Evaluation of the adherence to the asthma guidelines by the administration of a questionnaire in community pharmacies

Background. Several studies demonstrate that the adherence to asthma guidelines (GL) is poor, but only a few of them were performed in community pharmacies. Thus, we decided to study this phenomenon by administering a questionnaire (Q) in two pharmacies. Methods. A Q was developed and administered to 138 patients-customers of two community pharmacies in Rome. Results. The severity of the disease was established based on the frequency of daytime and nocturnal symptoms before therapy, following the stepwise approach recommended by the current GL. We observed up to 90 different treatments, while those listed by the GL, long-term preventive or quick-relief for the four categories of asthma, are only 19. In particular, many of them included antihistaminic drugs and mucoactive agents, pharmacological classes not recommended by the GL, while certain long-term preventive therapeutic schemes did not include glucocorticoids. Conclusions. The analysis of the effects on daytime and nocturnal symptoms and the interferences of the disease with school and work, showed that the control of asthma was inadequate, probably due to the low adherence to the GL. In conclusion, this small pilot study, which does have several methodological limitations (small population and geographic area, small number of pharmacies involved, the use of a Q to obtain information not easily reported by the patient) confirms the important role played by pharmacists in the analysis of the adherence of pharmacological treatments to official GL.