Regional lung network calls for better patient awareness and training and less wastage

Thousands of people with lung conditions including chronic obstructive pulmonary disease (COPD) and asthma in the East Midlands could be putting their lives at risk because they have not been shown how to use their inhalers correctly.

The East Midlands Respiratory Programme, supported by the East Midlands Academic Health Science Network (EMAHSN) and the East Midlands Clinical Network has produced four videos to highlight the importance of inhaler technique for both healthcare professionals and patients.

Whilst inhalers are the preferred method of effective delivery of medication for people primarily affected by asthma and COPD, evidence suggests that people with lung conditions are unable to use their inhalers sufficiently. Furthermore, in many cases, the healthcare professional showing them how to use the inhaler has not had the training themselves.

Research on inhaler usage suggests that there is poor use and knowledge around inhaler technique by healthcare professionals. One study cited by the Drugs and Therapeutics Bulletin found that 91% of healthcare professionals who teach inhaler technique could not identify all the steps involved in administering a metered dose inhaler. The East Midlands Respiratory Programme is focusing on education about inhaler use, believing if healthcare professionals can get the core elements right it will make a real difference to people with lung disease.

Some facts:

76,000 patients (1.6% of the East Midlands population) have been registered as having COPD. This resulted in nearly 11,000 COPD admissions in 2014/15 and considerable burden from

symptoms. Even more concerning is that around 83% of people with COPD are unable to use their inhalers correctly. This is concerning because correct inhaler use controls symptoms. Incorrect inhaler technique increases the risk of severe flare-ups and hospitalisation for people with COPD.

Around 45% of patients stop using their inhalers within a year, probably because they are incorrectly used and therefore do not appear to work. More than 385,000 people, about 9% of the population, live with asthma in the East Midlands. This resulted in over 8,000 emergency admissions in 2014/15 and 125 asthma related deaths in 2015. The National Review of Asthma Deaths identified that prescriptions and use of inhalers were key factors in some of the deaths. The UK has the 3rd highest death rate from Asthma in Europe. Anyone with asthma using a reliever medication three times a week or prescribed 12 inhalers a year needs urgent review. Asthma UK estimate that 100,000 people with asthma in the UK are at risk because they rely on reliever medication.

The Asthma UK Annual Asthma Survey 2015, found that 79% of people in the East Midlands received correct inhaler technique guidance from their nurse or GP and only 35% have asthma action plans – which could be putting their lives at unnecessary risk. In asthma, correct inhaler use saves lives. Asthma and COPD are now amongst the most common long-term conditions in the world and have combined costs to the NHS of over £2bn. Correct inhaler use is vital.

The new videos aim to provide a refreshing and engaging outlook for healthcare professionals and users of inhalers leading to an increase in awareness of the importance of using the devices correctly.

Professor Mike Morgan National Respiratory Clinical Director NHS England said: “delivering adequate inhaler training is a fundamental responsibility for every health care professional.

”Professor Mike Hannay, Managing Director of EMAHSN said that; “Asthma is often a silent killer, with many people just getting on with their lives and perhaps not taking their medication as prescribed. Much of the time, this may not be their fault, because they are not aware of the correct inhaler techniques and latest guidance.

“These new videos, make it very clear and very easy for both healthcare professionals and patients to see exactly how they should be taking their vital medicines.”

With World COPD day taking place on 16 November 2016, the Respiratory Programme is asking anyone who teaches about inhalers or uses them to watch the videos and check their understanding of inhaler techniques.

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Notes to editors

East Midlands Clinical Networks

• Support improvement in the quality and equity of care and outcomes of the East Midlands. www.emsenate.nhs.uk

East Midlands Academic Health Science Network

• EMAHSN is one of 15 Academic Health Science Networks in England. EMAHSN brings together the NHS, universities, industry and social care to transform the health of the region’s 4.6M residents and stimulate wealth.
• Current priorities focus on identifying and spreading innovations that address challenges including cancer, obesity, diabetes, mental health, respiratory disease, stroke, liver disease and support for frail older people.

Sources

Health survey for England, ONS

NHS Digital (formerly HSCIC)

Asthma UK Annual Asthma Survey 2015

Asthma UK funded research: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-016-0657-8

www.respiratoryfutures.org.uk


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