CHP Respiratory meeting

WelcomeDr Ninian Hewitt

What we do well

• Asthma- Control improved with ICS in the

90’s

What we do well

• COPD- More patients diagnosed- Referrals to PR

What we do well

• Prescribing- Lothian is one of the most

efficient low cost Regions in Scotland

Objectives

• If we are doing reasonably well why the fuss?

Objectives

Correct DIAGNOSISCorrect DRUG

Correct DOSE

All quality based We can do better for our patients

Quality Improvement

• AsthmaIsle of Wight

• Involved all Practices and Pharmacies• Result• Reduced Acute episodes • Reduced admissions• Reduced prescribingAll by concentrating on drug concordance and inhaler technique

Quality Improvement

• AsthmaNorthern Ireland

Co-ordinated drug control by GP pharmacy and PatientsLed to lower prescribing and better control

This has been sustained!

Quality Improvement

• Asthma Step down Inhaler usage Acute Prescribing• COPD Diagnosis (spirometry) Inhaler for appropriate • Severity Maximising exercise tolerance

CORRECT DDD

Prescribing to be introduced by - Katie Johnston & Maureen Reid

LJF first line may cover 90% of all patients Asthma COPD

CORRECT DDD

• Practical sessions – Anne Ritchie/Liz Young

• Central to all review Inhaler technique•Central to diagnosis esp. COPD Spirometry

Future

We are at an unprecedented time with new inhalers especially for COPD

Watch out for news from LJF this autumn

New CombinedNew dose schedulesLAMA/ LABA

Respiratory Toolkit

• The paper bag• Contents• Web addresses• Paper inserts• Trainhaler• COPD 6

Thank You and Enjoy the day