BREATHE A Randomized Trial of a Community Based Asthma Education and Care Program

Primary Objective:
To determine the effect of an education and referral intervention program initiated by community pharmacists, working with high-risk asthma patients, family physicians and respiratory therapists, on asthma control, as measured by the Asthma Control Questionnaire (Juniper EF)

Secondary Objective:
To determine the effect of an education and referral intervention program by community on ER visits / hospitalizations, inhaled corticosteroid use, courses of oral steroids and FEV1

Principal Investigator:
Tsuyuki, RT

Co-Investigators:
Charrois T, Nilsson C, Sin D, Newman S, Senthilselva A.

Time Line:
September 2002 – February 2004

Status:
Complete

Abstracts:
Improving Asthma Symptom Control: Design of the BREATHE Study. Presented: Canadian Association of Population Therapeutics Annual Conference, Quebec City, QC, March 30 – April 1, 2003. Published: Can J Clin Pharmacol 2003; 10(1):42.

Improving Asthma Symptom Control: Design of the Better Respiratory Education and Asthma Treatment in Hinton (BREATHE) Study

The role of multi-disciplinary teams in improving asthma care has been identified as an integral part of asthma management. Community pharmacists have access to refill data on reliever medications, therefore may be well-positioned to identify patients with poor control.

Purpose:
To determine the effect of an education, assessment and referral intervention program initiated by community pharmacists, working with high-risk asthma patients, family physicians and respiratory therapists, on asthma control.

Design:
Randomized, controlled trial involving community pharmacies in Hinton and Edson, Alberta. One-hundred high-risk patients (defined as having an ER visit or hospitalization for asthma within the last 12 months or using >3 canisters of short-acting beta-agonist in the previous 6 months) are randomized to intervention or usual care. Patients in intervention will receive intense education (by both pharmacists and respiratory therapists), medication assessment and referral (to both physicians and respiratory therapists).

Follow-up will occur at 2 weeks, 1, 2, 4 and 6 months. During follow-up, pharmacists will continue to educate, assess and refer as needed. Patients in usual care will receive written information, respiratory therapist referral and minimal follow-up.

The primary endpoint will be asthma control (as measured by the Asthma Control Questionnaire). Secondary endpoints include ER visits/hospitalizations, inhaled corticosteroid use, courses of oral steroids and FEV1.

Conclusions:
BREATHE offers a unique design and management program, involving the whole community, for the multidisciplinary management of asthma.

Publications:

Posters:
Improving Asthma Care in a Rural Setting: The Design of the BREATHE Study.