Asheville Project Validates Collaborative Care for Asthma
Asheville Project Validates Collaborative Care for Asthma
Bunting BA, Cranor CW
J Am Pharm Assoc. 2006;46:133-147
This viewpoint offers commentary on important clinical research in the area of pharmacy.
Patients from 2 employers in Asheville, North Carolina, who had a diagnosis of asthma, regardless of the severity or their use of healthcare resources, were eligible to enroll in a medication therapy management program. This study examined the 207 adult patients who agreed to participate, received a program intervention, and for whom forced expiratory volume in 1 second (FEV1) values and/or symptom criteria were available to evaluate severity. Patients agreed to participate in an individual session with a certified asthma educator and to meet long term with a pharmacist who served as a care manager/coach on at least a monthly basis. Monthly counseling sessions included review of medication use, assessment of inhaler technique, and review of symptom frequency and/or peak flow meter values. Recommendations for therapy changes, if needed, were then made to the patient's physician.
Most patients (82%) were classified as having severe or moderate persistent asthma at baseline. Following 1 year or more of participation, this figure decreased to 49%. For the 84 patients who were in the program for at least 1 year and who had both a baseline FEV1 measurement and at least 1 follow-up visit, an increase from 81% of predicted FEV1 to 90% of predicted FEV1 was attained during the program. Only 63% of patients indicated that they had an "action plan" at baseline; this improved to 99% of patients following participation in the program. Decreases in emergency department visits and hospitalizations also were observed. Estimates of direct cost savings averaged $725 per patient per year.
As was noted in previous Asheville Project findings for diabetes, education and medication therapy management services in a community-based program for patients with a chronic disease -- in this case, asthma -- led to improved clinical and economic outcomes. Pharmacists can use the data from this study to advocate for patients with chronic diseases to have routine sessions with their pharmacist provider, and these sessions should be reimbursed, given their demonstrated value. Data available to pharmacists, such as medication refill histories and the relative ease of patient access to them, make such collaborations between physicians, pharmacists, and patients a valuable adjunct to patient healthcare.
Abstract
Bunting BA, Cranor CW
J Am Pharm Assoc. 2006;46:133-147
This viewpoint offers commentary on important clinical research in the area of pharmacy.
Patients from 2 employers in Asheville, North Carolina, who had a diagnosis of asthma, regardless of the severity or their use of healthcare resources, were eligible to enroll in a medication therapy management program. This study examined the 207 adult patients who agreed to participate, received a program intervention, and for whom forced expiratory volume in 1 second (FEV1) values and/or symptom criteria were available to evaluate severity. Patients agreed to participate in an individual session with a certified asthma educator and to meet long term with a pharmacist who served as a care manager/coach on at least a monthly basis. Monthly counseling sessions included review of medication use, assessment of inhaler technique, and review of symptom frequency and/or peak flow meter values. Recommendations for therapy changes, if needed, were then made to the patient's physician.
Most patients (82%) were classified as having severe or moderate persistent asthma at baseline. Following 1 year or more of participation, this figure decreased to 49%. For the 84 patients who were in the program for at least 1 year and who had both a baseline FEV1 measurement and at least 1 follow-up visit, an increase from 81% of predicted FEV1 to 90% of predicted FEV1 was attained during the program. Only 63% of patients indicated that they had an "action plan" at baseline; this improved to 99% of patients following participation in the program. Decreases in emergency department visits and hospitalizations also were observed. Estimates of direct cost savings averaged $725 per patient per year.
As was noted in previous Asheville Project findings for diabetes, education and medication therapy management services in a community-based program for patients with a chronic disease -- in this case, asthma -- led to improved clinical and economic outcomes. Pharmacists can use the data from this study to advocate for patients with chronic diseases to have routine sessions with their pharmacist provider, and these sessions should be reimbursed, given their demonstrated value. Data available to pharmacists, such as medication refill histories and the relative ease of patient access to them, make such collaborations between physicians, pharmacists, and patients a valuable adjunct to patient healthcare.
Abstract
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