Using pharmacy electronic communication to identify patients at high risk of asthma exacerbation: a community-based study in Australia and New Zealand

Aim: Asthma exacerbations are associated with significant morbidity and mortality, yet identifying individuals at high risk of an exacerbation remains challenging in community settings. Pharmacists, with access to pharmacy dispensing systems, are well positioned to address this gap. This study aimed to determine whether the utilization of pharmacy electronic communication can assist community pharmacists in identifying people with asthma, within the patient cohort, who are at high risk of exacerbation. Methods: A retrospective analysis of de-identified data from 45 community pharmacies in Australia and New Zealand was conducted using data from reCare software. Patients with a respiratory medication dispensed in the previous 12 months who had consented to electronic communication were invited to complete a five-item questionnaire. Patients who visited a General Practitioner (GP)/hospital, used oral corticosteroid (OCS), or purchased ≥ 3 short-acting beta-agonist (SABA) inhalers for their asthma in the past year were considered at high risk of exacerbation. Responses were linked to patients’ dispensing records for pharmacist review and referral. Results: Of 1,043,815 eligible patients, 69,932 received invitations; 863 responded, and 253 completed the questionnaire fully. All those who completed the questionnaire met the criteria for being at high risk of asthma exacerbation. Among these, 55.7% reported GP/hospital visits, 100% used OCS, and 69.5% purchased ≥ 3 SABA inhalers. Poor adherence was reported by 58.1%. SABA overuse was significantly associated with GP/hospital visits (p < 0.01) and poor adherence (p < 0.01). Conclusions: Electronic communication integrated with data in pharmacy dispensing systems can support pharmacists in understanding individuals’ exacerbation risk and the need to refer people with asthma. Patient consultation regarding preferred communication methods is critical before broader implementation; validation of screening tools is also recommended.