Background
In an effort to get established in the Primary Care team community pharmacists are being involved in clinics in GP practices. This study examines 'asthma care' as a comprehensive package that involves sustained efforts in a clinic and a pharmacy. In the community pharmacy support is limited by the lack of access to 'complete' records; the lack of dedicated time and space to discuss care with patients . However, GP based clinics lack continuity of care and the 'dual impact' possible with community pharmacy involvement. The service developed here involved surgery staff and the community pharmacist working together in a clinic situation and in the pharmacy. The purpose of this paper is to present the outcomes of a community pharmacist-led asthma clinic and to highlight patients' views on of the clinic.

Method
Postal-questionnaires, semi-structured interviews and practical assessments determined patients' need. Data were collected at four stages (pre-clinic assessments, consultations at the clinic, post clinic outcomes and evaluation of service delivery). 54 adult asthmatics were randomly chosen from the GP practice list. Patients who consented were sent an appointment. The clinics were run according to agreed protocols which allowed the pharmacist and nurse to alter patients' treatments. A week after the clinic patients were given a 'results' sheet and a management plan at the community pharmacy. The views of patients were obtained by sending a post-clinic questionnaire to those who attended the clinics and organising focus groups for patients who chose not to attend the clinics.

Results
Twenty one (39%) patients attended the clinics. A summary of interventions is presented below.

Fifteen (71%) patients who attended a clinic responded to the evaluation questionnaire. All respondents found the clinics useful and 14 (93%) considered that they had benefited. All respondents said that the clinics had raised their awareness of how a pharmacist and nurse can help with their asthma and 14 (93%) said they would be happy to continue using the ongoing support and advice.

The results of the focus group indicated that the reasons why people do not attend general practice clinics are complex and multi-factorial and include personal, cultural, social and environmental and organisational factors.

Discussion
The outcomes of these clinics demonstrate the worthiness of nurses and community pharmacists working together to mutual benefit and improved patient care. The community pharmacist gained involvement in decisions around patient care and the multi-disciplinary approach assured patients that their asthma care was 'seamless'. This is an example of what has been discussed for many years as pharmaceutical care and medicines management.