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Novel pharmacist-led intervention secures the minimally important difference (MID) in Asthma Control Test (ACT) score: better outcomes for patients and the healthcare provider
journal contribution
posted on 2023-06-09, 15:31 authored by Michela Tinelli, White John, Andrea ManfrinIntroduction: A key priority in asthma management is achieving control. The Asthma Control Test (ACT) is a validated tool showing a numerical indicator which has the potential to provide a target to drive management. A novel pharmacist-led intervention recently evaluated and introduced in the Italian setting with a cluster randomised controlled trial (C-RCT) showed effectiveness and cost-effectiveness. This paper evaluates whether the intervention is successful in securing the minimally important difference (MID) in the ACT score and provides better health outcomes and economic savings. Methods: Clinical data were sourced from 816 adult patients with asthma participating in the C-RCT. The success of the intervention was measured looking at the proportion of patients reaching MID in the ACT score. Different levels of asthma control were grouped according to international guidelines and graded using the traffic light rating system. Asthma control levels were linked to economic (National Health Service (NHS) costs) and quality-adjusted life years outcomes using published data. Results: The median ACT score was 19 (partially controlled) at baseline, and 20 and 21 (controlled) at 3-month and 6-month-follow up, respectively (p<0.01). The percentage of patients reaching MID at 3 and 6 months was 15.8% (129) and 19.9% (162), respectively. The overall annual NHS cost savings per 1000 patients attached to the shift towards the MID target were equal to €346?012 at 3 months and increased to €425?483 at 6 months. Health utility gains were equal to 35.42 and 45.12 years in full health gained, respectively. Discussion: The pharmacist-led intervention secured the MID in the ACT score and provided better outcomes for both patients and providers.
History
Publication status
- Published
File Version
- Published version
Journal
BMJ Open Respiratory ResearchISSN
2052-4439,Publisher
BMJ Publishing GroupExternal DOI
Issue
5Volume
2018Page range
1-9Article number
e000322Department affiliated with
- Biochemistry Publications
Full text available
- Yes
Peer reviewed?
- Yes
Legacy Posted Date
2018-10-16First Open Access (FOA) Date
2018-10-16First Compliant Deposit (FCD) Date
2018-10-16Usage metrics
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