Pharmacists underutilised in asthma

boy using inhaler and spacer

Current asthma management practices need to be rethought, say Australian asthma experts in a new paper

And pharmacists should play an increased role in managing the condition, they say.

The National Asthma Council Australia has released a new discussion paper, Current practice and new approaches in asthma: perspectives of asthma practitioners and patients, which is a collective response from top asthma health professionals, researchers and patients on how the objectives of the 2018 National Asthma Strategy can be achieved.

The experts say that the next frontier for asthma care will be the use of more sophisticated technology and the emerging precision medicine approach to asthma management.

For now, there are potential improvements in current strategies, including exploring changes to medication scheduling to improve access and affordability, and rethinking the key self-management tool of asthma action plans.

Siobhan Brophy, CEO of the National Asthma Council Australia, told the AJP that the Council wants the discussion paper to kick-start different ways of thinking about how asthma is managed.

“The experts all agreed that pharmacists were underutilised and, with appropriate training and support, should play an increased role in asthma care.  

“Remuneration was identified as a critical issue for all health professional groups.”

Ms Brophy said that while there was substantial progress in reducing hospital attendances and mortality from asthma in the 1990s and early 2000s, little improvement has been observed in the last decade.

The paper closely aligns with the 2018 Strategy and highlights the following needs:

  • More effective self-management practices that consider the patient’s personal disease experience and their social and environmental context.
  • Further practical training and support for health professionals including communication skills and asthma literacy, the psychological aspects of asthma, and innovative approaches to patient-centred behaviour change.
  • Closing care gaps in asthma diagnosis, medication use and adherence, and current inequities in asthma outcomes, particularly for Aboriginal and Torres Strait Islander people.
  • Raising the profile of asthma in the community through education programs and awareness campaigns.
  • Translating the large amount of asthma research into practical knowledge.

Ms Brophy said that it is reassuring to see a strong sense of optimism amongst contributors that Australia is in a strong position to realise further improvements in asthma outcomes.

“Through stakeholder discussions, we were able to draw clear actions and identify new approaches in some areas to strengthen asthma care in Australia, whilst at the same time acknowledging that certain issues require further consideration and consultation.”

She said there were a lot of different ideas put forward about ways to improve asthma outcomes, including through pharmacy.

“Some are quite novel and would require thorough consultation and trialling, such as down-scheduling preventers.

“Others ideas could be adopted more easily, like ensuring pharmacists are aware of and can access training on implementing the asthma treatment guidelines.”

The paper is the first step in a series of consultation in a range of areas. The National Asthma Council

Australia is planning a symposium on asthma action plans to be held in the near future.

Ms Brophy encouraged pharmacists who are keen to update their asthma knowledge and skills to visit

“We have how-to videos on using all the latest inhalers, evidence-based resources on asthma for pharmacists and information about our training courses, plus treatment guidelines.”

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  1. Bruce ANNABEL

    Here I go again. Asthma advice and management is an obvious opportunity for community pharmacy that is continually ignored or is simply passing the profession by. Pharmacies in my experience over decades are mostly stockists of relevant prescription and OTC medicines offering little more than supply. Will pharmacy one day do more than place their assistants out the front asking ‘would you like our preferred brand or would you like the cheaper alternative’? Put another way it’s one thing for pharmacists to possess the knowledge but another for them to be out the front, engage with the patient and offer an asthmatic a professional service that adds real value to the management of their condition.

    • Jarrod McMaugh

      …and ensure that you refer to these clients as a “person with asthma” rather than describing them as their illness.

      As an aside, a lot more is needed than just offering improved consumer interaction – people need to value this interaction, and a lot of the time people don’t understand why I spend 15 minutes talking to them about their asthma, their technique, the roles of different medicines, asthma plans, etc – these things are needed, but a lot more needs to be done to improve health literacy at a cultural level, so that people actually understand why these conversations are important.

      As it is, not a small portion of my time spent with people (regardless of their condition) is spent overcoming their incredulity at the fact that I want to talk to them at all because “they already know” – it’s not an interaction that should be forced on people (because you’ll never see them again), but a big part of the education I provide is an undercurrent of what pharmacists do, not just about their condition or their medication.

      • Michael Dedajic

        The issue is, people are not prepared to talk about asthma for even 5 min let alone pay for this professional time that you spend with them.

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