A cluster randomised control trial to evaluate the effectiveness and cost-effectiveness of the Italian Medicines Use Review (I-MUR) for asthma patients

Background

Objective To evaluate the effectiveness and cost-effectiveness of Medicines Use Reviews provided by community pharmacists in asthma.

Design, setting and participants Cluster randomised, multi-centre, controlled trial in adult patients with asthma, conducted in 15 of the 20 regions of Italy between September 2014 and July 2015. After stratification by region, community pharmacists were randomly allocated to group A (trained in and delivered the intervention at baseline) or B (training and delivery three months later), using computerised random number generation in blocks of 10. Each recruited up to five patients, with both groups followed for nine months.

Primary outcome Asthma control, assessed using the Asthma-Control-Test (ACT) score (ACT?20 represents good control). Secondary outcomes Number of active ingredients, adherence, number of PCIs, cost-effectiveness compared with usual care.

Conclusions This community pharmacist-based intervention demonstrated both effectiveness and cost-effectiveness. It has since been implemented as the first community pharmacy cognitive service in Italy.

TRN: ISRCTN72438848 (registered 5th January 2015)