National Asthma and Allergy Awareness Month highlights how pharmacists in all healthcare settings are in a unique position to improve the management and outcomes of individuals with these conditions.
In 1984, the Asthma and Allergy Foundation of America (AAFA) declared May National Asthma and Allergy Awareness Month because it is peak season for individuals with these conditions. More than 25 million Americans suffer from these conditions, making them one of the most common chronic diseases.1.2
Despite the availability of effective therapies, there are significant challenges to adequate management of these disease states, indicating a need for improved treatment approaches. Pharmacists in all healthcare facilities are in a unique position to improve the management and outcomes of these individuals by addressing patient-related factors, participating in continuing education programs, providing education/advice, and providing OTC medication recommendations.
Pharmacists are often the first point of contact with a healthcare provider in community settings, and their ability to provide direct patient care activities makes their role critical in improving clinical outcomes. The most commonly reported patient-related factors associated with poor asthma control are lack of adherence and poor inhalation technique.3
Pharmacists can address this by assessing inhaler technique with each refill, which is likely more common than patient follow-up with their prescriber – and also highlighting the importance of adherence – and working with the patient to address any barriers they experience. to grab. In the inpatient setting, pharmacists can address these factors with a focus on ensuring that patients have their medications on discharge and are ideally set up for successful treatment after an exacerbation.
In all healthcare settings, pharmacists can address elements that affect asthma control, such as minimizing exposure to triggers (allergens and cigarette smoke), optimizing the management of comorbid conditions, and increasing physical activity. For example, the rate of depression and anxiety is high in patients with asthma; pharmacists should be aware of this correlation and increase their screening for these conditions in this patient population.3
It is important to note that the provision of tailored education and counseling can overcome barriers of low literacy and lead to an improvement in the self-management of asthma. One of the earliest illustrations of this was shown in The Asheville Project: Long-term clinical, humanistic, and economic outcomes of a community-based asthma drug therapy management program (DOI: 10.1331/154434506776180658) regularly followed up by pharmacists using scheduled consultation, monitoring and recommendations to prescribers resulted in sustained improvement (up to 5 years) in all objective and subjective measures of asthma control.4
There are many resources that pharmacists can use to improve counseling sessions. These include using asthma education checklists and completing certified asthma education programs, such as those offered by the National Asthma Educator Certification Board (NAECB).5.6
Pharmacists can help with drug access problems by helping to identify and apply for prescription support programs (PAPs) for low-cost or free access to asthma medications. Interestingly, the prevalence of telemedicine has increased over the past 2 years, making it easier for pharmacists to meet individual patients and/or their prescribers, provide advice and adapt treatment as needed, further increasing the accessibility of the profession for patients.
People with asthma are very likely to also have allergies. The pharmacist’s role in helping to manage these can overlap significantly with the management of asthma.8
As with asthma, it is imperative that counseling is provided to the patient, relatives and other caregivers. This is especially important with allergies, as many patients participate in self-care, possibly without the prescriber’s knowledge.
Allergies such as hay fever can typically be treated OTC with a variety of oral, nasal, and ocular. Patients may not realize that OTC drug selection needs to be optimized individually in the same way as prescription drugs.
These OTC options may still cause significant drug or drug interactions, or adverse effects that can be minimized with routine assessment. Pharmacists are also in a position to recognize when self-care is not an appropriate option for allergy management and can appropriately refer patients who rely on their judgment.
Special attention should be paid to any patient requiring prescriptions in the context of life-threatening allergies. For example, whenever an epinephrine rescue pen is dispensed, pharmacists can and should discuss its proper use, elicit avoidance, and how to recognize anaphylaxis.
Ideally, these drugs can be dispensed more than is necessary to be administered, and repetition in these instructions is often helpful for many patients. As asthma and allergies are among the most common medical conditions in the United States, it is imperative for pharmacists to continue to increase patient care activities to significantly improve clinical outcomes, adherence, health literacy, reduce hospitalizations and reduce the cost of healthcare for their patients. lower with these diagnoses.
In May, take a moment to help your patients breathe easier.
- AAFA. Asthma and Allergy Foundation of America. (nd). Retrieved on April 9, 2022, from https://www.aafa.org/asthma-and-allergy-awareness-month/
- Essential role of pharmacists in asthma … – sage journals. (nd). Retrieved on April 9, 2022, from https://journals.sagepub.com/doi/full/10.1177/0897190020927274
- www.ncbi.nlm.nih.gov. (nd). Retrieved April 9, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8562572/bin/plantbiotechnology-38-3-21.0715a-s001.pdf
- The Asheville Project: Long-term Clinical, Humanistic, and Economic Outcomes of a Community-Based Drug Therapy Management Program for Asthma. Define_me. (nd). Retrieved on April 28, 2022, from https://www.japha.org/article/S1544-3191(15)31554-5/fulltext
- Magazines-SAGEPUB-com.ezproxy3.lhl.uab.edu. (nd). Retrieved on April 28, 2022, from https://journals-sagepub-com.ezproxy3.lhl.uab.edu/doi/pdf/10.1177/0022219411426860
- Certified Asthma Educator (AE-C). Pharmacy students. (nd). Retrieved April 28, 2022, from https://www.pharmacystudents.org/multidisciplinary-certification/certified-asthma-educator-ae-c
- Pat Bass, MD (2020, August 11). Prescription Tools for Asthma Drugs. Very good health. Retrieved April 28, 2022, from https://www.verywellhealth.com/patient-assistance-program-for-asthma-medication-200788
- Mayo Foundation for Medical Education and Research. (2021, May 14). Allergies and Asthma: Double Problems. Mayo Clinic. Retrieved on April 9, 2022, from https://www.mayoclinic.org/diseases-conditions/asthma/in-depth/allergies-and-asthma/art-20047458