It was widely recognised that pulmonary rehabilitation is the only non-pharmacological evidence-based treatment for COPD which enhances the quality of life for patients along with improvement in self-sufficiency. Therefore, it was agreed that the transformational change be directed towards the pulmonary rehabilitation resource in NHS Ayrshire & Arran.
A work programme was devised under the sponsorship of the Respiratory Fast-Forward Prescribing Group, incorporating members of the community pharmacy and prescribing teams, a hospital pharmacist, the respiratory clinical nurse specialists, physiotherapy lead, public health representative, respiratory consultant and MCN manager. The group, chaired by a GP member with interest in respiratory, commenced implementing a comprehensive action plan to address prescribing while also acknowledging and seeking to address the need to provide support through other therapies and interventions that would benefit the patient.
The actions included targeting particular patient groups overusing short acting beta agonist inhalers; having prescribing teams work alongside nurses to ensure compliance with formulary, and appropriate switching and education of patients on respiratory medicines.
To support the primary care respiratory prescribing initiative, a community pharmacy respiratory project was initiated which aimed to improve patient outcomes through a clinical review in the pharmacy to assess patients’ inhaler techniques, provide targeted information about relevant services available to patients, and promote the use of the local Asthma Action Plan (where appropriate).