Pharmacist-Led Educational Intervention to Improve Knowledge, Medication Adherence, and Asthma Control Among Asthma Patients at Ayder Comprehensive Specialized Hospital: A Randomized Controlled Trial

Abstract

Introduction: Asthma is a significant public health concern in Ethiopia, with a prevalence of 9%. Poor control of asthma symptoms leads to frequent exacerbations, reduced quality of life, and higher healthcare costs. Objective: To assess the effect of a pharmacist-led educational intervention on medication knowledge, inhaler technique, medication adherence, and asthma control among adult asthma patients at Ayder Comprehensive Specialized Hospital. Methods: A single- blind randomized controlled trial was conducted from March 1, 2025, to August 31, 2025. A total of 131 asthma patients were randomly assigned through a computer generated sequence to either an intervention group (n = 66), which received structured pharmacistled education, or a control group (n = 65), which received routine care; outcome assessors were blinded to group allocation. Outcomes were measured at baseline and after three months. Data were analyzed using SPSS version 28.0, with chi-square tests and logistic regression (p < 0.05; 95% CI). Results: Of the 131 participants enrolled, 128 completed the study (97.7% response rate). Participants had a mean age of 45.8 } 16.9 years, with 55.0% being male. The intervention group showed significant improvements from baseline to follow-up: correct medication knowledge increased from 51.5% to 82.8%, proper inhaler technique from 47.0% to 79.7%, medication adherence from 18.2% to 45.3%, and well-controlled asthma from 28.1% to 59.4%. Multivariate analysis identified the intervention as the strongest protective factor, with the control group having significantly higher odds of poor medication knowledge (OR = 9.17, 95% CI: 3.37 – 24.94, p < 0.01), medication non-adherence (OR = 4.72, 95% CI: 1.76 – 12.64, p < 0.01), and uncontrolled asthma (OR = 3.8, 95% CI: 1.6-8.7, p < 0.01) compared to those in the intervention group. b Subgroup analyses confirmed the intervention’s effectiveness across all patient groups. For medication knowledge, a significant intervention effect was observed by comorbidity status (pvalue = 0.01) and exacerbation history (p-value = 0.03); for medication adherence, by exacerbation history (p-value = 0.05); and for asthma control, by education level (p-value = 0.05). Conclusion: This randomized controlled trial confirms that pharmacist-led education significantly improves asthma self-management and symptom control. It is suggested to integrate clinical pharmacists into standard chronic disease management.