New tool supporting medication reviews with asthma patients
The Oxford AHSN and the Guy’s and St Thomas’ NHS Foundation Trust respiratory pharmacy team have launched a new and evidence-based Asthma Structured Medication Review template for use with asthma patients. It can be imported free of charge into GP prescribing systems (EMISweb and SystmOne) to support standardised, high-quality care.
It has been extensively tested by pharmacists working across primary, secondary and tertiary care, and guides the user through:
- confirmation of inhaled corticosteroid adherence using the Medicines Possession Ratio calculation
- Identification of the potential reasons for inhaled corticosteroid (ICS) non-adherence e.g. using the Test of Adherence to Inhalers (TAI) questionnaire
- techniques to optimise inhaler use (good technique, maximise ICS use, minimise short-acting beta-agonists (SABA) use
- minimising the environmental impact of inhalers by choosing the most appropriate device type
- understanding oral corticosteroid exposure and knowing when to refer and ultimately, achieving better patient care and delivery of Quality and Outcomes Framework (QOF) and Investment and Impact Fund (IIF) requirement
“This new template has been designed by clinicians who are directly involved in optimising medication for asthma patients. It is a valuable tool that can be used to support medication reviews and related conversations. Ultimately, this will help patients get the most from their asthma medication.” Seema Gadhia, Pharmacy Lead, Clinical Innovation Adoption, Oxford AHSN
“There has never been a clearer role or more important time for pharmacists to deliver best care to our patients with asthma. I hope that this tool (and several others that complement it) will support the profession to be confident and competent respiratory clinicians.” Gráinne d’Ancona, Consultant Pharmacist, Respiratory and Sleep Medicine, Guy's and St Thomas' NHS Foundation Trust and Senior Lecturer, King’s College London.
“This template supports the fundamental pillars of good asthma care and is designed to be used by generalists. It supports the clinician to review and improve inhaled corticosteroid adherence, address short-acting beta-2-agonist reliance, optimise inhaler technique and respond appropriately to the information they gather, whilst still meeting the Quality and Outcomes Framework (QOF) targets and helping to support the achievement of both the respiratory care and environmental sustainability Impact and Investment Fund (IIF) targets.” Alicia Piwko and Maeve Savage, Highly Specialist Pharmacists COPD & Integrated Respiratory Care/Primary Care Network Pharmacists
The Asthma structure medication review template and instructions on how to use it are available here.
An aligned educational module on medication adherence is available here.
This template is one of many useful tools developed as part of the national Asthma Biologics programme. Further information is available on the Pharmacy Enhanced Role workstream section here.