Evaluation of a hospital pharmacy-based pharmaceutical care services for asthma patients

  • Elkhansa Abdelhamid
  • Abdelmoneim I. Awad
  • Abdellatif Gismallah
Keywords: Asthma, Pharmacists, Pharmaceutical Services, Sudan


Objectives: To implement and assess hospital-based pharmaceutical care services for patients with asthma.

Methods: A prospective, randomized, controlled study was conducted in Shaab teaching hospital, Khartoum, Sudan. Patients were allocated randomly either in the intervention group (60) or control group (40) patients.  The drug therapy of asthma for the patients in the intervention group was reviewed by a trained pharmacist, and interventions were suggested to the attending physicians for the identified problems. Intervention patients received comprehensive medication counselling and asthma education every 2 weeks, while the control group received the routine medical consultation and dispensing services. The outcome measures were recorded using structured forms at baseline and monitored during a follow-up of every two weeks for 6 months in both groups. Data were analyzed using SPSS version 13, level of significance was p<0.05.

Results: At the end of the study period the mean reduction in frequency of acute attacks (1.91; SD=0.18 vs. 1.0; SD=0.14; p=0.03), nocturnal asthma symptoms (3.5; SD=0.3 vs. 1.1; SD=0.2; p=0.02) and frequency of using inhaled β2 agonists per week (19.9; SD= 2.1 vs. 3.3; SD=0.3; p=0.01) were significantly greater in the intervention group compared to control. A significant mean reduction (p=0.002) in the days of sickness/week was in the intervention group, while in control group there was an increase in mean days of sickness/week. The intervention group showed a significant greater improvement in the score for assessing the inhalation technique (p<0.001), patient’s knowledge about asthma (p<0.001), and its drug-therapy (p=0.01) compared with control.

Conclusion: The present findings suggest that pharmacist’s intervention can have positive impact on asthma-related outcomes in patients.


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1. Schulz M, Verheyen F, Muhlig S, Muller JM, Muhlbauer K, Knop-Schneickert E, Petermann F, Bergmann KC. Pharmaceutical care services for asthma patients: a controlled intervention study. J Clin Pharmacol. 2001; 41: 668-76.

2. National Asthma Education and Prevention Program. Guidelines for the diagnosis and management of asthma, Expert Panel Report 2. Bethesda, Maryland: National Institutes of Health, National Heart, Lung, and Blood Institute, 1997.

3. Lahdensuo A, Haahtela T, Herrala J, Kava T, Kiviranta K, Kuusisto P, Perämäki E, Poussa T, Saarelainen S, Svahn T. Randomised comparison of guided self management and traditional treatment of asthma over one year. BMJ 1996; 312:748-52.

4. Beasley R, Cushley M, Holgate ST. A self-management plan in the treatment of adult asthma. Thorax 1989; 44:200-4.

5. Gibbs K , Small M. Asthma. In: Walker R and Clive E, eds. Clinical Pharmacy and Therapeutics.3rd ed. Churchill Livingstone, 375-398, 2003.

6. Cordina M, McElany JC, Hughes CM. Assessment of a community Pharmacy-Based program for patients with asthma. Pharmacotherapy 2001; 21(10):1196-203.

7. Herborg H, Soendergaard B, Jorgensen T, Fonnesbaek L, Hepler CD, Holst H, Froekjaer B. Improving drug therapy for patients with asthma-part 2: Use of antiasthma medications. J Am Pharm Assoc (Wash). 2001; 41(4): 551-9.

8. Herborg H, Soendergaard B, Froekjaer B, Fonnesbaek L, Jorgensen T, Hepler CD, Grainger-Rousseau TJ, Ersboell BK. Improving drug therapy for patients with asthma--part 1: Patient outcomes. J Am Pharm Assoc (Wash). 2001; 41(4): 539-50.

9. Emmerton L, Shaw J, Kheir N. Asthma management by New Zealand Pharmacists: a pharmaceutical care demonstration project. J Clin Pharm Ther. 2003; 8(5):395-402.

10. Narhi U, Airaksinen M, Erlund, H. Pharmacists Solving Problems in asthma management-experiences from a one year intervention program in Finland . Int J Pharm Pract. 2002; 3:55-9.

11.. Narhi U, Airaksinen M, Tanskanen P, Erlund H. Therapeutic outcomes monitoring by community pharmacists for improving clinical outcomes in asthma. J Clin Pharm Ther. 2000; 25:177-83.

12. Mangiapane S, Schulz M, Muhlig S, Ihle P, Schubert I, Waldmann H. Community Pharmacy-Based Pharmaceutical Care for Asthma Patients. Ann Pharmacother. 2005; 39(11): 1817–22.

13. Shaw JP, Emmerton L, Kheir NA, Barron PA, Becket G, Smith NA. Pharmaceutical care of asthma patients in a New Zealand community pharmacy setting. Pharm J.. Available at URL: http://www.pjonline.com/Editorial/20000916/practiceresearch/r24.html

14. Rupp MT, McCallian DJ, Sheth KK. Developing and marketing a community pharmacy-based asthma management program. J Am Pharm Assoc (Wash). 1997;37(6):694-9.

15. Armour C, Bosnic-Anticevich S, Brillant M, Burton D, Emmerton L, Krass I, Sainin B, Smith L, Stewart K. Pharmacy Asthma Care Program (PCAP) improves outcomes for patients in the community. Thorax 2007;62:496-502.

16. Hogerzeil HV, Bimo , Ross-Degnan D, Laing RO, Ofori-Adjei D, Santoso B, Azad Chowdhury AK, Das AM, Kafle KK, Mabadeje AF, et al. Field tests for rational drug use in twelve developing countries. Lancet. 1993;342(8884):1408-10.

17. Calva JJ, Sifuentes-Osornio J, Ceron C. Antimicrobial resistance in fecal flora: Longitudinal community-based surveillance of children from urban Mexico. Antimicrob Agents Chemother 1996; 40:1699-702.

18. Quick JD, Hogerzeil HV, Velasquez G, Rago L. Twenty-five years of Essentials medicines. Bull World Health Organ. 2002;80(11):913-4.

19. Awad AI, Eltayeb IB, Matowe L, Thalib L. Self medication with Antibiotics and Antimalarials in the community of Khartoum State, Sudan. JPPS 2005;8(2):326-31.

20. Eltayeb IB, Awad AI, Mohamed-Salih MS, Daffa-Alla MA, Ahmed MB, Ogail MA, Matowe L. Changing the prescribing patterns of sexually transmitted infections in the White Nile Region of Sudan. Sex Transm Infect. 2005;81(5):426-7.

21. Awad AI, Eltayeb IB, Baraka OZ. Changing antibiotics prescribing practices in health centers of Khartoum State, Sudan. Eur J Clin Pharmacol. 2006;62(2):135-42.

22. Berenguer B, La Cassa C, de la matta MJ, Martin-Calero MJ. Pharmaceutical care: past, present and future. Curr Pharm Des. 2004;10(31):3931-46.

23. Farris KB, Fernandez-Llimos F, Benrimoj SI. Pharmaceutical care in community pharmacies: Practice and research from around the world. Ann Pharmacother. 2005;39:539-41.

24. Lenth RV. Java Applets for Power and Sample Size [Computer software]. Available at URL: http://www.stat.uiowa.edu/~rlenth/Power

25. Grimshaw JM, Thomas RE, MacLennan G, Fraser C, Ramsay CR, Vale L, Whitty P, Eccles MP, Matowe L, Shirran L, Wensing M, Dijkstra R, Donaldson C. Effectiveness and efficiency of guideline dissemination and implementation strategies. Health Technol Assess. 2004; 8(6):iii-iv,1-72.

26. Gattis WA, Hasselblad V, Whellan DJ, O’Connor CM. Reduction in heart failure events by the addition of a clinical pharmacist to the heart failure management team: results of the Pharmacist in Heart Failure Assessment Recommendation and Monitoring (PHARM) Study. Arch Intern Med. 1999;159(16):1939-45.

27. Leape LL, Cullen DJ, Clapp M, Burdick E, Demonaco HJ, Erickson JI, Bates DW. Pharmacists participation on physician rounds and adverse drug events in the intensive care unit. JAMA. 1999;282(3):267-70.

28. Boulet LP, Boutin H, Cote J, Leblanc P, Laviolette M. Evaluation of an asthma self-management education program. J Asthma 1995;32(3):199-206.

29. Nazir Z, Razaq S, Mir S, Anwar M, Al Mawlawi G, Sajad M, ShehabA, Taylor RS. Revisiting the accuracy of peak flow meters: a double-blind study using formal methods of agreement. Respir Med. 2005;99(5):592-5.

30. Sibbald B, White P, Pharoah C, Freeling P, Anderson HR. Relationship between psychosocial factors and asthma morbidity. Fam Pract. 1998;5:12-7.

31. Johnson JA, Bootman JL. Drug related morbidity and mortality and the economic impact of pharmaceutical care. Am J Health-syst Pharm. 1997;54:554-8.

32. International Pharmaceutical Federation. Good pharmacy practice (GGP) in developing countries: Recommendations for stepwise implementation. Available at URL:
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