Impact of Clinical Pharmacy on Asthma in Pregnancy in a Maternal-Fetal Care Clinic

Abstract

Background: Asthma complicates 4% to 8% of pregnancies. The impact of clinical pharmacists providing asthma management and education to obstetric patients is unknown. Objective: Evaluate the impact of and patient satisfaction with clinical pharmacy services on asthma in pregnancy. Methods: This prospective quasi-experimental study enrolled 30 pregnant patients with asthma and assessed perceived asthma understanding, control, and inhaler technique before and after a clinical pharmacist visit and education. The primary outcome was change in pre- and postsurvey scores. Items were rated on a 5-point Likert-type scale; higher scores represented higher perceived knowledge or satisfaction. Secondary outcomes included inhaler technique scores, asthma control, correlating patient-specific factors with the primary outcome, and level of patient satisfaction with clinical pharmacy services. Results: Perceived knowledge of asthma in pregnancy median score (maximum score 50) significantly increased with clinical pharmacy education (37.5 pre vs 49 post, P = .001). Prior to clinical pharmacy services, patients highly rated their perceived knowledge of asthma in pregnancy with median scores on 7 of 10 items between 4 and 5. Despite this, significant changes were observed on 9 items. The proportion of patients with controlled asthma significantly increased after the pharmacist visit (33.3% vs 90%, P < .001). Satisfaction with clinical pharmacy services was overwhelmingly positive with average scores on all items 4.5 to 5. Inhaler technique scores significantly increased from baseline to follow-up (4 vs 7, P = .001). Conclusions: Pharmacists significantly improved patient perceived knowledge about asthma, asthma control, and inhaler technique. Patients were overwhelmingly satisfied with the care provided by the pharmacist.