2.4. Research Outcomes
death, inhaler skills, asthma
DISEASE PROGRESSION, DISEASE, DRUG SIDE EFFECTS, PATHOPHYSIOLOGY, COVID-19 INFECTION, ASTHMA, DISEASES
The primary outcome was to assess the pharmacist intervention effectiveness on medication adherence. Patients in the control group received routine care at the Hospital, including counseling and education from doctors, nurses, and pharmacists dispensing drugs. Patients in the intervention group received routine care, counseling, and education from the research team. The education and counseling content for patients of the research team consisted of 4 main parts: (1) Knowledge of diseases and drugs: providing information on the pathophysiology of asthma (name of the disease, cause, disease status, risk factors, symptom severity), exacerbation prevention, differentiating between controller and reliever (reliever), recognition and prevention of drug side effects, correcting inhalation technique errors, and correct storage of inhaler devices; (2) Advise based on the patient’s non-adherence reasons (according to the GMAS), emphasizing the role of adherence to inhaled corticosteroids (ICS) in reducing the risk of hospitalizations and death from asthma, especially for patients with mild asthma (steps 1 and 2), reminders to reduce forgotten medication intake, supplement knowledge, improve inhaler skills, increase adherence motivation. By joining the asthma club, patients could discuss the diseases, the benefits of drug cessation in symptom relief, disease progression, limiting exposure to individual risk factors, vaccination, diet, exercise, asthma prevention during exercise, and measures to prevent COVID-19 infection with doctors or pharmacists (directly or mobile); (3) Pharmacists also advise the patient’s doctors, discuss with the doctor about any encountered side effects, and choose the inhaler and spacer suitable for the patient; (4) Issuing documents for patients, the set of documents was built based on guidelines of The Global initiative against asthma 2020 (GINA) [Secondary outcomes were (1) the medication adherence rate; (2) determining the associated risk factors. Adherence was determined based on Atta Abbas Naqvi’s general medication adherence scale (GMAS), which is a Likert scale consisting of 11 questions across 4 levels from 0 to 3 points. Medication adherence was divided into 5 levels, including high adherence (30–33 points), good adherence (27–29 points), partial adherence (17–26 points), low adherence (11–16 points), and poor adherence (0–10 points). Adherence rates were divided into 2 groups: non-adherence (GMAS scores < 30 points) and adherence (GMAS scores from 30 to 33 points) [