Pharmaceutical care in the treatment of asthma

Abstract

Asthma is a chronic inflammatory disease of the airways, characterized by symptoms such as wheezing, shortness of breath, cough, etc. A high level of disease control can be achieved, in most patients, using appropriate medication. However, a large number of asthma exacerbations is still present, due to inadequate treatment or poor compliance. Studies showed that the majority of patients do not use inhalers properly, which can consequently cause inadequate treatment efficacy. Therefore, the role of the pharmacist is to demonstrate and make sure that patients understand and use inhalers properly. Individualized asthma plans, created with mutal efforts of the pharmacist and the patient, were shown to effect treatment outcomes significantly. In order to improve the level of adherence, patients should be educated about the use and timing of use of medications, appropriate doses, evaluation of treatment response, adverse events and mode of action in case of treatment inefficacy. Investigations have, undoubtedly shown that patients appreciate the support of the pharmacist and that pharmacists improve treatment outcomes, in asthma patients, significantly.

Astma je hronična inflamatorna bolest disajnih puteva koju karakterišu simptomi poput šištanja u grudima, kratkog daha, kašlja i sl. Primenom odgovarajućih lekova može se uspostaviti visok stepen kontrole nad bolešću kod većine pacijenata. Međutim, u praksi se i danas beleži veliki broj egzacerbacija astme, usled neodgovarajuće terapije ili nepridržavanja uputstva o pravilnoj primeni lekova od strane pacijenata. Istraživanja su pokazala da većina pacijenata nepravilno primenjuje lekove putem inhalacije, što može uzrokovati nedovoljan stepen efikasnosti terapije. Stoga je uloga farmaceuta da demonstrira i da se uveri da je pacijent razumeo pravilan način primene preparata za inhalaciju. Pokazano je da individualizovani, pisani astma plan u čijoj izradi učestvuju farmaceut i pacijent, značajno utiče na postizanje ishoda terapije. U cilju poboljšanja stepena adherence, pacijente je potrebno edukovati o načinu i vremenu primene lekova, odgovarajućim dozama, proceni odgovora na terapiju, ispoljavanju neželjenih dejstava i postupcima u slučaju neefikasnosti terapije. Studije su nedvosmisleno pokazale da pacijenti smatraju da im je pomoć farmaceuta potrebna i da farmaceuti značajno mogu poboljšati ishode terapije pacijenata sa astmom.