There are always a number of unsolved “niggles” ……. Personally, I think these give me the drive to keep trying to improve practice. My top three unsolved problems as they stand;
- Inhaler technique not being checked regularly and optimised. Far too many clinicians and patients cannot use inhalers correctly and it hasn’t improved significantly over the years. Data spanning 40 years show only 31% of patients with asthma or COPD use inhalers correctly. Recently, there has been an enhanced focus on the importance of inhaler technique and increased efforts to improve training to healthcare professionals and patients but it still feels we are a long way off making substantial improvements. Many HCPs and patients do not take the inhaler device seriously and do not think of it as an important medicine. This needs to change to improve patient’s lung health, quality of life and reduce overall NHS costs. I am beginning to wonder if a new approach to education is required.
- The burden of respiratory disease is increasing. Pharmacists and pharmacy technicians working in respiratory medicine are well placed to make a positive contribution to improving standards of care for patients in the future, but the current pharmacy workforce for respiratory is not sufficient, and our profession is often over-looked when services are commissioned. We need to ensure we have professional recognition of pharmacists working in respiratory medicine. I believe we need to define the level of clinical practice and specialised skills that characterise the respiratory pharmacist as a clinician, educator, researcher and manager. The recent Taskforce for Lung Health publication recognises the role of pharmacists in respiratory care and we need to continue to publicise and build upon this.
- Robust clinical guidelines, published by BTS, SIGN, NICE and other bodies are available to support evidence-based management of most lung diseases. Yet there is a stark picture of variation in the quality of care and outcomes experienced by people with respiratory disease in different parts of the UK. Identifying and reducing unwarranted variation must be the priority for the NHS moving forward.