Impact of a pharmacist-led asthma clinic in a high-risk pediatric population at a federally qualified health center within a medically underserved area

<h2>Abstract</h2><h3>Background</h3> There are few publications regarding pediatric asthma treatment at federally qualified health centers (FQHCs). FQHC patients are considered high risk with complex social determinants of health. This FQHC, located in a medically underserved area, has an established collaborative practice agreement for pharmacist-led management of pediatric asthma. <h3>Objective</h3> This study aimed to assess the asthma control of pediatric FQHC patients before and after pharmacist intervention. <h3>Methods</h3> This was a single-center, retrospective, observational cohort study. Patients were included if they had a current asthma diagnosis, were aged 4-21 years, and were an active patient of the FQHC. Patients were referred to the pharmacist-led asthma clinic to receive disease state, medication, and device education with guideline-directed asthma pharmacotherapy changes when needed. Patients and caregivers were surveyed using the age-appropriate Asthma Control Test (ACT) before the first asthma clinic appointment and at each follow-up visit. The primary end point was the change in ACT score from baseline to the most recent follow-up. Secondary end points included proportions of patients who achieved a clinically meaningful increase in ACT (a change of 2-3 points has been validated as a clinically meaningful difference), usage of systemic corticosteroids and emergent care, and patients converted to using the FQHC's on-site pharmacy. Continuous end points were evaluated using paired <i>t</i> tests and categorical variables with Fisher's exact tests. <h3>Results</h3> Thirteen patients were enrolled with an average age of 11.8 years and 4.4 years since asthma diagnosis. Pharmacist intervention showed a statistically significant improvement in the primary end point (mean ± SD ACT score increase 6.1 ± 3.1; <i>P</i> < 0.001). All patients had a clinically meaningful improvement in their asthma control. One patient (7.7%) sought emergent care with systemic corticosteroid usage. Among eligible patients, 4 of 5 (80%) were converted to using the FQHC's on-site pharmacy. <h3>Conclusion</h3> Pharmacist intervention improved asthma control in high-risk pediatric patients within an FQHC.