physician, or ensuring the patient would take responsibility for contacting the physician. Results Thirty-three pharmacists were randomized to the intervention group and 31 pharmacists were randomized to the control group. Pharmacists in the intervention group facilitated an appropriate plan in 44.8% of situations (117 out of a possible 261) compared with 29.3% (79 out of a possible 270) in the control group, (mean difference 15.5% (95% CI: 7.4–23.8%; P = 0.0004)). Intervention group pharmacists were better able to facilitate plans for the ‘under use of inhaled corticosteroids,’ ‘exposure to pet dander as an asthma trigger,’ and ‘overuse of short-acting beta-agonist’ problems. Intervention group pharmacists exhibited better overall communication skills (including empathy, coherence, verbal skills, and nonverbal skills). Conclusion This AEP produced improvements in pharmacists’ abilities to facilitate plans for SPs in a community pharmacy setting.
KeywordsAsthma Canada Community pharmacy Pharmaceutical care Pharmacist education Randomized controlled trial Simulated patient
This study was supported by an unrestricted educational grant from Merck Frosst Canada Inc., and in-kind contribution from Agro Health Associates Inc., and the Centre for Evaluation of Medicines. Conflict of interests: No conflict of interests.
- 7.Gibson PG, Powell H, 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 2002;(3): CD001117. DOI 10.1002/14651858.CD001117Google Scholar
- 9.Gibson PG, Powell H, Coughlan J, Wilson AJ, Hensley MJ, Abramson M, et al. Limited (information only) patient education programs for adults with asthma. Cochrane Database Syst Rev 2002;(1):CD001005. DOI 10.1002/14651858.CD001005Google Scholar
- 13.Role of the pharmacist in improving asthma care. National Asthma Education and Prevention Program. Am J Health Syst Pharm 1995;52(13):1411–6Google Scholar
- 14.The role of the pharmacist in improving asthma care. National Asthma Education and Prevention Program. Am Pharm 1995;NS35(11):24–9Google Scholar
- 19.Miller JP, Seller W. Curriculum perspectives and practice. Mississauga: Copp Clark Pitman; 1990Google Scholar
- 20.Sauve S, Lee HN, Meade MO, Lang JD, Farkouh M, Cook DJ, et al. The critically appraised topic: a practical approach to learning critical appraisal. Ann RCPSC 1995;28(7):396–8Google Scholar
- 23.Austin Z, Dolovich L, Lau E, Tabak D, Sellors C, Marini A, et al. Teaching and assessing primary care skills: the family practice simulator model. Am J Pharm Educ 2005;69:500–7Google Scholar
- 29.Davis D, Thomson O’Brien MA, Freemantle N, Mazmanian P, Taylor-Vaisey A. Impact of Formal Continuing Medical Education. Do conferences, workshops, rounds, and other traditional continuing education activities change physician behavior or health outcomes? JAMA 1999;282:867–74PubMedCrossRefGoogle Scholar
- 34.Currie JD, Chrischilles EA, Kuehl AK, Buser RA. Effect of a training program on community pharmacists’ detection of and intervention in drug-related problems. J Am Pharm Assoc 1997;NS37:182–91Google Scholar