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The role of pharmacy in supporting children and young people with asthma

Donal Markey blogs for Respiratory Futures

Wednesday, June 29, 2016

  • Donal Markey is a practising community pharmacist in Berkshire, the pharmaceutical advisor supporting Healthy London Partnership’s children and young people programme, part of the Asthma Clinical Leadership Group
  • He is also Head of Primary Care Commissioning for Dentistry, Optometry and Pharmacy in NHS England London
  • Here he explains what prompted the recent launch of an online asthma toolkit and learning hub for pharmacists

As a practicing community pharmacist, I see many children and young people who have asthma in my pharmacy.

When I ask them whether they know how to use their inhaler, many of them say that they do.

However, when carrying out an inhaler technique assessment, it often turns out that many of them are using their inhaler incorrectly. Common mistakes are not shaking the inhaler (pMDI) beforehand and not breathing out before inhaling the dose. Another common issue is the absence of a spacer device for younger children or the reluctance to use one with older children and adolescents.

When inhalers aren’t used properly they are less effective and the chances of a life-threatening asthma attack increase. 

An asthma audit carried out across London pharmacies in 2015 found that one in four children had requested emergency inhalers in the last 12 months.

These requests also suggest children and young people are struggling to manage and control their asthma.

We know there are still issues with asthma care for children and young people in London and change is needed across the system. Less than 52 per cent of children have an asthma action plan and there are too many admissions to hospital – of which 70 per cent are preventable.

An asthma audit carried out across London pharmacies in 2015 found that one in four children had requested emergency inhalers in the last 12 months.

More education is needed for families and schools, particularly around prevention and how to manage asthma. At Healthy London Partnership we are working to support all those who care for the 200,000 children and young people with asthma in London. 

In May this year we launched for testing an online asthma toolkit that aims to provide pharmacists, GPs, hospital staff, schools and parents and carers with all the practical tools, guidance and information they need to provide the best care.

To further support community pharmacists, we have just launched an asthma learning hub which aims to enable pharmacists in London to further develop their skills around children’s asthma care.

When developing the asthma audit across London pharmacies in 2015, it became apparent that there was a gap in the learning resources available to community pharmacists on asthma management in children and young people with most resources focused on adults. This was confirmed by feedback from community pharmacists who took part in the audit.

Developed with input from community pharmacists in the capital, the hub provides free online learning sessions for pharmacists to work through at their own pace.

The hub has a focus on inhaler technique assessments, use of spacer devices and includes videos and guidance on how to how to carry out an assessment, as well as details of common mistakes children and young people make when using their inhalers and spacers.

As an easily accessible source of advice and support, community pharmacists have a vital role to play in supporting and educating children and young people with asthma and their families.

Medicines-use review or new medicines service are advanced services commissioned by NHS England and available in approximately 88% of London pharmacies. They provide a perfect opportunity for community pharmacists to assess asthma control and inhaler technique and the hub includes tips on how pharmacists can apply their learning to ensure children and young people get the most out of these consultations.

As an easily accessible source of advice and support, community pharmacists have a vital role to play in supporting and educating children and young people with asthma and their families.

Asthma is often thought of as a trivial childhood illness but it can be deadly and needs to be taken seriously.

It can have a major impact on a child’s life, with time spent off school affecting their education. 

Time spent in hospital can be distressing, while parents often have to take time off work to care for them.

If community pharmacists can offer an inhaler technique assessment through a medicines use review or new medicines service to the children and young people we see with asthma, we can make a big difference in helping them to control their condition and reduce the risk of asthma attacks.

 

  • Healthy London Partnership is a partnership between London’s 32 CCGs and NHS England (London) which aims to transform health services in London and make the capital the world’s healthiest global city by 2020
  • Developed by Healthy London Partnership and Education for Health with funding from Health Education England, the asthma learning hub can be found here, and the toolkit here.