Asthma Friendly Pharmacies

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Asthma Friendly Pharmacies
Theresa Prosser, Pharm.D., BCPS, AE-C,
FCCP Tricia Berry, Pharm.D., BCPS
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Controlling Asthma in St. Louis (CASL)
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Asthma Friendly PharmaciesRationale Optimize
use of Pharmacists as a Resource

• Pharmacists
• Are readily accessible to patients
• May see patients frequently (e.g. refills)
• Have patient-specific drug refill data
• Have been shown to improve asthma outcomes
• Can screen identify drug related problems
• Can provide reinforce asthma education

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Asthma Friendly PharmacyAFP Model Integrate
brief interventions into workflow

• screen all respiratory Rxs for drug problems
• Non-adherence w/ controller medications
• Overuse of relief meds ( 1 canister/mo of SABA)
• Monotherapy with long acting beta agonists
• Need for spacers, peak flow meters, care plans
• Adverse reactions (e.g., thrush, hoarseness)

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Asthma Friendly PharmacyAFP Model Integrate
brief interventions into workflow

• Provide/reinforce brief educational messages when
  dispensing
• Tobacco cessation
• (the 5 As ask, advise, assess, assist,
  arrange)
• Technique MDI, DPI, spacing devices
• Adherence controller vs. relief meds
• Encourage PCP follow-upaction plans, post
  steroid bursts (ED/hosp)

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AFP Model facilitate communication with PMD Fax
part 1 Identify/resolve drug related problems
To Asthma Friendly Pharmacy Re Patient
name Address Address Date 314-xxx-xxx F
ax 314-xxx-xxxx DOB 00/00/00 Date 00/00/00
PLEASE REVIEW AND REPLY TO THE PHARMACY FAX
ABOVE. Please consider prescribing a   ?
Spacing device ? Long-term controller regimen
(e.g., an inhaled corticosteroid, leukotriene
modifier) ? Smoking cessation aid (e.g.,
buproprion) ? _______________________ ________
________ Substitution permitted Dispense as
written
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• AFP Model facilitate communication with PMD Fax
  part 2 Inform of educational messages provided

PLEASE REVIEW REPLY IF PHARMACISTS ACTION IS
NEEDED. INCLUDE IN PATIENTS CHART PER CLINIC
DOCUMENTATION PROCEDURE.   ? The patient is
not currently aware of an asthma action plan
(AAP) prescribed. If you would like the
patient to receive education on an AAP, please
complete the AAP and return to the
pharmacy fax number above. ? Potential overuse of
short-acting beta-agonist noted__________________
__ ? Potential non-adherence to a prescribed
long-term controller regimen ______ ? Patient
education provided on the following
device____________________ Demonstrated
technique was ? Poor/inadequate ? Acceptable
? Excellent ? Potential medication side effect
noted ? The AAP was reviewed as requested ?
Smoking cessation was advised for   ? OTC
nicotine recommended ? Prednisone was prescribed
by ED/urgent care/hospital provider____________
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Asthma Friendly Pharmacies AFP Brief
Intervention Model
Provide reinforce educational messages
Patient
Rx received screened by R.Ph.
Encourage follow-up
Notify/resolve drug related problems
Asthma care provider
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Asthma Friendly Pharmacies Progress to date

• implementing, metro area AFPs 41
• Listing at SLRAC website
• http//www.asthma-stlouis.org/News/pharmacyli
  st.htm
• Integrated program into St. Louis College of
  Pharmacys experiential curriculum

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AFP PromotionsPilot Program 1

• Breathe Your Best for School Success
• Purpose asthma prepared school children
• Location Jennings School district (2005)
• Population elementary grades 1-5
• Partners
• School nurses
• Asthma Friendly pharmacists/staff
• Family Practitioners and Pediatricians
• SLRAC staff BP and CAC committees members
• CASL members

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AFP PromotionsPilot Program 1

• Breathe Your Best for School Success
• Incentives
• Each child packet of school supplies/fun items
• Grand prize drawing 10 Rams tickets!!!
• Primary Outcomes
• Increase the AAP to school nurses
• Increase the relief inhalers w/ school nurse
• Increase permissions to carry relief inhalers

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AFP PromotionsPilot Program 2

• Asthma messages
• Purpose combat asthma myths
• Location St. Louis Metro SW Illinois
• Partners
• Asthma Friendly Pharmacists/staff
• St. Louis Univ. Health Communication Lab
• SLRAC staff BP and CAC committees