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Pharmacists as the delivery channel for adherence support in asthma

Mes, Marissa Ayano; (2019) Pharmacists as the delivery channel for adherence support in asthma. Doctoral thesis (Ph.D), UCL (University College London). Green open access

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Abstract

Non-adherence to inhaled corticosteroids remains a key challenge in asthma care in the United Kingdom (UK) – it increases healthcare costs, morbidity, and mortality. The growing pressure on UK primary care increased interest in pharmacists as a potential delivery channel for adherence support. However, research on UK pharmacist-led adherence support for asthma is limited. // This thesis addresses the gap in the literature by examining the effectiveness of previous pharmacist-led interventions in improving adherence in adults with asthma (systematic review/meta-analysis, 11 studies), exploring the perspectives of UK pharmacists (online questionnaire, n = 127) and adults with asthma (qualitative study, n = 17) on pharmacist-led adherence support for asthma, and assessing the feasibility and acceptability of a new pharmacist-led adherence support intervention delivered to adults with asthma in general practice (before-and-after study, n = 31). // Previous pharmacist-led interventions significantly improved adherence in adults with asthma (d = 0.49, 95% CI 0.35 – 0.64, p < 0.0001), with effective interventions addressing the ability and motivation to adhere to medication. UK pharmacists reported feeling most confident in and focusing mostly on patient education as adherence support (i.e. ability-related processes). Adults with asthma used their trust in other healthcare professionals (e.g. general practitioners) to gauge their trust in pharmacists. While they were open to pharmacist-led support due to gaps in existing asthma care, they were also concerned about pharmacist competency and role overlap with other healthcare professionals. The new pharmacist-led adherence intervention delivered in general practice demonstrated high acceptability among pharmacists and adults with asthma, but further work is needed to improve the feasibility of the study design. // This research suggests that pharmacist-led adherence support is worth exploring further. With additional adherence-focused support/training for pharmacists and public awareness of pharmacist-led care, UK pharmacists may be able to make a valuable contribution to asthma care.

Type: Thesis (Doctoral)
Qualification: Ph.D
Title: Pharmacists as the delivery channel for adherence support in asthma
Event: UCL
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Copyright © The Author 2019. Original content in this thesis is licensed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) Licence (https://creativecommons.org/licenses/by/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request.
Keywords: medication adherence, pharmaceutical care, pharmacists, medicines management, general practice pharmacist, asthma
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy
URI: https://discovery.ucl.ac.uk/id/eprint/10084713
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