Quality indicators measuring pharmaceutical care for asthma and chronic obstructive pulmonary disease within primary care: a scoping review

PURPOSE: Despite the growing emphasis on quality improvement, an overview of quality indicators (QIs) measuring pharmaceutical care in asthma and COPD remains limited. Numerous QIs have been developed for general respiratory care, yet often designed for physician-led hospital settings rather than pharmacist-led primary care. This scoping review provides an overview of existing QIs measuring pharmaceutical care for asthma and COPD within primary care, including an evaluation of their clinimetric properties. METHODS: A systematic literature search was conducted across five electronic databases. The population included adult asthma and/or COPD patients; concept aimed at QIs measuring structures, processes, and outcomes; in the context of pharmaceutical care provided by pharmacists in primary care. Selected articles were categorized using a two-stage approach; a study-level classification followed by an indicator-level classification of identified QIs. RESULTS: Of the 46 articles identified 23 articles (47.9%) focused on development, 16 articles (33.3%) on validation, and 9 articles on feasibility (18.8%). Overall, 188 QIs measuring pharmaceutical care for asthma and/or COPD were identified, categorized into five healthcare domains; 1) screening and diagnosis (10.6%), 2) guideline-based pharmacological treatment (21.8%), 3) self-management support (25.0%), 4) referral for expert advice (7.4%) and 5) disease control assessment (35.1%). Identified QIs included structure (1.6%), process (81.9%) and outcome (16.5%). 155 QIs (82.4%) were evaluated on development-related metrics, 46 QIs (24.5%) on validation and 42 QIs (22.3%) on feasibility. CONCLUSION: A vast overview of QIs have been identified for pharmaceutical care in asthma and COPD, noting their practical utility and validation depends on their applicability for internal clinical improvement or external 'pay-for-performance' schemes.