Transcript Slide 1
And Breathe….. Educational solutions for the NHS pharmacy workforce Why are we here? Educational solutions for the NHS pharmacy workforce 2 Burden of asthma UK has largest prevalence of asthma in the world. There are 4.1 million adults with asthma in the UK and 1.3 million children Three people die each day from asthma, of which most are preventable 75 percent of hospital admissions for asthma are avoidable Educational solutions for the NHS pharmacy workforce 3 Burden of COPD COPD is a leading cause of mortality and morbidity worldwide and the 5th biggest cause of death in the UK One person dies from COPD every 20 minutes in England, around 23,000 a year 15 percent of those admitted to hospital with COPD die within three months and around 25 percent die within a year of admission Educational solutions for the NHS pharmacy workforce 4 Financial burden of respiratory disease NHS spends about £1 billion a year on prescribed respiratory medicines Cost per item is highest of all BNF categories at over £17 per item on average Only around 40 percent of asthmatics are compliant with treatment. If this doubled to 80 percent, the NHS could save £90 million per year COPD is the second most common cause of emergency admission to hospital and one of the most costly inpatient conditions to be treated by the NHS Educational solutions for the NHS pharmacy workforce 5 Pharmacy interventions improve outcomes Respiratory disease is an area where there is evidence that high quality pharmacy intervention can significantly affect patient outcomes Recent evidence: • SIMPLE project • The inhaler technique improvement project Educational solutions for the NHS pharmacy workforce 6 Learning outcomes By the end of this session you will be able to: Describe the differences between asthma and COPD and identify the signs that should alert people to the fact that their condition is not being well controlled Outline ways to improve outcomes for patients by helping them to take their medicines correctly Provide lifestyle advice to support people to manage their condition Identify useful resources available to the public and to healthcare professionals Educational solutions for the NHS pharmacy workforce 7 COPD and asthma: the differences Small groups One envelope per group 5 minutes to identify characteristics of each disease Educational solutions for the NHS pharmacy workforce 8 How did you do? COPD ASTHMA Airway obstruction Permanently damaged and narrowed Inflammation causes constriction; usually reversible Cough symptoms Chronic cough often with sputum Irritating cough, often at night Persistent and progressive Variable Uncommon Common Not common Common but variable Over 35 years Any age Nearly always Possibly Breathlessness Significant diurnal or day-today variability of symptoms Night-time symptoms that keeps patient awake Main age group affected Smoker or ex-smoker Educational solutions for the NHS pharmacy workforce 9 Asthma – the facts Asthma is a chronic lung condition in which the airways are inflamed and narrowed, making it harder to breathe normally The changes to the airways are fully reversible Although asthma often runs in families, many people with asthma do not have relatives with the condition. Hay fever and eczema are frequently associated with asthma – either in the person with asthma or in their family Educational solutions for the NHS pharmacy workforce 10 COPD - The facts COPD comprises a number of respiratory diseases, predominantly chronic bronchitis and emphysema It is preventable and treatable, characterised by airflow limitation that (unlike asthma) is not fully reversible. The airflow limitation is usually progressive and not curable 90 percent of cases are caused by cigarette smoking Although COPD affects the lungs, it also produces significant systemic consequences Educational solutions for the NHS pharmacy workforce 11 SIMPLE Stop smoking Inhaler technique Monitor control and adherence Patient education on medicines Lifestyle Education Educational solutions for the NHS pharmacy workforce 12 Stop Smoking Stopping smoking has been shown to reduce the rate of decline on lung function so is the key message for all those with asthma or COPD, regardless of their age NICE PH45 Tobacco Harm Reduction “This guidance recommends harm reduction as an additional new option particularly for those who are highly dependent on smoking who want to quit, but can’t just stop in one go” Educational solutions for the NHS pharmacy workforce 13 Inhaler technique Inefficient inhaler technique is a common problem resulting in poor drug delivery, decreased disease control and increased inhaler use Even with effective technique, maximum lung deposition from MDI is 15 percent Large volume spacers may be easier to use and they increase deposition to 30 percent Incorrect use is a huge cost to the NHS Educational solutions for the NHS pharmacy workforce 14 “Can you show me how you use your inhaler?” 75 percent of patients using an inhaler for on average 2-3 years reported they were using their inhaler correctly What percentage actually were? 10 25 50 75 90 10% Educational solutions for the NHS pharmacy workforce 15 How good is your technique? Patients’ inhaler technique can be significantly improved by brief instruction given by a trained healthcare professional What percentage of healthcare professionals who teach use can demonstrate them correctly? 9 29 59 69 79 99 9% Educational solutions for the NHS pharmacy workforce 16 Types of inhaler How many types of inhaler are on the market? MDI • Slow and gentle DPI • Fast and forceful Educational solutions for the NHS pharmacy workforce 17 Practical support http://www.leicestershospitals.nhs.uk/professionals Educational solutions for the NHS pharmacy workforce 18 Which inhaler is best? As healthcare professionals we consider the evidence and the costs BUT To optimise medicines use the key is the patient’s perspective Getting it right from their point of view can have a big impact on adherence and therefore the health outcomes Educational solutions for the NHS pharmacy workforce 19 Monitoring Educational solutions for the NHS pharmacy workforce 20 Patient education on medicines Difference between relievers and preventers Side effects Use of spacers Corticosteroids Oxygen use Educational solutions for the NHS pharmacy workforce 21 Lifestyle What lifestyle interventions should you be discussing? Educational solutions for the NHS pharmacy workforce 22 Lifestyle interventions Stop smoking Weight management Exercise Self management plans Trigger avoidance Vaccination Advice on heart disease, anxiety, depression for COPD Pulmonary rehabilitation Educational solutions for the NHS pharmacy workforce 23 Prevention of exacerbations Offer annual influenza / pneumococcal vaccination Give self management advice including use of rescue treatment where appropriate Optimise bronchodilator therapy with one or more longacting bronchodilator Add inhaled corticosteroids (as combination) Use of breathing techniques Educational solutions for the NHS pharmacy workforce 24 Education Educational solutions for the NHS pharmacy workforce 25 CPPE support Inhaler technique workshops Focal point : Asthma iPDF: New medicines service asthma and COPD Inhaler technique videos Coming soon: Learning@lunch: COPD Focal Point: COPD Educational solutions for the NHS pharmacy workforce 26 In Summary Respiratory diseases place a huge burden on the NHS and the wider economy There is mounting evidence that effective pharmacy-based interventions , particularly involving inhaler technique, can have a large impact on outcomes for both patients and the NHS Pharmacy technicians are well placed to support people with these long term conditions SIMPLE! 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