None listed
Conditions
Brief summary
In patients with asthma, reliever over-reliance and overuse is common. A recently developed, brief, online intervention has been shown to identify and change patient beliefs driving inappropriate reliever use in an online sample. There is a need to trial this intervention in in the community setting and test the effect on beliefs about relievers and actual reliever use. Objective To investigate the effect, feasibility and acceptability of a brief community pharmacy-delivered behaviour change intervention, on individual’s beliefs about short-acting beta2 agonist (SABA) and on SABA use in patients with asthma. Methods This is a non-randomized, before- and after- study of individuals aged 18 years and older, prescribed a SABA for their asthma symptoms, attending one of two enrolled community pharmacies in Auckland, New Zealand. We aim to recruit 120 participants. At enrolment, all participants will complete the 4-item SABA Reliance Questionnaire (SRQ), Asthma Control Test and Medication Adherence Report Scale via an online survey system. Control participants will receive usual care from their community pharmacy. Intervention participants will receive a brief, pragmatic intervention aimed to shift any misplaced beliefs about SABA. This includes delivery of targeted, standardized information, based on responses to the SRQ, a personalized discussion between the pharmacist and participant based on the specific responses to the questionnaires and referral to the general practitioner for those at risk of SABA overuse. Feasibility will be evaluated through participant recruitment and retention rates, intervention fidelity, the appropriateness and procedures of outcome measures pre- and post-intervention, and acceptability by obtaining feedback from participants (both patients and pharmacists) on the intervention
Interventions
This is a non-randomised, before-after, study. The first 30 participants at each pharmacy will be allocated to control, the following 30 participants will receive the intervention.
The intervention will include three components:
1. Delivery of targeted, standardised information, based on responses to the SABA reliance questionnaire (SRQ). This will be administered online via a weblink while the participant is at the pharmacy;
2. Personalised discussion between the pharmacist and participant b
This is a non-randomised, before-after, study. The first 30 participants at each pharmacy will be allocated to control, the following 30 participants will receive the intervention. The intervention will include three components: 1. Delivery of targeted, standardised information, based on responses to the SABA reliance questionnaire (SRQ). This will be administered online via a weblink while the participant is at the pharmacy; 2. Personalised discussion between the pharmacist and participant based on the specific responses to the study questionnaires (conducted by the pharmacist after the online component) and 3. Referral to general practitioner (GP) for those at risk of SABA overuse. The standardised information helps patients understand what their SRQ responses might mean for them. The aim of this information is to raise awareness of the problem of SABA overuse and provides advice about the correct use of SABA inhalers. This information will be provided directly to the patient on their personal device. To complement the standardised messages, the pharmacist will have an in-person, brief discussion (expected to be less than 5 minutes) with the participant regarding their responses to the SRQ. The SRQ will provide the participant with a score between 4 and 20. A score of 12 or more indicates the participant holds beliefs that may lead them to over rely on SABA. For these participants, the pharmacist will give behaviour-change messages verbally along with written information to shift beliefs, based on the specific responses to each statement in the SRQ. For participants with scores of less than 12 on the SRQ, the pharmacists will provide messages that reinforce and strengthen the current beliefs about SABA. The standardised information and information provided by the pharmacist has been designed specifically for the study, based on previous work conducted by the research group. Finally, all participants who indicate they are not using a preventer or report they are using SABA more than twice a week will be categorised as at risk of SABA overuse and will be referred to their GP. Pharmacists will also discuss this with the participant and urge the patient to have a discussion with their GP about their answers to the questionnaire and potential for preventer treatment. The project coordinator will shadow the pharmacist in 10% of the sample (with participant permission) to check for intervention fidelity.
Sponsors
Dr Amy Chan
Study design
Allocation
Non-randomised trial
Intervention model
Other
Primary purpose
Educational / counselling / training
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Individuals presenting to one of the two enrolled community pharmacies will be eligible to participate in the study if they meet the following eligibility criteria: - Aged 18 years or over - Prescribed a short acting beta agonist (SABA) as a ‘reliever’ for their asthma symptoms.
Exclusion criteria
Individuals will not be eligible to participate if they are using a SABA for a reason other than asthma (e.g. viral respiratory infection, exercise-induced asthma), do not manage their own medicines or anticipate changes to their medicines within the next 90 days (i.e. are following a step up/down medication management approach).
Outcome results
None listed