A nationwide survey of 1,406 people, carried out between April and June 2021 by the Taskforce for Lung Health – a coalition of over 40 organisations aiming to improve lung health in England – revealed that 75% of respondents with asthma and chronic obstructive pulmonary disease (COPD) in England did not have their annual inhaler check last year.

“We know that up to 90% of people who use inhalers can't use them correctly,” Darush Attar-Zadeh, a community pharmacist and a taskforce member, added last week (April 8).

This is why community pharmacies should be “funded to provide annual inhaler technique checks to address the huge unmet need in lung disease in England”, the taskforce stressed. 

C+D has approached both the Department of Health and Social Care and NHS England and NHS Improvement to ask if they would consider the taskforce’s request for funding.

 

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“With more than 1.6 million people visiting a community pharmacy each day,” Mr Attar-Zadeh said, pharmacists are “well placed to help patients with their inhaled medication”.

Pharmacies also offer “a convenient and less formal environment for those who cannot easily access other kinds of health service”, he added.

The coalition pointed out that pharmacies need “further integrating into the patient pathway to work with the rest of the NHS to reduce the existing health inequalities in lung disease”.

 

Millions missing out on checks

 

The taskforce estimates that 3.3 million people annually “miss out” on learning how to use their inhalers as intended.

However, only 43% of those who did have an inhaler check were asked to show their healthcare professional that they ‘could use my inhaler with the correct technique’ before completing the technique check, the taskforce added.

Of the respondents, 88% said they found the inhaler technique check helpful, with 41% changing the way they used their inhaler based on the feedback they received.

While “correct inhaler technique can be tricky, especially as models differ”, the taskforce said, it is “essential” that patients are given guidance to ensure “they get the full benefit of the medication to manage their condition well and prevent it from worsening”.

 

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According to data published by the Office for Health Improvement and Disparities, 30,577 people were admitted to hospital for emergency asthma treatment during 2020/21.

Access to “crucial” annual asthma checks is “likely” to have been impacted by COVID-19, “as all primary care services are currently experiencing backlogs”, the taskforce added.

The NHS does not have “enough capacity or the sufficient workforce to see and support all of the patients who need care”, it said.

 

Pharmacy “could hold the key” to reducing health inequalities

 

Following the survey results, the taskforce is also calling for regular reviews with a GP to be part of the care every patient with a lung condition receives, “to make sure inhaled medication is always used safely and effectively”.

Commenting on the study, Lottie Renwick, vice-chair of the Taskforce for Lung Health and senior policy officer at Asthma + Lung UK, said that community pharmacy “could hold the key to providing much needed care and reduce health inequalities”, given “99% of the most deprived communities live within a 20-minute walk” of one.

 “Community pharmacies need to be recognised as a vital resource and used to support people living with lung conditions at a time when health services are increasingly stretched,” she added.

Alastair Buxton, director of NHS services at the Pharmaceutical Services Negotiating Committee (PSNC), told C+D today (April 11) that PSNC has been asking the NHS and the government for a “properly commissioned” inhaler technique check service outside of its involvement with the taskforce,

“Pharmacy teams support these patients through the new medicine service, but regular reviews of inhaler technique are required for maximal impact.

“This should be commissioned via the Community Pharmacy Contractual Framework, and it would require additional funding over and above the current contract sum,” Mr Buxton added.

Under the Pharmacy Quality Scheme (PQS) 2021/22, pharmacy teams were asked to identify patients with asthma or COPD, who were prescribed a new inhaler between April 1, 2020 and August 31, 2021, “but did not have their inhaler technique checked due to the COVID-19 pandemic”.