Oct-Dec, 2011 - Indian Journal of Pharmacy Practice

Satyanarayana V - Evaluation of the Impact of a Therapeutic Management and Effect of Pharmacist Intervention on Children with AsthmaCurrently, asthma affects approximately 15 millionindividuals in the United States. On an annual basis, 5,000deaths, 500,000 hospitalizations, and 2 million emergency9, 10, 11department visits are attributed to asthma . Asthmacontinues to be under – diagnosed and under – treated, itsappropriate management requires correct diagnosis,assessment of severity, proper management includingappropriate follow-up, and specialty referral whereappropriate. The guidelines for treatment of asthmarecommend greater involvement of the patients in the12, 13management of their diseases .According to the National Heart, Lung and Blood Institutes(NHLBI) current guidelines, asthma treatment entails amultilevel intervention including appropriatepharmacological therapy, patient education, control ofasthma triggers, and monitoring of asthma severity with13objective measures of lung function . Collaborativeapproach between patient and pharmacist may improvepatient medication adherence behavior and therapeuticoutcomes. Role of pharmacist as asthma educator isappreciated worldwide in reducing the risk factors and14improving patient knowledge . The role of pharmacist inpatient education and evaluation of therapy is taking no morerelevance every day. Their knowledge of drug therapy makesthem the appropriate professional to instruct and educate thepatient on the correct use of medications. For many years,pharmacists have been taking an active role not only in theeducation of the patient, but also in the monitoring andevaluation of therapy, and detecting potential problems (adverse – reactions and interactions, therapy failures, nonadherenceto treatment, duplication of therapy, etc.) that15, 16, 17directly affect the quality of life of the patients .Pharmaceutical care practice is intended to meet a need in thehealth care system that has arisen due to the increase incomplexity of drug therapy and the significant level of drug –18related morbidity and mortality associated with drug use .Therefore, the introduction of pharmaceutical care is requiredin developing countries to aid in the resolution of medication– related problems. The existence of variations inpharmaceutical care models and practices among countries19were also reported .Medicine use is rational (appropriate, proper, correct) whenpatients receive the appropriate medicines, in doses that meettheir own individual requirements, for an adequate period of20time, and at the lowest cost both to them and the community .Irrational (inappropriate, improper, incorrect) use ofmedicines is when one or more of these conditions are notmet. Worldwide, it is estimated that over half of all medicines21, 22are prescribed, dispensed or sold inappropriately .Moreover, it has been estimated that half of all patients fail to23take their medication as prescribed or dispensed . Irrationaluse may take many different forms, for example,polypharmacy, over-use of antibiotics and injections, failureto prescribe in accordance with clinical guidelines andinappropriate self-medication. However, despite the globalproblem of inappropriate use, few countries are monitoringmedicines use or taking sufficient action to correct the24situation . Thus the purpose of the study is to conduct adetailed prospective study about to evaluate the impact of atherapeutic management and effect of pharmacistintervention on children with asthma. The present study wasconducted with the following objectives:-1. To study the current line of therapeutic managementfollowed in the department of pediatrics in the Gandhigeneral hospital, Hyderabad, Pediatric unit has five unitsdistributed into two wards, each unit consisting of 30beds total of 150 beds, providing specialized health careservice to all strata of people in A.P.2. To compare this with standard treatment guidelines.3. To find the impact of counseling in patients withbronchial asthma and their parents.4. To educate the patient and parents regarding the healthcondition and importance of life style modification.5. To promote rational use of drugs.MATERIAL AND METHODSStudy Design: This study was a prospective, observational,interventional study consisting of 100 patients with bronchialasthma. Following prescription analysis patients areevaluated about therapeutic management of asthma inchildren's.Study Site: This study was conducted in the Gandhi Hospital,paediatric unit has five units distributed in two wards, eachunit consisting of 30 beds total of 150 beds, providingspecialized health care service to all strata of people in anAndhra Pradesh.Duration: This study was conducted for a period of 6 monthsststfrom 1 November 2010 to 31 April 2011Study Criteria:Ø Inclusion Criteria:· Patients with history of bronchial asthma in the age groupof 1 to 12 yrs.· Patients and their parents willing to give their informedconsent to participate in the studyIndian Journal of Pharmacy Practice Volume 4 Issue 4 Oct - Dec, 2011 40