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Impact of a Network System for Providing Proper Inhalation Technique by Community Pharmacists

Objective. The availability of many types of inhalers in the treatment of asthma has resulted in a wide range of prescription choices for clinicians. With so many devices available, however, there is some confusion regarding their proper use among both medical staff and patients. Since 2007, Kitano Hospital and Kita-ku Pharmaceutical Association, Osaka, Japan, have provided a network system for delivering instruction on correct inhalation technique through community pharmacists. We examined the clinical effects of this network system. Methods. Our measurements included the manner in which community pharmacists instruct patients with asthma, the frequency of asthma exacerbations, patients’ adherence to inhalation therapy using a 5-point Likert scale questionnaire, and patients’ health status both prior to this system and at 4 years after. Results. Usable information was obtained from 53 community pharmacists and 146 patients with asthma at baseline and from 60 community pharmacists and 148 patients at 4 years. When compared with baseline values, significant improvement was found in pharmacists’ instruction and significant decreases were observed in the frequency of asthma exacerbations (1.4 ± 1.6 vs. 1.0 ± 1.4 times/yr, p = .042) and emergency room visits (0.5 ± 1.0 vs. 0.2 ± 0.5 times/yr, p = .004). Adherence to the inhalation regimen significantly increased (4.0 ± 0.7 vs. 4.2 ± 0.8, p = .041), but health status was unchanged. Conclusions. Our network system may improve asthma control and adherence to inhalation regimens.