Allergic Rhinitis Self-management Program in Community Pharmacy
|Institution:||University of Sydney|
|Chief Investigator:||Dr Lorraine Smith|
Background: Allergic Rhinitis (AR) affects approximately 1 in 5 Australians and most self-medicate. The aims of this study were to test a brief, tailored intervention delivered by Pharmacists and Pharmacy Assistants to enhance patient self-management of AR, and to evaluate the feasibility of implementing the model.
Methods: This was a ten day study involving 20 pharmacies and 228 patients. At visit 1, intervention group patients received counselling on causes and treatment of AR and were assisted to identify symptoms and triggers, and devise strategies to control these. The control group received standard pharmacy care. Both groups made a daily record of their symptom severity and adherence to medication, and completed questionnaires at visit 1 and visit 2. Data were collected during Spring, 2008 and Autumn, 2009.
Results: Due to seasonal differences in some outcome measures of the control group, separate analyses were conducted for the Spring and Autumn data sets. Significant improvements were found over time for the Spring intervention group on AR-related self-efficacy, symptom severity, adherence to medications, and quality of life. Autumn intervention group scores also significantly improved over time for all measures except for adherence to medications. Change scores analysis revealed no significant differences between intervention and control group scores for either season. Two factors contributing most to symptom severity scores were quality of life and the strategies devised to control AR triggers. Taking medication(s) every day did not contribute significantly to symptom severity scores. Pharmacy staff could provide most support to patients in the areas of medication adherence and dose information when control of symptoms was important, and practical action strategies when control of triggers was important. The service was evaluated as being highly valuable to both patients and pharmacy staff. Training of pharmacy staff was seen to be an important factor in increasing skills and confidence.
Conclusions: This study showed the potential role that pharmacy staff can provide in facilitating patient self-management and improving outcomes for AR sufferers. Establishing a therapeutic alliance with patients requires knowledge and skill on the part of the pharmacy team along with a dedicated time commitment and provides an opportunity for those community pharmacies who are prepared to move beyond the boundaries of current models of care.