Assessment of adherence to National Guideline Recommendations for asthma care in community pharmacies
Nieuwe ontwikkelingen in behandeling en zorg (Nederlands)Background - Pharmaceutical care guidelines aim to provide recommendations for pharmaceutical care, reduce unwanted pharmacy practice variation and ultimately improve the quality of healthcare.
Objectives - This study evaluated community pharmacists’ adherence to recommendations for the provision of care to asthma patients with first dispensing and follow-up refill encounters.
Methods - Data were collected from community pharmacists in the Netherlands. Data included (1) pharmacists’ self-assessment of their adherence to guideline recommendations, (2) independent observations of dispensing encounters, and (3) a nationwide questionnaire on pharmacists’ views on the desirable (clinical) feasibility.
Results - The 21 pharmacists that performed self-assessment judged their adherence concerning inhalation instructions as high. The lowest scores were reported for recommendations to collect additional information with respect to the type of lung disease and for asking patients’ expectations, wishes and concerns.
68 dispensing encounters were observed. In 83% of the 35 observations of first dispensing, an inhalation instruction was provided. This percentage was lower (62%) at refill dispensings. During all encounters, pharmacy staff seldom explored patients’ perceptions or responded to patients’ expectations, wishes and concerns. 104 pharmacists completed the feasibility questionnaire. The highest score was found on the recommendation regarding providing inhalation instruction. They reported that checking patients’ expectations, wishes and concerns regarding the treatment was desirable for 61-70% of the patients.
Conclusions - More efforts on guideline implementation are needed, especially on follow up dispensings and on gaining relevant information from patients and other healthcare professionals. Pharmacists still have opportunities to grow in applying a patient-tailored approach and explore patients’ individual needs, rather than providing practical information.