A new study showing how interventions by community pharmacists can help asthma patients achieve better asthma control could have major cost benefits for health services around the world.
The economic burden of asthma is estimated to be €72 billion annually in the 28 countries of the European Union.
The research, led by a team from the Medway School of Pharmacy found that community pharmacists who carry out a review with asthma patients of the way they use their medicines had a beneficial effect on patients’ asthma control. The study showed that this benefit was cost-effective compared with usual care methods.
The research involved one of the largest ever trials of a community-pharmacist intervention for asthma, with 283 pharmacists and 1,263 patients in Italy taking part. The intervention, known as I-MUR, is a private, structured interview between pharmacists and patients, looking at five areas: asthma symptoms; medicines use; attitude towards medicines; adherence; and identification of pharmaceutical care issues.
In the trial, pharmacists were randomly assigned to receive immediate or delayed (by three months) training in I-MUR intervention. After three months, patients who had received the intervention were 76% more likely to have achieved good asthma control compared with patients in the other group.
Principal investigator, Andrea Manfrin, said that the I-MUR intervention led to a reduced average number of active ingredients among patients’ medications (from five to four), improved self-reported adherence and established a clear link between asthma control and adherence to treatment.
The economic analysis, conducted by the London School of Economics (LSE), adopted a ‘willingness-to-pay’ threshold of €30,000 (£25,300) per quality-of-life year gained, in line with the UK’s National Institute for Health and Care Excellence (NICE); the researchers’ analyses showed that, at the conclusion of the study after nine months, the probability that the intervention was more cost-effective than usual care reached 100%.
The research, entitled A cluster randomised control trial to evaluate the effectiveness and cost-effectiveness of the Italian medicines use review (I-MUR) for asthma patients (Andrea Manfrin, Janet Krska and Trudy Thomas (Medway School of Pharmacy/universities of Kent and Greenwich) Michaela Tinelli, LSE) is published in the journal BMC Health Services Research.