Assessing the pharmaceutical care needs of asthmatic patients.

OBJECTIVES: To measure patients' perceptions of their care needs, by developing a tool to assess these needs and evaluate its utility in community pharmacy practice.
METHOD: A survey tool comprising 37 items was developed to assess asthmatic patients' perceptions of their health-related needs, using data from literature reviews and expert opinions. The tool was piloted on 25 patients to ensure the content of the questionnaire was valid. Changes were made following piloting and the modified tool was then tested in the main study, on 101 patients from thirteen community pharmacies in Portugal. Data from this phase were subjected to factor analysis and reliability testing.
RESULTS: 118 asthmatic patients were recruited, of which 101 questionnaires were eligible for analysis. From these, 40 were male (39.6%) and 61 were female (60.4%). The mean age of respondents was 41 years (sd = 19.02). The first changes made to the survey tool included the adding of items relevant to patients recruited in the pilot and the simplification of the scaling used. The survey tool was then subjected to factor analysis and reliability testing. Six scales emerged, which described the need for GP support, specialist support, pharmacist support, nurse support, other carers' support and written support. Internal consistency was good (Cronbach's coefficient alpha ranged from 0.81 to 0.93). Although there were no significant associations between educational level and other factors, other attributes influenced the communication between pharmacist and physician (chi2 = 6.972; P = 0.031). Patients with a lower level of education (up to six years) valued communication between these two professionals more than among patients with higher education. The patient's age group was associated with an expressed need for explanation of inhaler technique (chi2 = 6.494; P = 0.039). There was extended need in both oldest and youngest patients. There was a significant difference between high and low scorers to the factor 'pharmacist's role in asthma' (F1) and patients treated by either specialist or GP (chi2 = 4.935; P = 0.026). There were differences between those who were bothered by their asthma or not and their perceptions of 'Pharmacist's ideal role in asthma' (F1 & 3) (chi2 = 5.967; P = 0.051).
CONCLUSION: The tool needs further development to ensure its validity and utility in practice. This will provide greater insight into patients' perceptions of their healthcare needs, which can allow health professionals to target their interventions. Such a tool may then be used in pharmacies that intend to change their current practice, to raise pharmacists' awareness of patients' demands. Developing ways to meet those needs will ultimately lead to an increased quality service and therefore 'client' satisfaction.