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The least cost-effective inhaler device is the one that the patient cannot use. In deciding which device and drug formulation to prescribe healthcare professionals should first determine the patient’s ability to use the prescribed device correctly. Inhalation is the main route for the administration of drugs for conditions such as asthma and COPD. The advantage of administering drugs by inhaler is that the drugs are delivered directly to the site of action within the airways. The onset of action is rapid and systemic adverse effects are minimised.

Fran Robinson talks to a patient who has had asthma all her life, feels that annual asthma reviews are a waste of time (except when they are conducted by PCRS members). In this article she explains why and Ren Lawlor, Senior Lecturer,  Advanced Nurse Practitioner,  Department of Adult Nursing and Paramedic Science, University of Greenwich reflects on this patient’s experiences.

Key facts

PCRS welcome this further update of the long established, comprehensive and highly respected BTS/SIGN guideline for asthma. We are pleased that today BTS/SIGN have announced that future UK-wide guidance for the diagnosis and management of chronic asthma will be jointly produced by BTS, SIGN and NICE, something PCRS has campaigned for (Keeley & Baxter 2018).

E-cigarettes have become increasingly popular in recent years. The main reason given by current vapers for using e-cigarettes is to help them stop smoking tobacco. This pragmatic article provides information on the safety and effectiveness of e-cigarettes as a stop smoking tool.

Leadership skills enable respiratory nurse to raise standards of care Fran Robinson talks to Deirdre Siddaway Respiratory Specialist Nurse, Suffolk Originally published in the Autumn 2018 edition of the Primary Care Respiratory Update. Find out more about the Respiratory Leadership Programme

The PCRS Respiratory Leadership Programme celebrated its 10th anniversary in 2017. To mark this milestone we are highlighting how some of the programme’s alumni are using the skills they have learned to improve patient care. Originally published in the Winter 2017 edition of the Primary Care Respiratory Update. Find out more about the Respiratory Clinical Leadership Programme

How one long term condition might be used to fulfil the potential of PCN investment. PCRS Service Development Committee member, Stuart Shields, has written "10 top tips for PCN clinical directors - The respiratory long term condition perspective"  to support Primary Care Network clinical directors working to improve local respiratory services.  

The exhaled carbon monoxide (CO) test detects exposure to CO in the last 12-18 hours. This can be used to assess smoking status AFTER a quit attempt and used prior to a quit attempt as a motivational tool. Higher levels (parts per million) equate with greater inhalation of tobacco smoke assuming the cause is tobacco smoking. It must be noted that the exhaled CO test indicates recent exposure to CO and will not indicate smokeless tobacco use and is not a measure of dependency.