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Impact of pharmacist-led educational interventions on asthma control and adherence: single-blind, randomised clinical trial

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Abstract

Background Asthma is an important cause of morbidity and mortality worldwide. Education is a critical component in the management of asthma. Objective This study sought to assess the impact of pharmacist-led educational interventions on asthma control and adherence. Setting Tertiary Hospitals in Nigeria Method This was a single-blind, three-arm, prospective, randomised, controlled, parallel-group study conducted in the Respiratory Units of the University of Nigeria Teaching Hospital, Enugu State and the Lagos University Teaching Hospital, Lagos State between March 2016 and September 2017. The three arms were: Usual Care, Individual Intervention, Caregiver-assisted Intervention (1:1:1 ratio). The Intervention arms received education for 6 months while the Usual Care arm received no education. The Asthma Control Test and the 8-item Morisky Medication Adherence Scale were filled at baseline, 3 months, and 6 months after baseline. Data were analyzed using the IBM SPSS Version 25.0 with statistical significance set as P < 0.05. Main outcome measure Asthma control and adherence. Results Seventy-eight (78) asthma patients participated; thirty-nine (39) per hospital; thirteen (13) in each arm. The Individual Intervention arm possessed significantly better asthma control compared to Usual Care at 3 months (21.42 Vs. 18.85; P = 0.004, t = 3.124, df = 25, 95% confidence interval = 0.88 − 4.28) and 6 months (21.81 Vs. 19.58; P = 0.003, t = 3.259, df = 25, 95% confidence interval = 0.82 − 3.64). The Individual Intervention arm also possessed significantly better adherence compared to Usual Care at 3 months (6.81 Vs. 4.94; P = 0.001, t = 3.706, df = 25, 95% confidence interval = 0.83 − 2.90) and 6 months (7.28 Vs. 5.13; P < 0.001, t = 4.094, df = 25, 95% confidence interval = 1.07 −3.24). The Caregiver-assisted Interventions had no significant improvement in asthma control and adherence. Conclusion The individualized educational interventions produced better improvements in asthma control and adherence.

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Acknowledgements

The asthma patients are appreciated for their participation. The authors are grateful to Professor Elizabeth Juniper for granting permission to utilize the Symptom/Peak Flow Diary. Professor Donald Morisky granted permission to utilize the 8-item Morisky Medication Adherence Scale (MMAS-8-Item). The Asthma Control Test (ACTTM) developed and validated by GlaxoSmithKline was utilized in the study. Special thanks go to the pharmacist researchers: Chidera Chika, Nneamaka Akankali, Kosisochukwu Okonkwo, Zimuzor Chike-Aliozor, Somtochukwu Ekwunife, Chinecherem Ironkwe, Lillian Nweke, Ifeoma Nwatu.

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The authors received no funding to conduct this study.

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  1. Mathew J. Okonta: Deceased.

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  1. Department of Clinical Pharmacy and Pharmacy Management, Faculty of Pharmaceutical Sciences, University of Nigeria, Nsukka, Enugu State, PMB 410001, Nigeria

    Kosisochi C. Amorha, Mathew J. Okonta & Chinwe V. Ukwe

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Amorha, K.C., Okonta, M.J. & Ukwe, C.V. Impact of pharmacist-led educational interventions on asthma control and adherence: single-blind, randomised clinical trial. Int J Clin Pharm 43, 689–697 (2021). https://doi.org/10.1007/s11096-020-01187-x

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