Authors (including presenting author) :
Fung KH(1), Lo CH(1), Chong CY(1), Luk IW(1), Lui WW(1), Sin CMH(1), Tsang FH(1), Wong YF(1), Chiu WK(2), Cheng JW(2), Poon E(2), Lee L(2), Tsang M(2), Ng SK(2), Li YK(2), Ma PK(2), Wong PS(2)
Affiliation :
(1) Pharmacy Department, (2) Department of Paediatrics & Adolescent Medicine, United Christian Hospital
Introduction :
Asthma is one of the most prevalent chronic diseases in the paediatric population. Improper inhaler technique and lack of insightful knowledge on asthma management would jeopardise asthma control, increase the incidence of asthma exacerbation and hospitalisation. A pharmacist-managed paediatric asthma clinic was established in United Christian Hospital to provide education to patients and caregivers to improve asthma-related knowledge, attitude and practice, optimise inhaler technique, and correct misconceptions regarding long-term use of inhaled corticosteroids (ICS).
Objectives :
Primary outcome: To assess the impact of a pharmacist-managed paediatric asthma clinic on children’s asthma control. Secondary outcomes: To assess caregivers’ asthma knowledge and competence of inhaler technique.
Methodology :
It was a prospective cohort study investigating the impact of a pharmacist-managed paediatric asthma clinic from 1 June to 30 November 2020. Patients with poor asthma knowledge and/or inhaler technique were referred to clinic by paediatricians. At the first visit, patients and caregivers were assessed for asthma-related knowledge, attitude and practice, and asthma control using two validated assessment tools, namely the modified Knowledge, Attitude and Practice (KAP) questionnaire, Asthma Control Test (ACT) or Childhood Asthma Control Test (C-ACT). Other assessments included inhaler- and device-cleaning techniques, and caregivers’ knowledge on ICS. Standardised education was delivered by pharmacist. Corrections to suboptimal inhaler technique were conveyed using pre-defined patient information leaflets. The same assessments were repeated at subsequent visit. The pre- and post-intervention results were compared using the Mann-Whitney U test.
Result & Outcome :
A total of 19 patients aged 9.7 ± 3.8 years were recruited. The modified KAP score was significantly improved (6.5 vs 9.9, p< 0.001) after pharmacist education. The pre- and post-intervention inhaler- and device-cleaning technique scores were 2.5 vs 3.6, (p=0.085) and 1.1 vs 2.9 (p=0.002) respectively. Asthma control as indicated by the numerically increased ACT and C-ACT score and ICS knowledge score showed a trend of improvement, albeit statistically insignificant (20.6 vs 22.2, p=0.757; 19.6 vs 21.8, p=0.124; 5.2 vs 5.8, p=0.180). This study demonstrated that pharmacists play an important role to improve the knowledge, attitude and practice in asthmatic children and their caregivers.
