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To the Editor: Dr Weinberger and colleagues¹ implemented the same protocol for patients with both asthma and COPD. However, there are many differences with regard to the appropriateness of peak-flow-monitoring, clinical interventions and outcomes, health-related quality of life, knowledge, self-efficacy, compliance, etc between these 2 diseases. In addition, the distinction between asthma and COPD was only based on smoking history and age. The increase in ED visits and hospital admissions within the pharmaceutical care group might also be attributed to increased knowledge followed by increased self-monitoring (peak flow and symptoms). Administering a sufficient evaluation of self-efficacy would have been a useful approach.² Furthermore, the authors did not compare their results with studies that have supported pharmaceutical care programs.^2-4

Martin Schulz, PhD
Center for Drug Information and Pharmacy Practice
ABDA—Federal Union of German Associations of Pharmacists
Berlin, Germany

1. Weinberger M, Murray MD, Marrero DG, et al. Effectiveness of pharmacist care for patients with reactive airways disease: a randomized controlled trial. JAMA. 2002;288:1594-1602. FREE FULL TEXT 2. Schulz M, Verheyen F, Muehlig S, et al. Pharmaceutical care services for asthma patients: a controlled intervention study. J Clin Pharmacol. 2001;41:668-676. ABSTRACT 3. Herborg H, Soendergaard B, Froekjaer B, et al. Improving drug therapy for patients with asthma, 1: patient outcomes. J Am Pharm Assoc (Wash). 2001;41:539-550. PUBMED 4. Cordina M, McElnay JC, Hughes CM. Assessment of a community pharmacy-based program for patients with asthma. Pharmacotherapy. 2001;21:1196-1203. FULL TEXT | PUBMED

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;289:1104.

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