Community pharmacy services

Pharmacist review of asthma patients is cost-effective, Italian study finds

Italians adopt medicines use review protocol to improve patients’ asthma as well as improve cost-effectiveness of care.

A study conducted in Italy has found that a medicines use review (MUR) for asthma, with a protocol adapted from the UK, had a beneficial effect on patients’ asthma control and was cost effective compared with usual care. 

The study[1] involved 283 pharmacists and 1,263 patients, and according to the researchers, is one of the largest ever of a community-pharmacist intervention for asthma. 

The Italian MUR involved a structured interview carried out in private at the community pharmacy and looked at five areas: asthma symptoms; medicines use; attitude towards medicines; adherence; and identification of pharmaceutical care issues. 

In the trial, pharmacists were randomly assigned to receive immediate or delayed (by three months) training in the intervention. 

After three months, patients who had received the intervention were 76% more likely to have achieved asthma control (Asthma Control Test [ACT] score change from ≤ 19 to ≥ 20) compared with patients in the other group. 

Using a willingness-to-pay threshold of $30,000 (£25,300) per quality-of-life year gained, in line with the UK’s National Institute for Health and Care Excellence, the researchers’ analyses showed that at the conclusion of the study after nine months, the probability that the intervention was more cost effective than usual care reached 100%. 

The researchers also found that the intervention led to a reduced average number of active ingredients among patients’ medications and improved self-reported adherence. 

Reporting in BMC Health Services Research, the team says the study adds to the evidence base supporting the cost-effectiveness of MURs in asthma. Since the trial, the Italian asthma MUR has become a nationally funded MUR service in Italy and the team says it is now being considered for implementation in other respiratory conditions. 

Citation: The Salvadore DOI: 10.1211/PJ.2017.20202744

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