ASTHMA TREATMENT ADHERENCE CHECKS: PRESENT AND FUTURE

IntroductionIn spite of its importance in optimising clinical outcomes and determining whether an escalation in therapy is indicated (e.g. initiating a biologic agent), the difficulty in identifying suboptimal adherence to asthma therapy persists. The most common method used to measure adherence by pharmacists in hospital asthma centres is the prescription refill check (PRC), but it is both flawed (e.g. assumption made that therapy collected has been appropriately administered) and can be time consuming to collect and interpret. This may therefore make it a barrier to effective and timely asthma management. The aim of this retrospective study was to quantify the time taken to complete a PRC from primary care using data retrieved from shared local care records (LCR) versus those obtained by contacting general practice (GP) directly, and the additional time taken when there was a need to obtain hospital prescription data.MethodsData were scrutinised for patients for whom a PRC was conducted between August 2019 and May 2021 to ascertain the time interval taken between identification of the need for the PRC and its availability on the patient’s electronic record.ResultsData for 885 patients were scrutinised and are illustrated in table 1. A PRC using direct data extraction from a LCR took on average less than 2 days to complete. In contrast, there was an eleven fold increase in the time taken to complete a PRC when GP’s had to be contacted. Retrieval of data from another hospital also added a delay to availability of prescription data.ConclusionsGiven the frequency of sub-optimal adherence and its impact, access to robust and complete data needs to be efficient. The stark disparity amongst sources suggests that while the utility of electronic monitoring of therapy is established, appropriate direct access to prescription data is essential. This would then streamline the process by reducing demand on healthcare professionals to provide the data, would minimise delays in treatment escalation decisions, and the significant decrease in hospital pharmacy resource needed to obtain this data would allow pharmacist’s time to be better spent improving non-adherence rather than detecting it.