Adherence enhancement for patients with asthma in community pharmacy practice: tools development and pharmacists’ feedback
Bibliographic record
Abstract
To develop tools for identifying and addressing medication adherence barriers so that they are asthma-specific, to assess pharmacists’ perspectives on the use of the tools and their implementation in the community pharmacy practice. Development of asthma adherence tools involved analysis of available tools that focused on identifying and resolving asthma-specific barriers to adherence, followed by selection and modification of tools. Semi-structured interviews were conducted with practicing community pharmacists on pharmacists’ experiences in addressing adherence for patients with asthma, barriers, special concerns and perceptions regarding the proposed tools and their implementation in practice. Audio-recorded interviews were transcribed. Thematic analysis was conducted to describe pharmacists’ feedback. Three asthma-specific tools, which were adapted from the Adherence Starts with Knowledge-12 adherence tool and the Drug Adherence Work-up tool, were utilized in this study, including: (1) a patient questionnaire to identify asthma medication adherence barriers, (2) a pharmacist ‘Conversation Starter’ document to efficiently facilitate identification and resolution of barrier(s), and (3) a patient pamphlet entitled ‘Breathe Easier’ to address and educate patients regarding identified barrier(s). Pharmacists’ (N = 5) overall perspectives on the approach and proposed tools were positive. All pharmacists acknowledged high patient need for asthma education and adherence support. Most of the interviewees agreed that common adherence barriers were addressed in the tools and that the main barrier regarding program implementation was time. Providing focused counselling by utilizing tools that identify specific patient issues and offer possible solutions may help overcome the time barrier. The proposed tools can enhance patient–pharmacist communication and have the potential to improve adherence and overall asthma management, which can lead to a decreased asthma burden.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.063 | 0.147 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.005 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".