Do the public know?

boy using inhaler and spacer

Steven Kastrinakis discovers a ‘stark mismatch’ between what patients with asthma know about their condition, and what health professionals want them to know

It is estimated that one in nine Australians have asthma. As pharmacists, most of us would have come across many patients with asthma on a daily basis.

Many of them seem to have their asthma well under control, as they would have had to manage their symptoms for years or even decades. However, recently we discovered that this may not be the case at all.

This month, Advantage Group was invited by Asthma Australia to participate at the inaugural public event, The Allergy Show, as the only exhibiting pharmacy group. Our Professional Services Team was present at the show to represent community pharmacies, and conduct services that a typical local pharmacy could offer in the asthma and allergy space.

As I talked to the team about what they learnt afterwards, there was an overwhelming sense that there was a stark mismatch in what the community understands about asthma management and what we know as healthcare professionals.

Over two days running asthma checks and talking to a cross section of the community we found the following issues:

  • most people with asthma had no knowledge of Asthma First Aid at all;
  • virtually no one had an Asthma Action Plan; and
  • many hadn’t had a review of their asthma medication(s) in two to three years.

Given the perceived community awareness on asthma, this came as a surprise to me. And my team continued:

  • many people had no understanding of why they were taking a preventer medication for asthma;
  • some reported that they were using their preventers “every now and then”; and
  • not many people used a spacer, and they didn’t understand the importance and benefits of using it in administrating their medication.

More alarmingly, most people hadn’t visited their doctor for a few years despite showing symptoms of asthma (ie frequent shortness of breath, using Over-The-Counter relievers more than three times a week, etc.). Many considered it as something that they simply need to put up with, and commented that they thought “it was just me”.

In 2014/15, 421 people in Australia died of asthma. It’s a common and chronic disease, but one that should not be taken lightly. As health professionals, I think most of us know that, but I’m starting to ask myself, do the public know?

According to Albert L. Sheffer, M.D. from the Asthma Educators Group in the US, it is estimated that the risk of death from asthma is 1 in 10,000. Among people with severe disease, the risk increases to 1-3 per 100 people.

Any person who has suffered an episode of respiratory failure due to asthma has a risk of 1-2/10 persons of dying from asthma over the next 10 years.

As we move into potentially another Thunderstorm Asthma season, it’s more important than ever to intensify our community education in this area.

I’m genuinely surprised and concerned about this gap in knowledge that the community has around asthma management.

I wonder whether there is more that can be done by the government to increase awareness in this area.

As pharmacists we are the front line in health, and we have a role to play in helping educate the public on asthma management. At Advantage Group, our Professional Services Business Development Managers are out at our community pharmacies every day offering support, advice and encouragement to pharmacists to increase their offering of professional services such as asthma checks.

The reality is, that although every pharmacy in the country can offer asthma checks, some are choosing not to. I don’t know what the reason for this is, whether it’s a resource issue, or a lack of having the right tools.

Asthma checks may involve some, if not all of the following: a peak flow test, inhaler technique check, education on using a spacer, education on Asthma First Aid and perhaps also a MedsCheck if required.

That may seem like a lot to get through with one patient, but the components of the asthma check itself are not particularly lengthy. On the scale of things, this small amount of time in your day could really make a substantial difference in your patients’ management of asthma.

Maybe as pharmacists we’re just a bit stuck in our ways or we’re not fully recognising our true value in society in offering services to the community in this space. Here are some tips which may be of consideration for pharmacists in the community:

  • invest the time in exploring screening or testing services which would benefit your community;
  • implement strategies which would enable you to offer these services on a regular basis;
  • upskill your team to be able to conduct meaningful conversations with patients with chronic diseases, to reduce complacency and determine need for review;
  • adopt a proactive approach in working other healthcare professionals in the community and not hesitate to refer when required; and
  • if appropriate, always include the patient’s family members in the discussions to ensure that there is a general understanding of the disease management.

From our straw poll over the weekend, it is evident that there is a really big need in the community for a more proactive approach in chronic disease screening and management. I believe as pharmacists we can step up, and at Advantage Group we will definitely be encouraging our pharmacies to do so.

I also encourage pharmacists to get out to these types of events more and talk to those who might not enter a pharmacy regularly or are slipping through the cracks of the healthcare system.

Steven Kastrinakis is the CEO of Advantage Pharmacy.

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