Non-clinical considerations when developing an asthma support pathway for use across UK community pharmacy (ID 361)
Pharmacists Consortium London North West
Funding: This service development has received a grant from the International Primary Care Respiratory Group and Asthma Right Care, with funding from AstraZeneca. Support for focus group meetings was received from Chiesi Ltd and Astra Zeneca Ltd.
Abstract
ContextWidespread over-reliance on short acting beta agonist (SABA) inhalers by asthma patients is well documented. Patients regularly visit Community Pharmacies (CPs), where healthcare support is frequently more accessible than elsewhere. This enhances the value of CP in the drive to reduce excessive SABA use.
Design and evaluation of a support pathway
We have previously described a design and evaluation protocol for a support pathway utilising the Reliever Reliance Test (RRT) in CP1. The RRT is a self-assessment test designed to encourage patients to explore their apparent over-reliance on SABA, as a preliminary to behaviour change. Focus group discussions, involving pharmacists experienced in CP asthma support, identified and refined essential non-clinical considerations that are reported here.
Pathway and evaluation content
The support pathway1 comprises: identification of patients possibly over reliant on SABA; introduction of patients to the RRT at the time of medicine collection; invitation to complete the RRT in their own time at their convenience and, if they wish, have a follow-up support consultation. The evaluation1 includes completion of questionnaires by patients and pharmacists.
Lessons learnt to date
The pathway and evaluation needed to:
• Be flexible enough to be compatible with national and local quality guidance and incentive schemes
• Be compatible with CP operational variables including: the mode of prescription presentation (electronic, by patient, by representative); range of experience and expertise of pharmacy personnel, including day-to-day changes; unpredictable collection of medication by patients or representatives.
• Minimise patient communication problems resulting from impaired physical abilities, hidden disabilities and language issues
• Include monitoring, with consent, of demographics to check for inadvertent exclusion from support
• Facilitate unbiased patient completion of the RRT and return for a follow-up consultation, without manipulating patient choice.
Message
Good service design requires detailed awareness of real-life considerations.
1. Attar-Zadeh, D et al. 2022, IPCRG World Conference. https://my.ltb.io/#/showcase/ipcrg-eposters
Conflicts of interest: None
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