Pharmacists Improve Asthma Care Despite Gaps in Practice

Community pharmacists have the knowledge and access to meaningfully improve asthma outcomes across global communities, but persistent gaps in guideline-driven practice and structured follow-up are standing in the way, according to a study published in Healthcare.¹

“Asthma is a lifelong respiratory disease that requires proper pharmacotherapy, patient counseling, and an action plan designed to reduce the frequency and severity of asthma symptoms,” wrote the authors of a US Pharmacist article.² “Although death from asthma is uncommon, it is estimated that nearly one-half of all asthma patients do not have proper control over their condition.”

The regional study, conducted in the Aseer region of Saudi Arabia, reveals a concerning dichotomy. Although 64.8% of pharmacists possess high knowledge, only 51.7% implement high-level counseling practices for the management of asthma. This gap is particularly significant in the Aseer region, where high-altitude environmental factors and cooler temperatures contribute to an adult asthma prevalence of 19.2%, which is notably higher than the national average.¹

These findings are mirrored in broader scoping reviews of the Gulf Cooperation Council (GCC), where a significant portion of asthma patients fail to receive appropriate diagnosis or regular monitoring. In some areas, the rate of poorly controlled asthma has been reported as high as 97%, highlighting a desperate need for more structured pharmacist intervention, according to Research in Social and Administrative Pharmacy.³

The pathology of asthma involves a complex inflammatory cascade where allergens trigger mast cells and macrophages to release mediators such as histamine and cytokines. If left unmanaged, this process causes chronic mucus production and bronchiole constriction, potentially leading to permanent airway remodeling and chronic disease.^2,4

READ MORE: Community Pharmacists Boost Asthma and Allergy Care

Beyond the clinical impact, uncontrolled asthma places a staggering $81.9 billion in economic burden on the US health care system annually, driven largely by hospitalizations and emergency visits. Pharmacists are uniquely positioned to mitigate these costs because they serve as the most accessible providers and often act as the first point of contact in primary care settings.^1,4

Effective management requires pharmacists to guide patients through the Global Initiative for Asthma (GINA) guidelines’ stepwise approach. Recent updates have significantly shifted toward a preference for inhaled corticosteroids combined with formoterol as the primary reliever, moving away from traditional short-acting beta-agonist monotherapy.^1,2,4

This shift aims to treat underlying inflammation and prevent the life-threatening exacerbations associated with overusing rescue inhalers alone. However, many practitioners in the GCC remain unaware of these recent updates, often due to undergraduate curricula that prioritize traditional pharmaceutical sciences over direct clinical patient care.^1,3,5

According to the Journal of Pharmacy Practice, pharmacists must also master the technical nuances of various delivery devices, including pressurized metered-dose inhalers, dry-powder inhalers, and soft-mist inhalers. Inhaler mishandling is remarkably common, with errors such as a lack of hand-lung synchronization or failing to hold the breath after inhalation contributing to poor control.⁴

For both the provider and the patient, the current study identifies time constraints as the most pervasive barrier to delivering this essential technical education. Other obstacles include a lack of financial incentives and a public perception that views pharmacists primarily as medication vendors rather than skilled health care experts.^1,3

The evolution of the profession in the United Kingdom offers a potential roadmap for overcoming these systemic barriers through multidisciplinary integration. Since a seminal paper in 1990 called for a move away from traditional dispensing, UK pharmacists have evolved into independent prescribers and integral members of multidisciplinary teams, as stated by the European Respiratory Society.⁵

By 2026, all new UK pharmacists will be permitted to prescribe at the point of registration, allowing them to lead medicine optimization efforts for vulnerable groups like pregnant women. Evidence shows that when clinical pharmacists are embedded into respiratory teams, they improve patient adherence and safety while significantly reducing the time required to reach therapeutic doses.

Bolstering the pharmacist’s role in this space requires addressing readiness gaps through targeted, guideline-oriented training and the adoption of structured follow-up routines. By integrating into national health care strategies, such as Saudi Vision 2030, pharmacists can transition from simple dispensers to indispensable leaders in the global fight against respiratory disease.

Increasing the involvement of community pharmacists in structured follow-up and guideline-based care is essential for achieving optimal clinical outcomes.^1,4

“Strengthening pharmacist-led interventions through targeted guideline-oriented training, improved access to asthma management guidelines and tools, and supportive health-system integration may further enhance pharmacists’ roles in asthma management,” concluded the authors of the current study.¹ “Expanding the involvement of community pharmacists in structured asthma follow-up and guideline-based care and addressing identified barriers could contribute to improving asthma control and management in Saudi Arabia.”

READ MORE: Asthma Resource Center

REFERENCES

1. Salem HH, Siddiqua A, Aljali RS, et al. Knowledge, practice and barriers of community pharmacists towards asthma management: a cross-sectional study in Saudi Arabia. Healthcare. 2026;14(9):1175. https://doi.org/10.3390/healthcare14091175

2. Smith TJ. A pharmacist’s review of asthma. US Pharmacist. July 13, 2018. Accessed May 19, 2026. https://www.uspharmacist.com/article/a-pharmacists-review-of-asthma

3. Mahmoud A, Abuhelwa AY, Owen T, et al. Role of pharmacists in the care of adult asthma patients: a scoping review. Res Social Adm Pharm. 2024;20(9):860-869. https://doi.org/10.1016/j.sapharm.2024.06.005

4. Bridgeman MB, Wilken LA. Essential role of pharmacists in asthma care and management. J Pharm Pract. 2021 Feb;34(1):149-162. doi: 10.1177/0897190020927274.

5. Clements J, Bowman E, Tolhurst R, et al. The role of the clinical pharmacist in the respiratory or sleep multidisciplinary team. Breathe. 2023;19(4):230123. https://doi.org/10.1183/20734735.0123-2023