Evaluation of a pharmacist-managed asthma clinic in an Indian Health Service clinic.

OBJECTIVES: To observe whether American Indian and Alaskan Native (AI/AN) patients at the Yakama Indian Health Service seen at the pharmacist-managed asthma clinic improved asthma outcomes. DESIGN: Retrospective chart review, single group, preintervention and postintervention. SETTING: Pharmacist-managed asthma clinic at an Indian Health Service ambulatory care clinic. PATIENTS: Sixty-one AI/AN patients who were seen at least once in the asthma clinic from 2010 to 2014. INTERVENTION: Pharmacist-provided asthma education and medication management. MAIN OUTCOME MEASURES: Asthma-related hospitalizations and emergency department or urgent care (ED) visits. RESULTS: The total number of asthma-related hospitalizations and ED visits between the 12-month periods preceding and following the initial asthma clinic visit were 11 versus 2 hospitalizations (P = 0.02) and 43 versus 25 ED visits (P = 0.02), respectively. Over the same period, asthma-related oral corticosteroid use showed a nonsignificant decrease in the number of prescriptions filled (n = 59, P = 0.08). In contrast, inhaled corticosteroid prescription fills significantly increased (n = 42, P = 0.01). CONCLUSION: A reduction of asthma-related hospitalizations and ED visits were observed during the course of the intervention. Increased access to formal asthma education and appropriate asthma care benefit the Yakama AI/AN people. A controlled trial is needed to confirm that the intervention causes the intended effect.