***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 OBJECTIVES Despite advances in recent years , asthma morbidity and mortality have been noted to be on the increase in the past decade . The present study examined the failures and recommendations of past studies and introduced a new milieu for asthma care -- the community pharmacy . The study incorporated a care protocol with the important ingredients of asthma education on medications , triggers , self-monitoring and an asthma plan , with pharmacists taking responsibility for outcomes , assessment of a patient 's readiness to change and tailoring education to that readiness , compliance monitoring and physician consultation to achieve asthma prescribing guidelines . METHODS Thirty-three pharmacists in British Columbia , specially trained and certified in asthma care , agreed to participate in a study in which experienced pharmacists would have asthma patients allocated to enhanced ( pharmaceutical ) care ( EC ) or usual care ( UC ) . Pharmacists less experienced were clustered by geography and had their pharmacies r and omized to two levels of care ; each pharmacy then had patients r and omized to EC versus control , UC versus control or EC versus UC depending on their pharmacy r and omization . Six hundred thirty-one patients provided consent , of which 225 in EC or UC were analyzed for all outcomes . Patients were followed for one year . RESULTS Compared with patients in the UC group , the results of those in the EC group were as follows : symptom scores decreased by 50 % ; peak flow readings increased by 11 % ; days off work or school were reduced by approximately 0.6 days/month ; use of inhaled beta-agonists was reduced by 50 % ; overall quality of life improved by 19 % , and the specific domains of activity limitations , symptoms and emotional function also improved ; initial knowledge scores doubled ; emergency room visits decreased by 75 % ; and medical visits decreased by 75 % . A patient satisfaction survey revealed that the population was extremely pleased with their pharmacy services . Cost analysis reinforces the EC model , which is more cost effective than UC in terms of most direct and indirect costs in asthma patients . CONCLUSION Specially trained community pharmacists in Canada , using a pharmaceutical care-based protocol , can produce impressive improvements in clinical , economic and humanistic outcome measures in asthma patients . The health care system needs to produce incentives for such care 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 Objectives To implement and assess hospital-based pharmaceutical care services for patients with asthma . Methods A prospect i ve , r and omized , controlled study was conducted in Shaab teaching hospital , Khartoum , Sudan . Patients were allocated r and omly either in the intervention group ( 60 ) or control group ( 40 ) patients . The drug therapy of asthma for the patients in the intervention group was review ed by a trained pharmacist , and interventions were suggested to the attending physicians for the identified problems . Intervention patients received comprehensive medication counselling and asthma education every 2 weeks , while the control group received the routine medical consultation and dispensing services . The outcome measures were recorded using structured forms at baseline and monitored during a follow-up of every two weeks for 6 months in both groups . Data were analyzed using SPSS version 13 , level of significance was p<0.05 . Results At the end of the study period the mean reduction in frequency of acute attacks ( 1.91 ; SD=0.18 vs. 1.0 ; SD=0.14 ; p=0.03 ) , nocturnal asthma symptoms ( 3.5 ; SD=0.3 vs. 1.1 ; SD=0.2 ; p=0.02 ) and frequency of using inhaled β2 agonists per week ( 19.9 ; SD= 2.1 vs. 3.3 ; SD=0.3 ; p=0.01 ) were significantly greater in the intervention group compared to control . A significant mean reduction ( p=0.002 ) in the days of sickness/week was in the intervention group , while in control group there was an increase in mean days of sickness/week . The intervention group showed a significant greater improvement in the score for assessing the inhalation technique ( p<0.001 ) , patient ’s knowledge about asthma ( p<0.001 ) , and its drug-therapy ( p=0.01 ) compared with control . Conclusion The present findings suggest that pharmacist ’s intervention can have positive impact on asthma-related outcomes in patients Background : Feedback is a critical component of any educational intervention . When it comes to feedback associated with inhaler technique education , there is a lack of knowledge on its role or its potential to solve the major issue of poor inhaler technique . Aims : This study aims to explore the role of feedback in inhaler technique education and its impact on the inhaler technique of patients over time . Methods : A parallel-group , repeated- measures study was conducted in the community pharmacy in which the effectiveness of current best practice inhaler technique education utilising qualitative visual feedback ( Group 1 ) was compared with a combination of qualitative and quantitative visual feedback ( Group 2 ) . The impact of these two interventions on inhaler technique maintenance was evaluated . Community pharmacists were r and omly allocated to recruit people with asthma who were using a dry powder inhaler . At Visit 1 their inhaler technique was evaluated and education delivered and they were followed up at Visit 2 ( 1 month later ) . Results : Both educational interventions result ed in an increase in the proportion of patients with correct inhaler technique : from 4 % to 51 % in Group 1 and from 6 % to 83 % in Group 2 ( Pearson ’s Chi-Squared , P=0.03 , n=49 , and Pearson ’s Chi-Squared , P=0.01 , n=48 , respectively ) . The magnitude of improvement was statistically significantly higher for Group 2 compared with Group 1 ( n=97 , P=0.02 , Pearson ’s Chi-Square test ) . Con 
    Output:
    
Based on the evidence generated by RCTs , pharmacists ' have a positive impact on the percentage of controlled patients , ACQ scores , severity and symptoms .