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dc.contributor.advisorBlenkinsopp, Alison
dc.contributor.advisorMorgan, Julie D.
dc.contributor.advisorSilcock, Jonathan
dc.contributor.advisorClifton, I.J.
dc.contributor.authorCapstick, Toby G.D.*
dc.date.accessioned2017-11-28T11:38:32Z
dc.date.available2017-11-28T11:38:32Z
dc.date.issued2014
dc.identifier.urihttp://hdl.handle.net/10454/13962
dc.description.abstractDespite national guidelines, the management of difficult asthma remains suboptimal, and there may be opportunities for pharmacists to improve asthma outcomes. This six-month prospective, randomised, open study investigated the effects of pharmaceutical care across primary and secondary care on difficult asthma. Fifty-two patients attending a hospital difficult asthma clinic were randomised (1:1) to receive usual medical care (UC), or pharmacist interventions (PI) comprising asthma review, education, and medicines optimisation from a hospital advanced clinical pharmacist, plus follow-up targeted Medicines Use Review (t-MUR) from community pharmacists. Forty-seven patients completed the study. More interventions were performed in the PI group at baseline (total 79 vs. 34, p<0.001), but only six patients received a t-MUR. At six-months, PI were non-inferior to UC for all outcomes. The primary outcome measure was Juniper’s Asthma Control Questionnaire score and reduced (improved) from a median (IQ) score of 2.86 (2.25, 3.25) and 3.00 (1.96, 3.71) in the PI and UC groups respectively to 2.57 (1.75, 3.67) and 2.29 (1.50, 3.50). At baseline, 58.8%, 46.9% and 17.6% of patients had optimal inhaler technique using Accuhalers, Turbohalers or pMDIs; education improved technique but this was not maintained at six-months. Adherence rates <80% were observed in 57.5% of patients at baseline, and was improved in the PI group at six-months (10/20 PI vs. 3/21 UC had adherence rates of 80-120%, p=0.020). This study demonstrates that the management of difficult asthma by specialist pharmacists is as effective as usual medical care. Future research should investigate whether pharmacist-led follow-up produces further improvements.en_US
dc.description.sponsorshipThe Pharmaceutical Trust for Educational and Charitable Objects (PTECO) (now known as Pharmacy Research UK).en_US
dc.language.isoenen_US
dc.rights<a rel="license" href="http://creativecommons.org/licenses/by-nc-nd/3.0/"><img alt="Creative Commons License" style="border-width:0" src="http://i.creativecommons.org/l/by-nc-nd/3.0/88x31.png" /></a><br />The University of Bradford theses are licenced under a <a rel="license" href="http://creativecommons.org/licenses/by-nc-nd/3.0/">Creative Commons Licence</a>.eng
dc.subjectAsthma; Pharmacist interventions; Pharmacist prescribing; Quality of life; Asthma control; Hospital pharmacists; Community pharmacists; Care transitionsen_US
dc.titleThe Effectiveness of Pharmacist Interventions in Improving Asthma Control and Quality of Life in Patients with Difficult Asthmaen_US
dc.type.qualificationleveldoctoralen_US
dc.publisher.institutionUniversity of Bradfordeng
dc.publisher.departmentSchool of Pharmacy, Faculty of Life Sciencesen_US
dc.typeThesiseng
dc.type.qualificationnameDPharmen_US
dc.date.awarded2014
refterms.dateFOA2018-07-30T01:22:28Z


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