Pharmacoeconomic assessment of clinical pharmacist interventions for patients with moderate to severe asthma in outpatient clinics : experience in taiwan.

objectiveTo assess the economic and humanistic outcomes of clinical pharmacist interventions for patients with asthma and to assess the effect on patients' quality of life. STUDY

designA prospective cohort study was conducted at a medical centre in southern Taiwan. PATIENTS AND

methodsSeventy patients with moderate to severe asthma were enrolled in the study from July 2003 to December 2003. Patients who were 17-53 years of age and were attending the outpatient clinic were referred to the pharmacist intervention programme. Patients were educated about their disease, pharmacotherapy, self-management and inhalation and peak flow meter techniques to use during the intervention period. A modified Asthma Quality-of-Life Questionnaire (AQLQ) was given to the patients at the first intervention (baseline) and 3 months later (intervention period) to assess quality of life. An asthma general knowledge questionnaire and an asthma diary chart were also used to assess patients' knowledge about asthma and the improvement in their symptoms. The cost effectiveness was evaluated based on the reduction in total costs/mean cost at each visit.

resultsOf the 70 asthmatic patients enrolled in the study; 55 completed the questionnaires at baseline and after the intervention period. Only 25 of 55 (45.5%) patients completed the asthma diary chart. After the pharmacist intervention period, the patients' quality of life, common knowledge about asthma, and peak expiratory flow rate (PEFR) were significantly improved as compared with baseline (p < 0.001). The frequency of use of beta(2)-agonists and corticosteroids were also reduced, although the reduction was not statistically significant. Total cost per patient at baseline was statistically different from that after the 3-month intervention period (New Taiwanese dollars [$NT] 2880 vs $NT1683, respectively; costings are costs during the study period).

conclusionFor patients with moderate to severe asthma, pharmacist intervention can be a cost-effective addition to the management of patients at an outpatient clinic by improving PEFR and patient quality of life, and saving medical resources.