Background and objectives: Drug Related Problems (DRPs) lead to an increased rate of hospitalization due to asthma exacerbations. In the past, pharmacist provided pharmaceutical care using paper documentation which might lost and was not connected to an electronic medical record. Then, the SMART AsthCOPD application program was developed to solve those problems. The objectives of this study were to assess the impact of computer application on DRPs, assess the impact on the accuracy of patient technique for MDI use and the rate of hospitalization from asthma exacerbation before and after using the SMART AsthCOPD application program to care patients with asthma.
Methods: Patients aged 18 years or older with an asthma diagnosis, ICD-10 coded J45-J46 who were seen for three visits in an internal medicine adult asthma clinic and a pharmacy specialist clinic from October 1, 2016 to September 30, 2018 were included. Data of clinical outcomes were retrospectively collected from an electronic medical record from September 1, 2016 to October 31, 2018. McNemars test was used to compare the correctness of technique to use MDI, and hospitalization from asthma exacerbations.
Results: Of 497 patients, who were provided pharmaceutical care for three visits. The average age was 58.08 ± 15.25 years. The most commonly identified DRP in these patients was non-adherence. Incorrect MDI technique was seen in 44.7%. Most of them had no caregiver and use MDI without spacer. After the third pharmaceutical care, patients had proper MDI technique from 63.0% to 89.1% (p<0.001). The rate of emergency department visits and hospital admissions due to asthma exacerbation decreased from 15.3% to 5.6% and 6.2% to 3.4%, respectively (p<0.001, p<0.001).
Conclusion: Providing pharmaceutical care with using the computer application program significantly improves the proper technique to use MDI. Moreover, pharmacist can continuous follow-up patients with DRPs and the incidence of hospitalization due to disease exacerbation were decreased.