Assessing the Pharmacist’s Role in Counseling Asthmatic Adults Using the Correct Inhaler Technique and Its Effect on Asthma Control, Adherence, and Quality of Life

Rawa’a Ibrahim AL-awaisheh,1 Ahmad R Alsayed,1 Iman A Basheti1,2 1Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, 11937, Jordan; 2School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, AustraliaCorrespondence: Iman A Basheti, Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, P. O. Box 166, Amman, 11931, Jordan, +962 797708060, Email Iman.basheti@sydney.edu.auPurpose: This study was designed to assess inhaler technique skills, asthma control level, adherence, and quality of life scores amongst asthmatic patients living in Amman, Jordan, investigating the role of pharmacist’s educational intervention.Patients and Methods: This single-blinded randomized parallel-group active-controlled study was conducted at the Jordan University Hospital (JUH) clinic in 2019. Patients were assessed at baseline and follow-up (after three months) on their inhaler technique (based on validated published checklists), asthma control based on the asthma control test (ACT) questionnaire, adherence to treatment, and quality of life (QoL). Patients in the active group were counseled on correct inhaler technique and administration skills, orally and using inhaler adhesive labels delivered by the clinical pharmacist.Results: Asthma patients (n = 157; active, n = 79, and control, n = 78) were recruited into the study and grouped based on the controller inhaler they were using (Turbohaler (TH) and Accuhaler (ACC). There was no statistically significant difference between both groups at baseline for inhaler technique, adherence, ACT, and QoL. At follow-up, 93.7% of the active group patients used their inhalers correctly, while only 16.7% of the control group used them correctly (P-value < 0.001). Also, the ACT mean score was significantly higher for the active group (21.21± 5.27) versus the control group (15.92± 7.31; P-value < 0.001). The QoL mean score was significantly improved for the active group compared with the control group (active = 63.85± 24.78, Control = 38.746± 3.23, P-value < 0.001). Improvement in adherence for the active group was noticed compared with the control group but did not reach a significant level (P-value=0.691).Conclusion: Through a practical educational intervention, pharmacists were found to significantly improve patients’ asthma inhaler technique, ACT scores, and QoL scores for patients with asthma.Keywords: inhaler techniques, ACT, adherence, QoL