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RESEARCH QUESTION

Can on TRACk, a TRain, prepAre, Communicate strategy, improve inhaler medication adherence and inhaler technique of lung patients?

HYPOTHESIS

On TRACk, a blended intervention that prepares both patients and pharmacy technicians for two inhaler medication consultations and trains technicians in their communication will improve inhaler medication adherence and inhaler technique in patients with asthma/COPD and lead to better health outcomes

STUDY DESIGN

A cluster randomized controlled trial with two groups: (1) on TRACk group; (2) usual care group

STUDY POPULATION

All patients (=16 years) with asthma and/or COPD who collect their inhaler medication for the first time in the community pharmacy will be asked consecutively to participate in this study by the pharmacy technician. Exclusion criteria: simultaneous experimental SABA use

INTERVENTION

On TRACk combines two innovative and proven successful elements: (1) online training of PTs to improve their inhaler medication counseling (both content, including giving a correct inhalation instruction, and patient-centred communication style), (2) preparing technicians and patients for these counseling moments in which inhaler technique is evaluated and medication use is discussed based on topics chosen by patients.

OUTCOME MEASURES

Primary outcome: adherence to inhaler medication and inhaler technique

Secondary outcomes: disease control, quality of life, hospitalizations, work absence, beliefs about medication, self-efficacy in understanding and using medication, perceived efficacy in interactions

SAMPLE SIZE/DATA ANALYSIS

To achieve a 15% higher adherence (based on pharmacy refill data) in the on TRACk group compared with the control group, calculated with a power of 0.90, alpha of 0.05, and accounting for clustering, 135 patients per group are needed. Allowing a 25% dropout rate, 180 patients will be included per group (five patients per technician, 2 technicians per pharmacy and 18 pharmacies per group).

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