Referral Uptake Rates High in Patients With Poorly Controlled Asthma

Pharmacist-initiated general practitioner referrals for patients with poorly controlled asthma led to high rates of referral uptake, with approximately half of patients reporting changes to their asthma therapy upon referral.

Sarah Serhal, a PhD candidate at the Woolcock Institute of Medical Research, and colleagues conducted the study to assess the “uptake and outcomes of pharmacist-initiated general practitioner referrals for patients with poorly controlled asthma.”

Pharmacists referred at-risk patients to a general practitioner for assessment, and the researchers compared patient clinical data to “explore predictors of uptake and association with health outcomes,” according to the researchers.

A total of 148 patients received a general practitioner referral and 78% of those patients consulted their general practitioner. The researchers categorized those patients as action takers, while they categorized patients who did not consult their general practitioner as action avoiders.

“Patient rurality and more frequent pretrial [general practitioner] visits were associated with action takers,” according to the study’s authors.

Nearly half (44%) of the patients who were action takers reported changes to their asthma therapy. Patients who were action takers were significantly more likely to have an action plan by month 12 of the study than those who were action avoiders (P=.001). Action takers also made significantly more visits to a general practitioner during the study period (P=.034).

The researchers found in a univariate analysis that “a significantly higher proportion of action takers had incurred a hospital admission and/or emergency presentation in the 12 months preceding entry into the trial, when compared to action avoiders.”

“[General practitioner] review is essential for optimal asthma management, and our findings illustrate that 78% of patients with poorly controlled asthma took up their pharmacist’s referral for medical review,” the study’s authors concluded. “There was evidence of medication changes among those who acted upon their referral. Thus, there is an opportunity for pharmacists and [general practitioners] to collaborate to optimize patient care.”

Serhal S, Krass I, Emmerton L, et al. Patient uptake and outcomes following pharmacist-initiated referrals to general practitioners for asthma review. NPJ Prim Care Respir Med. 2022;32(1):53. doi:10.1038/s41533-022-00315-6