Respiratory conditions - quality prescribing strategy: improvement guide 2024 to 2027

Respiratory conditions are a major contributor to ill health, disability, and premature death – the most common conditions being asthma and COPD. This quality prescribing guide is designed to ensure people with respiratory conditions are at the centre of their treatment.


Appendix 1: Resources for clinicians and patients

My Lungs My Life

My Lungs My Life is a comprehensive, free website for anyone living with COPD, asthma or for parents/guardians of children with asthma. The resource is a collaboration between NHS, third sector and the University of Edinburgh.

In addition to general information regarding conditions, videos demonstrating technique on a number of the most commonly prescribed inhaler devices are provided. These may be considered useful when initiating or changing inhalers at a patient level.

Don’t Waste a Breath

The Don’t Waste a Breath website, developed by NHS Grampian, provides information for patients on inhaler technique and how to recycle inhalers. This website complements My Lungs My Life and is aimed directly at patients.

Personal Asthma Action Plans

There is substantial evidence to support the value of personalised actions plans for asthma in both adults and children. Clinicians should refer to local guidance and resources. Access a generic template from Asthma + Lung UK.

Stepping down of Chronic Asthma Drugs

Following a period of stable asthma, clinicians should consider stepping down treatment. The State of the Art Review ‘Why and how to step down chronic asthma drugs’ on the BMJ website provides a helpful reference source.

Charity Resources

The Chest Heart and Stroke Scotland website, the Asthma + Lung UK website and the Asthma and Allergy Foundation website have lots of information to support healthcare professionals and patients. There are patient leaflets, booklets and toolkits available for use and all have a patient helpline providing advice.

RESPe

RESPe is a free online learning resource provided by CHSS working with the University of Edinburgh for all healthcare professionals.

Resources to assist GP practices to review environmentally friendly respiratory prescribing

Access PrescQIPP respiratory care resources and campaign materials (developed jointly by NHS England and PrescQIPP). PrescQIPP also showcase good practice examples of projects in respiratory care and signpost to self-care resources available for organisations to use to support their own respiratory care campaigns.

Patient information resources to support environmentally friendly prescribing are included in the resources listed with the PrescQIPP inhaler carbon footprint bulletin e.g. What should I do if I need to use my reliever inhaler often for my asthma? (See example 1 below)

Greener practice has a toolkit designed to help UK general practices improve asthma outcomes whilst also reducing carbon emissions. It contains step-by-step Quality Improvement (QI) projects. Project resources include downloadable searches, educational videos, templates and patient information (See example 2 below).

The Royal College of General Practitioners (RCGP) Green Impact for Health toolkit has been developed and can help any general practice improve their sustainability and environmental impact; reduce their harmful impact on planetary health, the risks of climate change and reduce their practice expenses. It answers the question – ‘What can we do in our practice?’ and covers many aspects, including prescribing of inhalers.

The Centre for Sustainable Healthcare (CSH) offers strategic input and consultancy on sustainable healthcare research and practice to national and local programmes. There is a CSH network for Sustainable respiratory care with many resources and projects shared. Join the network to access their resources.

Example 1: Patient information leaflet focusing on SABA overreliance from PrescQIPP, which can be adapted for local use

What should I do if I need to use my reliever inhaler often for my asthma?

If you need to use your reliever inhaler for three or more days each week, then it may be a sign that your asthma is not well controlled.

Continue to use your reliever inhaler when you need it, and make a routine appointment at the GP surgery, so we can see if there is anything we can do to help you.

What can I also do to help myself?

  • make sure you use your preventer (treatment) inhaler every day even if you don’t have any symptoms. This should reduce how much you need to use your reliever inhaler.
  • look at your inhaler dose counter, if it has one, or think about ways to help you remember to use your inhaler.
  • check that you are using your inhaler correctly so that you get all the benefits from using your inhaler. You can read a leaflet or watch a video on how to use your inhaler.
  • follow your asthma action plan, which tells you what to do when your asthma symptoms are getting worse.

What is a reliever inhaler?

Reliever inhalers work quickly when you have symptoms like difficulty breathing, wheezing or coughing.

They contain a medicine that relaxes the muscles in your lungs and so opens your airways. This makes it easier to breathe and stops you from wheezing or coughing.

What is a preventer (treatment) inhaler?

Preventer (treatment) inhalers contain medicines what reduce any swelling or inflammation in your lungs making it easier to breathe.

They shield you from your asthma triggers.

Preventer inhalers should be taken every day as instructed on the label from your pharmacy.

Talk to your doctor, nurse or pharmacist if you are concerned about using an inhaler every day.

Example 2: Patient information leaflet from Greener Practice

View the leaflet ‘Inhalers and the environment – choosing an inhaler which is good for you and good for the planet’.

Contact

Email: EPandT@gov.scot

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