Incidence and Impact of Drug-related Problems on Asthma Control, and Effectiveness of a Pharmacist-led Education Program in Pediatric Asthma

Lukkana  Matvises; Rindawan  Phankien; Thanida  Utthar

doi:10.64960/srimedj.v41i4.271156

Authors

Lukkana Matvises Department of Pharmacy, Faculty of Medicine, Khon Kaen University, Muang District, Khon Kaen Province, Thailand 40002
Rindawan Phankien Department of Pharmacy, Faculty of Medicine, Khon Kaen University, Muang District, Khon Kaen Province, Thailand 40002
Thanida Utthar Pediatric Nursing Section, Nursing Division, Faculty of Medicine, Khon Kaen University, Muang District, Khon Kaen Province, Thailand 40002

DOI:

https://doi.org/10.64960/srimedj.v41i4.271156

Keywords:

pediatric asthma, drug-related problems, medication compliance, inhaler technique, pharmacist education, asthma control

Abstract

Background and objectives: Asthma is the most common chronic disease in children, with a prevalence of 13% in Thailand. Drug-related problems (DRPs), including poor medication compliance and incorrect inhaler technique, are major contributors to uncontrolled asthma. This study aimed to determine the incidence and types of DRPs, to evaluate the association between DRPs and asthma control, and to assess the effectiveness of a pharmacist-led education program on asthma control at Srinagarind Hospital, Khon Kaen University.

Methods: This was a retrospective observational study utilizing electronic medical records of pediatric patients with asthma aged less than 18 years attending the Pediatric Respiratory Clinic between January 1, 2023 and December 31, 2024. The outcomes of interest included: (1) the incidence and types of DRPs, encompassing poor medication compliance and incorrect inhaler technique; (2) the association between DRPs and asthma control; and (3) the rate of asthma control following a pharmacist-led education program. Asthma control was assessed according to the Global Initiative for Asthma (GINA) 2024 criteria at the subsequent clinic visit. Data were analyzed using the Chi-square test and Fisher’s exact test to compare DRP incidence and asthma control rates, and multiple logistic regression to identify independent factors associated with uncontrolled asthma.

Results: A total of 303 patients were enrolled, of whom 58.4% were male, with a mean age of 8.0 ± 3.5 years. DRPs were identified in 45.9% of patients. Poor medication compliance was independently associated with uncontrolled asthma (adjusted OR 2.04, 95% CI 1.09–3.80, p = 0.020). Following the pharmacist-led education program, 69.8% of patients with DRPs achieved asthma control (p = 0.003). The highest asthma control rate was observed in the 0–4 year age group (81.3%, p = 0.001), followed by the 6–12 year age group (76.9%, p = 0.008), whereas the adolescent group aged 12–18 years demonstrated the lowest control rate (45.8%, p = 0.200).

Conclusions: DRPs were highly prevalent among pediatric asthma patients, particularly poor medication compliance, which was independently and significantly associated with uncontrolled asthma. The pharmacist-led education program demonstrated favorable effectiveness in young children and school-aged children; however, targeted strategies for adolescents were still needed. These findings supported the integration of clinical pharmacist roles and systematic DRP screening into routine asthma care.

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