Telecuidado Farmacêutico como Estratégia para Otimizar o Controle de Asma em Usuários de uma Farmácia de Medicamentos Especiais

Abstract

Introduction: Asthma is a global health issue affecting approximately 339 million people worldwide. Inhalation devices for asthma treatment are dispensed to 1,173 users at a Specialty Medication Pharmacy (FME) in southern Brazil through the Unified Health System (SUS). However, there has been no assessment of asthma control in this population so far. Telehealth has been recently regulated in Brazil, allowing pharmacy services to be offered remotely. Telecare has been implemented since 2020, characterized as a remote pharmacotherapeutic monitoring service. Objective: The objective of this study was to evaluate the level of asthma control among users who received remote services. Materials and Methods: This was a quantitative-descriptive observational study conducted between July and October 2021. The Asthma Control Test (ACT) was administered via telephone to 159 users who had been approved for dispensation of a corticosteroid combined with a LABA inhalation device at the FME in a city in southern Brazil. Participants had updated contact information and agreed to participate in the study. Variables such as age, sex, and ACT score were tabulated using means and standard deviations. This research was approved by the Research Ethics Committee (CEP) under protocol number CAEE 40194820100005312. Results and Discussion: The sample consisted of 49 males with a mean age of 58 years (SD 18.65) and 110 females with a mean age of 60.5 years (SD 16.74). Users were categorized into ACT score groups: 49.69% were "poorly controlled," 29.56% were "partly controlled," and 20.75% were "well controlled." Regarding age groups, 3.14% were aged up to 17 years with a mean ACT score of 17 (SD 5.55), 5.03% were aged 18-29 years with an ACT score of 17 (SD 5.09), 40.25% were aged 30-59 years with an ACT score of 15 (SD 4.15), and 51.57% were over 60 years with an ACT score of 16 (SD 5.02). The results indicate unsatisfactory control in 79.25% of the sample regardless of age, despite regular access to medication, consistent with other Brazilian studies showing that only about 12% of adults with asthma are well-controlled. The main Medication-Related Problems (MRPs) reported in the literature affecting disease control are related not only to access but also to adherence and inhalation device technique. All users assessed were included in the clinical trial measuring the effectiveness of the service. Conclusion: The study highlights that merely ensuring access to medication is insufficient for asthma control and underscores the importance of implementing programs that allow for the monitoring and health education of these users. Based on the reported data, it will be possible to evaluate asthma control after pharmaceutical intervention in the same sample.