Studying the impact of Clinical Guided Consultation Software System when used by a Community Pharmacist conducting Asthma Reviews in Primary Care: A feasibility analysis (ID 429)
Liverpool University Hospitals NHS Foundation Trust
Funding: The STARRS-GM project has been developed as part of a Joint Working initiative between HInM (Health Innovation Manchester) and AstraZeneca UK. As part of this Joint Working Agreement, Astra Zeneca UK funded the licenses for the use of the LungHealth software, project management costs and the resource to deliver clinics and to perform the initial audit and case-finding.
Abstract
Background: We have previously reported that Clinical Guided Consultation (CGC) software is able to deliver guideline level care in Asthma when used by nurses. We wished to determine the feasibility and impact of a community pharmacist using such technology when conducting reviews in a targeted Asthma population within primary care.Methodology: 32 patients (17 Female, age 59 (SD 16 years)) on the Asthma register underwent review between Aug-October 2022 by a Clinical Pharmacist using the CGC as part of the STARRS-GM project. Patients were selected due to a) collection of >=6 SABA inhalers in the past 12 months plus additional “NRAD” criteria thus deemed “high risk” or b) Being on high dose inhaled steroid therapy exhibiting good control on a previous review thus potentially suitable for “therapy de-escalation”. All reviews were done face-to-face with software algorithms incorporating holistic assessment of asthma staging, control and prompting pharmacological and non-pharmacological management.
Results: When taking the overall cohort (mean ACQ 19 (SD 5) 69% staged at “Specialist Therapies”), the software determined Asthma control to be: “Poor” in 56%; “Partial” in 22% and “Good” in 22% (Table 1). 28% were felt to have sub-optimal adherence. Inhaler technique check was performed in 30 patients with deficiencies successfully corrected in all but one. 8 patients (25%) did not have a Peak flow meter at home whilst 3 did not have a management plan; these being successfully addressed during the consultation (McNemar test; p<0.05). Overall, 63% had Asthma therapy escalated, 22% had Asthma therapy unchanged whilst 16% had therapy de-escalated the latter using in-built step-down algorithms incorporating and intelligently interpreting FeNO measurements guiding safe “step down”.
Conclusion: The implementation of a Clinical Guided Consultation software to conduct Asthma reviews in primary care by a community pharmacist is both feasible and effective with implications for clinical pathway redesign.
Conflicts of interest: The CGC has been developed and owned by LungHealth Ltd. Drs. Chakrabarti, Angus, Davies, Professor Pearson and Mr. McKnight are all directors of LungHealth Ltd and were all involved in the development of the CGC
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