The Jones Morbidity Index as an aid for community pharmacists to identify poor asthma control during the dispensing process

Abstract

Objective: To determine if the Jones Morbidity Index can be used in community pharmacy when asthmatic patients collect their prescriptions to identify those who have poor control. Method: Structured questionnaires were completed by asthmatics who presented prescriptions at community pharmacies to assess their morbidity and knowledge of asthma and their attitudes towards and usage of medication. Setting: Community pharmacies throughout the UK. Key findings: Complete data on 306 patients were returned by 41 community pharmacists. Seventy-one patients reported using an asthma diary, 161 attended an asthma clinic and 194 had visited their doctor during the past year because of an acute exacerbation (GPV). Problems with metered dose inhaler (MDI) technique were identified in 165 patients. Patients' mean (SD) asthma knowledge score (K) (maximum 5) was 3.48 (1.32). Over the past six months they had received 0.88 (1.78) courses of oral prednisolone (P), 1.12 (1.85) courses of antibiotics (A) and 1.20 (4.51) courses of cough medicine (CM). Using the Jones Morbidity Index (JMI), 74 patients (24.2%) had low morbidity, 90 (29.4%) had medium morbidity and 142 (46.4%) had high morbidity. Comparisons between the morbidity categories revealed significant differences for P, A, GPV, "happy with" preventer (P<0.001) and "happy with" reliever (P<0.01) together with CM, K and compliance (P<0.05). More patients classed as having high morbidity overused their reliever (P<0.01) and were less compliant with their preventer (P<0.001). There was no association between JMI and medication. Conclusion: The JMI is a valuable tool to identify poor asthma control when patients present prescriptions at community pharmacies. More than half the asthmatics presenting their prescriptions at pharmacies had symptoms and signs indicating poor control.