Pharmacists Could Enhance Asthma And COPD Care

Pharmacists are being urged to identify and refer patients with chronic lung and other conditions who have problems with their medication, following research showing that two thirds of asthma and COPD patients are under-using preventer inhalers and risking unnecessary breathing problems.


The research, discussed at the Royal Pharmaceutical Society's annual event, the British Pharmaceutical Conference in Manchester, showed that 64% of patients with asthma or COPD in a Cheshire PCT were under-using their preventer inhalers. They made them last days or weeks longer than would be expected if they were using them correctly.


This meant that the patients, who live in a part of the country with the highest asthma-related hospital admission rate in the UK, were missing out on essential corticosteroid drugs which form the backbone of preventive treatment for asthma and COPD. It is estimated that poorly controlled asthma costs the NHS ВЈ900m every year1.


"Maximum benefit from these important medicines is only achieved by regular use, even when patients are symptom free. The fact that so many patients aren't using their preventer inhalers means that we must look for new ways to identify those who need extra help with their medicines," explained Dr Ian Cubbin, of Liverpool John Moores University.


He suggested that pharmacists could play an important role in monitoring repeat prescriptions and referring patients who are under-using medication, as well as advising on good technique when using an inhaler:


"Patients with chronic diseases, such as asthma and COPD, see their community pharmacist more often than their GP. Through clinical medication reviews, pharmacists can help or refer patients who are having problems with their medicines before these become more serious, and thus help to reduce hospital admissions," he added.


Notes


The study was called An investigation into how poor compliance traditionally associated with corticosteroid therapy in asthma and chronic obstructive pulmonary disease can be improved to enhance long-term management and patient care. Authors: E. Marsden, I Cubbin and A McAlavey. It involved patients in the former Ellesmere Port and Neston Primary Care Trust. A total of 2, 340 patients with a diagnosis of either asthma or COPD were included in the study. Of these, 64% were under-using their corticosteroid inhaler and therefore receiving the drug at sub-therapeutic levels. A further 3% were over-using their inhaler and the remaining 33% were found to be compliant.


About asthma


5.4 million people currently receive treatment for asthma in the UK, and there are over 80,000 asthma-related admissions to hospital each year1. At least 75% of these admissions could be prevented with appropriate primary care management1.


About COPD


Chronic obstructive pulmonary disease (COPD) is an umbrella term for chronic bronchitis, emphysema and other lung diseases which result in damage to the airways, making it hard to breathe normally. An estimated 3 million people in the UK have COPD2, although many remain undiagnosed.


References


1.
Asthma UK. Where do we stand? December 2004


2.
Stang P, Lydick E, Silberman C et al. The Prevalence of COPD: Using smoking rates to estimate disease frequency in the general population. Chest 2000; 117: 354S-359S



The British Pharmaceutical Conference is the flagship annual conference of the RPSGB and is now in its 147th year. This year, it takes place in Manchester from Sunday 6 September - Wednesday 9 September inclusive. Around 1000 pharmacists from the UK and internationally will convene to debate practice issues and scientific developments affecting the profession during the four-day event.


Research released at BPC is published in the Journal of Pharmacy and Pharmacology.


Source
Royal Pharmaceutical Society of Great Britain

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