***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background : No r and omised studies have addressed whether self-management for asthma can be successfully delivered by community pharmacists . Most r and omised trials of asthma self-management have recruited participants from secondary care ; there is uncertainty regarding its effectiveness in primary care . A r and omised controlled study was undertaken to determine whether a community pharmacist could improve asthma control using self-management advice for individuals recruited during attendance at a community pharmacy . Methods : Twenty four adults attending a community pharmacy in Tower Hamlets , east London for routine asthma medication were r and omised into two groups : the intervention group received self-management advice from the pharmacist with weekly telephone follow up for 3 months and the control group received no input from the pharmacist . Participants self-completed the North of Engl and asthma symptom scale at baseline and 3 months later . Results : The groups were well matched at baseline for demographic characteristics and mean ( SD ) symptom scores ( 26.3 ( 4.8 ) and 27.8 ( 3.7 ) in the intervention and control groups , respectively ) . Symptom scores improved in the intervention group and marginally worsened in the control group to 20.3 ( 4.2 ) and 28.1 ( 3.5 ) , respectively ( p<0.001 ; difference adjusted for baseline scores = 7.0 ( 95 % CI 4.4 to 9.5 ) . Conclusions : A self-management programme delivered by a community pharmacist can improve asthma control in individuals recruited at a community pharmacy . Further studies should attempt to confirm these findings using larger sample s and a wider range of outcome measures Background : Despite national disease management plans , optimal asthma management remains a challenge in Australia . Community pharmacists are ideally placed to implement new strategies that aim to ensure asthma care meets current st and ards of best practice . The impact of the Pharmacy Asthma Care Program ( PACP ) on asthma control was assessed using a multi-site r and omised intervention versus control repeated measures study design . Methods : Fifty Australian pharmacies were r and omised into two groups : intervention pharmacies  implemented the PACP ( an ongoing cycle of assessment , goal setting , monitoring and review )  to 191 patients over 6 months , while control pharmacies gave their usual care to 205 control patients . Both groups administered question naires and conducted spirometric testing at baseline and 6 months later . The main outcome measure was asthma severity/control status . Results : 186 of 205 control patients ( 91 % ) and 165 of 191 intervention patients ( 86 % ) completed the study . The intervention result ed in improved asthma control : patients receiving the intervention were 2.7 times more likely to improve from “ severe ” to “ not severe ” than control patients ( OR 2.68 , 95 % CI 1.64 to 4.37 ; p<0.001 ) . The intervention also result ed in improved adherence to preventer medication ( OR 1.89 , 95 % CI 1.08 to 3.30 ; p = 0.03 ) , decreased mean daily dose of reliever medication ( difference −149.11 μg , 95 % CI −283.87 to −14.36 ; p = 0.03 ) , a shift in medication profile from reliever only to a combination of preventer , reliever with or without long-acting β agonist ( OR 3.80 , 95 % CI 1.40 to 10.32 ; p = 0.01 ) and improved scores on risk of non-adherence ( difference −0.44 , 95 % CI −0.69 to −0.18 ; p = 0.04 ) , quality of life ( difference −0.23 , 95 % CI −0.46 to 0.00 ; p = 0.05 ) , asthma knowledge ( difference 1.18 , 95 % CI 0.73 to 1.63 ; p<0.01 ) and perceived control of asthma question naires ( difference −1.39 , 95 % CI −2.44 to −0.35 ; p<0.01 ) . No significant change in spirometric measures occurred in either group . Conclusions : A pharmacist-delivered asthma care programme based on national guidelines improves asthma control . The sustainability and implementation of the programme within the healthcare system remains to be investigated Education on optimal medication use is an essential strategy to improve asthma control . The current authors investigated whether pharmacist interventions , focused on appropriate use of asthma medication and tailor-made to the patient 's current asthma control , would improve asthma control in adult patients . A 6-month r and omised , controlled , parallel-group trial was conducted in 66 community pharmacies in Belgium . Patients were r and omly assigned to receive usual pharmacist care ( n = 94 ) or a pre-defined pharmacist intervention ( n = 107 ) . This intervention mainly focused on improving inhalation technique and medication adherence . Primary outcome was the level of asthma control , as assessed by the Asthma Control Test ® ( ACT ) . Mean ACT scores did not change from baseline for both study groups . However , a pre-defined subgroup analysis of patients having insufficiently controlled asthma at baseline showed that the intervention had significantly increased the ACT score after 6 months compared with usual care . The intervention also reduced , for the complete study group , reliever medication use and the frequency of night-time awakenings due to asthma . Inhalation technique and adherence to controller medication were significantly better in the intervention group . In conclusion , pragmatic community pharmacy-based programmes can significantly improve therapeutic outcomes in adult asthma patients Objective To assess the impact of an intervention initiated by community pharmacists , involving the provision of educational material and general practitioner ( GP ) referral , on asthma knowledge and self-reported asthma control and asthma-related quality of life ( QOL ) in patients who may have suboptimal management of their asthma , as evidence d by pharmacy dispensing records . Setting Community pharmacies throughout Tasmania , Australia . Methods Forty-two pharmacies installed a  software application  that data mined dispensing records and generated a list of patients with suboptimal asthma management , as indicated by having three or more canisters of inhaled short-acting beta-2-agonists dispensed in the preceding 6 months . Identified patients were r and omised to an intervention or control group . At baseline , intervention patients were mailed intervention packs consisting of a letter encouraging them to see their GP for a review , educational material , asthma knowledge , asthma control and asthma-related QOL question naires , and a letter with a dispensing history to give to their GP . Pharmacists were blinded to the control patients ’ identities for 6 months , after which time intervention patients were sent repeat question naires , and control patients were sent intervention packs . Main outcome measures Asthma knowledge , asthma control and asthma-related QOL scores . Results Thirty-five pharmacies completed the study , providing 706 intervention and 427 control patients who were eligible to receive intervention packs . Intervention patients ’ asthma control and asthma-related QOL scores at 6 months were significantly higher compared to the control patients ( P < 0.01 and P < 0.05 , respectively ) and to the intervention patients ’ baseline scores ( P < 0.001 and P < 0.05 , respectively ) . Symptom-related QOL was significantly higher compared to the control patients ( P < 0.01 ) and activities-related QOL significantly improved compared to baseline ( P < 0.05 ) . No significant change was observed in asthma knowledge . Conclusion The results suggest that community pharmacists are ideally placed to identify patients with suboptimal asthma management and refer such patients for a review by their GP . This type of collaborative intervention can significantly improve self-reported asthma control and asthma-related QOL in patients identified as having suboptimal management of their asthma . A larger trial is needed to confirm the effects are real and sustained Objective To assess the suitability of Australian community pharmacies as cardiovascular disease risk profile screening centres and evaluate whether community pharmacists can play an important role in detecting , educating and referring screened individuals at high risk of cardiovascular disease . Setting 14 Australian community pharmacies . Method Opportunistic cardiovascular disease risk profiling for members of the public aged greater than 30 years with no existing cardiovascular diseases was performed . All major cardiovascular risk factors were measured . Exercise habits , existing conditions and therapy , and family history were also assessed . The results were used to calculate each subject ’s 10-year risk of developing cardiovascular events , based on Framingham Risk Equations ( New Zeal and tables ) . Each subject ’s knowledge of cardiovascular risk factors was assessed using a multiple-choice question naire . Written educational material s and verbal counselling were provided . Referral to a doctor for further assessment was recommended as appropriate . The screened individuals were followed up via mailed out question naire . A r and om sample of individuals at elevated risk was phoned to assess for outcomes of the screening and referral process . Main outcome measures Risk of developing cardiovascular disease and knowledge of cardiovascular risk factors . Results A total of 655 individuals ( 71.4 % female ) were screened for cardiovascular disease risk factors . Ages ranged from 30 to 90 years ( median : 54 years ) and 14.2 % were smokers . Of the individuals screened , 28.1 % had a 10-year risk of developing cardiovascular disease greater than 15 % , including 6.9 % who had a 10-year risk above 30 % . The median calculated 10-year risk of developing cardiovascular disease was 9.5 % . Approximately one-third of the individuals had elevated blood pressure , and almost two-thirds were either overweight or obese . The mean total serum cholesterol was 5.31 mmol/l , with 40 % of individuals having a level above 5.5 mmol/l and 20 % having a high-density lipoprotein cholesterol level below 1.0 mmol/l . There was a statistically significant improvement in the knowledge of cardiovascular disease risk factors at follow-up . Almost half of the contacted high-risk subjects reported lifestyle changes or started drug therapy following re-testing by their general practitioner . Conclusion A pharmacy-based cardiovascular disease risk profile screening and education program has the potential to identify and refer many undiagnosed individuals at high risk of cardiovascular events , and help contain the burden of heart disease The Asthma Control Question naire ( ACQ ) measures the adequacy of asthma treatment as identified by international guidelines . It consists of seven items ( 5 x symptoms , rescue bronchodilator use and FEV1 % of predicted normal ) . A validation study suggested that in clinical studies measurement of FEV1 and bronchodilator use may not be needed but this has never formally been tested in a clinical trial . The aims of this analysis were ( 1 ) to examine the measurement properties of three shortened versions of the ACQ ( symptoms alone , symptoms plus FEV1 and symptoms plus short-acting beta2-agonist )  and ( 2 ) to determine whether using the shortened versions would alter the results of a clinical trial . In the r and omised trial , 552 adults completed the ACQ at baseline and after 13 and 26 weeks of treatment . The analysis showed that the measurement properties of all four versions of the ACQ are very similar . Agreement between the original ACQ and the reduced versions was high ( intraclass correlation coefficients : 0.94 - 0.99 ) . Mean differences between the ACQ and the shortened versions were less than 0.04 ( on the 7-point scale ) . Clinical trial results using the four versions were almost identical with the mean treatment difference ranging from -0.09 ( P=0.17 ) , to -0.13 ( P=0.07 ) . For interpretability , the minimal important difference for all four versions was close to 0.5 . In conclusion , these three shortened versions of the ACQ can be used in large clinical trials without loss of validity or change in interpretation OBJECTIVE To evaluate whether systematic asthma care involving a register-recall system , postcard prompts for review , and education for general practitioners and staff in Australian general practice improves the quality of care and health outcomes for adult patients with moderate to severe asthma . DESIGN AND SETTING Cluster r and omised controlled trial in 40 general practice s in urban and rural South Australia and New South Wales over the 2 years 2004 and 2005 ; practice s were r and omly allocated to the intervention or control group . PARTICIPANTS 565 adult patients of these r and omly allocated practice s who had doctor-diagnosed moderate to severe asthma and were taking inhaled corticosteroids .  MAIN OUTCOME MEASURES Clinical asthma indicators , quality of care , acceptability of the intervention to patients , quality of life , and asthma self-management skills at baseline , 6 months and 12 months . RESULTS Although 46 % of patients in the intervention group practice s responded to the postcard prompts , only 32 % actually attended for their asthma review . At 12 months , there was a statistically significant difference in provision of written asthma action plans ( rate ratio , 1.9 ; 95 % CI , 1.0 - 3.5 ; P = 0.04 ) for intervention group patients compared with control group patients ; there was no significant difference in other indicators . CONCLUSION We found little objective evidence of improvement in patient management and outcomes result ing from a systematic model of asthma care . TRIAL REGISTRATION Australian New Zeal and Clinical Trials Registry ACTRN12605000091606 O 
    Output:
    
While many different methods were used for risk assessment and management services by the pharmacists , all the studies demonstrated that community pharmacists were capable of identifying people with poorly controlled asthma and undiagnosed COPD and providing them with suitable interventions .
The literature review identified that community pharmacists can play an effective role in screening of people with poorly controlled asthma and undiagnosed COPD along with delivering management interventions .
However , there is very little literature available on screening for these chronic respiratory conditions .