Outcomes of Telepharmacy on Asthma Control at Ratchaburi Hospital

Abstract

Objective: This study aimed to assess clinical, humanistic and economic outcomes of telepharmacy in asthma patients.  Material and Methods: A quasi-experimental research design, with one-group pretest-posttest, was conducted to study telepharmacy. This real-time pharmaceutical care using communication technology was conducted in 29 asthma patients, over 12 weeks. Clinical outcomes were evaluated; including, asthma control, drug-related problems, adherence to use of inhaled corticosteroids (ICS), ICS-side effects, emergency room visits and hospitalizations due to acute exacerbation. Patient satisfaction was used to assess humanistic outcomes, and cost-saving was used to assess economic outcomes.  Results: Clinical outcomes showed statistically significant improvement in the number of well-controlled patients; increasing from 34.48% to 89.66% (p-value<0.01). ICS adherence improved from the mean percentage of number of times patients forgot to use ICS; which decreased from 5.86±18.67 to 0.21±0.74 (p-value<0.01). The mean number of drug-related problems decreased from 1.45±0.91 to 0.21±0.41 (p-value<0.01), and the mean number of ICS-side effects decreased from 0.66±0.72 to 0.14±0.44 (p-value<0.01). A total of 51.72 % of patients also required additional advice on inhaler techniques by a pharmacist. The mean number of emergency room visits and hospitalizations, due to acute exacerbation, decreased to zero by the end of the study. Humanistic outcomes revealed that patient satisfaction was at the ‘very satisfactory’ level (4.82±0.27 out of 5.00), and economic outcomes found that patients could save 49.99±34.90% compared to usual care.  Conclusion: This study shows that patients receiving telepharmacy have better outcomes in ICS adherence and asthma control, can prevent future risks (acute exacerbation, ICS-side effects), save costs and were very satisfied with telepharmacy overall.