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PrescQIPP respiratory webkit

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Context

PrescQIPP NHS programme produces guidance and tools to support medicines optimisation in primary care. The Asthma Focus resources were developed following the publication of the national review of asthma deaths report and subsequent update of the British Thoracic Society guidelines. The respiratory webkit brings together all the PrescQIPP respiratory resources on a web-based format allowing easy access of tools and ability to select projects to implement.

Aims

To improve the care of patients with asthma (both adults and children) and raise awareness of the key safety messages highlighted in the National Review of Asthma deaths reported as well as where particular inhaled medicines fit on the British Thoracic Society Asthma treatment pathway.

Description

The Asthma Focus section of the Webkit contains resources to support medicines optimisation for patients with asthma, which include:

A bulletin and briefing highlighting key evidence, national guidance, spend on treatments and options for implementation of change.

Pathway documents indicating where inhaled therapies fit on the treatment pathway are available for adults, children aged five to 12 and children under five. 

Tools for healthcare professionals to support inhaler technique assessment are available for different types of inhaler including links to video demonstrations, tips to improve inhaler technique and space for the healthcare professional to provide feedback to the patient in writing. 

Audit tools are available to support practices wishing to review at risk asthma patients and those that may be on long-term high dose inhaled corticosteroids.

For members, benchmarked prescribing data to help them identify variation in practice. The data also shows a comparison to the 10 closest CCGs.

Implementation

Member CCGs can download data and the tools currently and use them as they wish locally. They are adaptable to meet local need and also include the option to add local NHS organisation branding. The resources (excluding data) will be freely available in May 2015.

Suggestions for further implementation

Medicines management teams can work with local clinicians CCG to agree and complete the adaptable pathways with local formulary choices. The audit tools and searches can be used locally in practices to identify at risk patients and those needing review, so measures can be introduced to improve their care.

Challenges and learning

There are no licences ICS/LABA combination products available for use in children aged five to 12 at step four of the pathway. Any use at this step of a combination product (which is recommended by the BTS and NRAD) would be off label and this presents a challenge for prescribers. We plan to do further work to address this issue.

Quality assurance/MHRA registration

PrescQIPP resources go through a robust Quality Assurance process, both from a strategic point of view as well as the consideration of evidence base. Stakeholders such as the pharmaceutical industry may also comment on the resources before they are signed off and published.

Full QA process available here: http://www.prescqipp.info/prescqipp-reference-resources/finish/1-public-documents/831-prescqipp-quality-assurance-process