Comparison of pathway designs for providing community pharmacy support to asthma patients thought to be overusing SABA in NW London (ID 460)
Pharmacists Consortium London North West
Funding: The work reported here is being supported by the International Primary Care Respiratory Group, with funding from AstraZeneca.
Abstract
BackgroundWe have reported findings from two community pharmacy (CP) projects, focusing on improving patient understanding of asthma and its management. Here we compare and contrast them.
Strategies
In the 2019 project (Project 1, in I9 CPs), patients suspected of overusing SABA, were invited opportunistically to an initial consultation (IC) plus follow-up (FU) consultation, 3-4 months later. Tools used included structured questionnaires, discussions, Asthma Control Tests (ACT), CO and Peak Flow (PF) measurements; airway models, Patient Medication Records (PMRs) and the Asthma Right Care (ARC) SABA slide-rule[1].
In the 2022/3 project (Project 2, in 11 CPs), patients using 6 or more SABA cannisters annually, were identified from PMRs. In place of an IC, each patient was invited to take away and complete a Reliever Reliance Test (RRT) and attend a similar but shorter FU to discuss their RRT scores[2].
Achievements
Project 1: 98 consenting patients attended IC and 71, FU. Prior to IC, mean SABA use was 7 cannisters annually. Education and support provided included: inhaler usage discussion, signposting to online resources; inhaler technique coaching; raising PF meter ownership; boosting awareness and completion of Personal Asthma Action Plans (PAAPs); referrals where required[1]. Patients reported increased confidence in managing their asthma, improved inhaler usage and technique.
Project 2: 105 patients accepted an RRT and 80 patients attended FU. Education and support provided at FU was similar to project 1. Consenting patients reported improved understanding of asthma, inhaler purpose and technique[2].
Lessons learned
Explaining to patients how asthma affects lung function and the role of their inhalers, improved patient-reported understanding in both projects. Additionally, all consultations facilitated PAAP completion, inhaler coaching and appropriate referrals.
Messages for others.
CP-delivered asthma support utilising consultations demonstrated value in both projects. The second pathway saved patient and pharmacist time.
1. https://thorax.bmj.com/content/76/Suppl_1/A123.2
2. Attar-Zadeh D. This meeting
Conflicts of interest: None. Those funding the work exerted no influence over the abstract content.
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