Time is the key issue I believe. It takes an effort to search and identify problem patients and even more to working positively to engage with these patients to reduce potential risk. With the dawning of PBPs, I feel there is huge scope to identify the problematic cohort and address many of the principles that came out of NRAD-like inhaler technique, increased use of preventative therapies and less reliance on reliever medicines through better PPAP use. Education of patients highlighting risks of poor control of Asthma, prompting regular review must be made a public campaign. It doesn’t seem to be on any politicians agenda (maybe I’m biased as we don’t have any local government).
Soar Beyond have developed an i2i programme for PBPs to advance these recommendations within a practice and to date has been hugely successful, as its structured insight through to implementation of the recommendations, maximises patient outcomes following the process.
Throw in poor inhaler technique of HCPs and SABA’s put onto repeat prescribing lists… its a recipe for disaster. Few are bold enough to make the call to assess each and every salbutamol request as a means of monitoring control/ management -as this would cause a backlog of work in an already pressured environment.
It appears that those of us with any insight is very forward thinking about NRAD and have actioned recommendations and want to make change possible but few are listening to the choir.