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module menu icon Example of a planned CPD entry after reading this module

Example of a planned CPD entry after reading this module

Title: Improving asthma care

What did you learn?

“I learnt that treatment is moving away from short-acting beta-agonists (SABAs) and ‘two inhaler’ prescribing. Instead, combination inhalers containing a corticosteroid (ICS) and the long-acting beta-agonist formoterol are becoming the mainstay of treatment for most patients with asthma.

It was depressing to read that so many patients with asthma still have suboptimal control when there are such effective medicines available. Avoidable hospital admissions and asthma deaths are still commonplace and although the contributory factors are complex, there is much scope to improve patients’ quality of life and enable them to take more control over their asthma.

These thoughts were running through my mind while reading the CPD module and thinking about what I and my team could do differently. An obvious area was to plan how I could use this learning in the services my pharmacy already provides, particularly the NMS.

What form did the learning take?

In addition to completing the Pharmacy Magazine CPD module on Next Steps in Asthma Care, I looked at the updated (2024) NICE/BTS/SIGN guideline on chronic asthma.

Give an example of how this learning has benefited the people who use your services

I felt it was crucial, given the many pressures that we are under in community pharmacy, not to try and make unrealistic changes in my practice. NHSE, in its medicines optimisation priorities, mentions using the NMS as a key tool to establish effective use of treatment at diagnosis, as well as using treatment changes as a chance to remind patients about compliance and reinforce advice about optimal medicines use.

We are seeing more patients prescribed combination ICS/LABA inhalers and I’ve done a few NMS consultations with them. I found that patients who had been diagnosed with asthma for the first time were pretty happy with their new inhaler — but dealing with those who were being changed from separate ICS and SABA inhalers to a single combination product was much less straightforward.

Some people were worried about using steroids regularly but most were reassured after I explained how small a dose they would be using and that the new treatment would be more effective at keeping their asthma under control.

There will be a lot of patients who have been using the same inhalers for a long time and whose asthma control is poor – but they have got used to this and it is normal for them. When doing a NMS intervention for these patients, I always ask one of my dispensary team to do a quick check of the PMR to spot potential overuse of SABAs and underuse of inhaled corticosteroids.

During the NMS conversation I use the Asthma Control Test to help patients understand whether their asthma is well controlled or not. It only takes a couple of minutes and I find it is a powerful, helpful tool.”

Reflection exercise

Thinking about what you have read in this CPD module, write down three things you are going to do as a result. These might include:

  • Discussing the AIR and MART treatment approaches with your team
  • Teaching key dispensary staff who use the PMR system how to check the number of SABA inhalers issued in the past six months
  • Signing up to be a SABA guardian
  • Identifying asthma patients who might be better suited to AIR or MART
  • Ordering some Asthma Control Test sheets or printing them off to share with your support team.
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