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Download Slide 1 - NHS Lambeth CCG
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Medicines Optimisation SE London asthma and COPD guidelines Finlay Royle Senior Clinical Commissioning Pharmacist Lambeth CCG 1 Medicines Optimisation Key theme: Quality, Safety and Medicines Waste 2 Medicines are the most common therapeutic intervention in healthcare, but their use is often suboptimal for a variety of reasons and this can lead to medicines not being used as intended and ‘waste’ in the health economy. 3 4 Asthma Pyramid metrics (Lambeth CCG practices) September 2015 v May 2016 % patients receiving intervention 120% Sep-15 100% May-16 Asthma pyramid metric 80% 60% 40% 20% 0% Short-Acting Beta-Agonist Step 4 (inhaled steroid) Quit Smoking CO check Treatment Asthma Action plan Inhaled steroid issued (adherence check) Intervention type Spacer issued Very Brief Inhaler check Advice 5 6 SEL Respiratory Guidelines: Management of COPD & Asthma New inhaler treatments available on market: – New molecules – New combinations – New devices Previous guidelines across L&S out of date SE London group set up: – – – – Consultants, nurses, pharmacists across SEL Review evidence, safety and value Patient feedback on devices Guidelines for asthma & COPD SEL Respiratory Guidelines: Management of COPD & Asthma General recommendations: • Detect & treat tobacco addiction • Branded prescribing • Patient adherence / technique check • Self-management plans • High-dose inhaled steroid – specialist • Spacer device for Metered-dose inhalers 8 Asthma 9 10 Asthma – key changes 11 Respiratory – asthma New devices on formulary: DuoResp Spiromax Fostair Nexthaler (& MDI) Easyhalers Lower lid to present dose Open lid to present dose Click to present dose Budesonide + formoterol Beclometasone + formoterol Various drugs Dose counter Dose counter Dose counter If cap is opened, dose released, counter decreases Counter only decreases if powder inhaled If clicked, dose released, counter decreases 12 COPD 13 14 COPD – key changes Respiratory – COPD LABA / LAMA devices on formulary: Ultibro Breezhaler Duaklir Genuair Anoro Ellipta Insert capsule, pierce Click to present dose Lower cap to present dose Once daily dosing Twice-daily dosing Once daily dosing Visual indicator Audible and visual indicators Ellipta device available for steroid Rx Follow-on from Seebri Breezhaler Follow-on from Eklira Genuair Follow-on from Incruse Ellipta 16 Make a pledge to be an Antibiotic Guardian It takes less than 2 minutes https://antibioticguardian.com/ 17
