Evaluation of a pharmacist-managed asthma clinic in an Indian Health Service clinic

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Abstract
Objectives: To observe whether American Indian and Alaskan Native (AI/AN) patients at the Yakama Indian Health Service seen at the pharmacist-managed asthma clinic improved asthma outcomes.
Design: Retrospective chart review, single group, preintervention and postintervention.
Setting: Pharmacist-managed asthma clinic at an Indian Health Service ambulatory care clinic.
Patients: Sixty-one AI/AN patients who were seen at least once in the asthma clinic from 2010 to 2014.
Intervention: Pharmacist-provided asthma education and medication management.
Main outcome measures: Asthma-related hospitalizations and emergency department or urgent care (ED) visits.
Results: The total number of asthma-related hospitalizations and ED visits between the 12-month periods preceding and following the initial asthma clinic visit were 11 versus 2 hospitalizations (P ¼ 0.02) and 43 versus 25 ED visits (P ¼ 0.02), respectively. Over the same period, asthma-related oral corticosteroid use showed a nonsignificant decrease in the number of prescriptions filled (n ¼ 59, P ¼ 0.08). In contrast, inhaled corticosteroid prescription fills significantly increased (n ¼ 42, P ¼ 0.01).
Conclusion: A reduction of asthma-related hospitalizations and ED visits were observed during the course of the intervention. Increased access to formal asthma education and appropriate asthma care benefit the Yakama AI/AN people. A controlled trial is needed to confirm that the intervention causes the intended effect.
Published by Elsevier Inc. on behalf of American Pharmacists Association