Improvements in Asthma Control After Pharmacist Involvement in an Outpatient Pediatric Asthma Clinic.

Abstract

Background: Asthma is one of the most common pediatric disease states. However, current literature about outpatient pharmacy appointment effectiveness on pediatric asthma control is not widely available. Objective: To determine whether outpatient pharmacist visits in pediatric patients with asthma result in a measurable difference in asthma control, utilizing the validated asthma control test (ACT) and childhood asthma control test (C-ACT) scoring tools. Methods: This study enrolled 16 children ages 6-17 years old at an outpatient primary care clinic (November 2023-April 2024). The patients visited the outpatient pharmacist 2 to 3 times over a 12-week period. The primary outcome was the change in the patient's ACT or C-ACT from the baseline to the final study visit. Additional outcomes of interest included improvement in inhaler technique using a Vitalograph AIM® device, medication adherence rates, and change in emergent interventions from 6 months before enrollment compared to 3 months after the final visit. Results: The median improvement in asthma control test was 3 at the final study visit (4 or 12 weeks after counseling), which was statistically significant (P = 0.0348). This was an improvement from 50% of patients controlled at baseline to 100% at the final visit (P = 0.0053). Emergent interventions including oral steroid courses, emergency department visits, and hospitalization for asthma were less common after pharmacist intervention than before enrollment (P = 0.0464). Improvements in technique were seen at the initial visit using Vitalograph AIM® to visualize counseling points. Conclusion: Our study supports that outpatient pharmacist visits can have a measurable impact on pediatric asthma control.