Isle of Wight Free Steroid Inhaler Pilot Project

Patients are empowered to improve the quality of their care through a simple contract that requires them to comply with an annual treatment plan in return for free steroid inhaler prescriptions. Primary care GPs, Asthma Specialist Nurses and Community Pharmacists work closely to manage patients and ensure that the annual reviews are attended. This project responds to many of the recommendations in the National Review of Asthma Deaths (NRAD).

We know that many patients with Asthma fail to attend their annual reviews and the aim of this project is to provide them with an incentive of free prescriptions for steroid inhalers. Participants must meet the inclusion criteria i.e. adults aged 18+, diagnosed with asthma.

The All People with Asthma – Personal Asthma Action Plan (PAAP) forms the basis of a ‘contract’ between the patient and HCPs that requires full attendance at the annual asthma review.  The patient can then take this to their pharmacist who will undertake an ‘MUR (Medicines Use Review) Plus’  at regular intervals on three separate occasions throughout the 12-month cycle.  For example, this would be 1) initial consultation and enrolment onto pharmacy database, 2) between 3-5 months, 6-9 months and then again at 12months.

This project expects the GP Practice and Community Pharmacy to jointly manage the patient who must also engage with the healthcare professionals to get the best out of their care. It complies with many of the recommendations from the NRAD including:

• All people with asthma -personal asthma action plan (PAAP)
  
• Annual structured review by a healthcare professional with specialist training 
  
• Asthma control assessment at every review. Where loss of control is identified, immediate action is required including escalation of responsibility, treatment change and follow-up 
  
• Patients prescribed more than twelve Short-Acting Beta-Agonists (SABAs; fast-acting ‘reliever’ medicines) in 12 months - for urgent review of their asthma control
  
• Assessment of inhaler technique - routinely undertaken and also checked by the pharmacist
  
• Monitoring non-adherence with preventers
  
• A single combination inhaler where long-acting beta agonist bronchodilators are prescribed for people with asthma 
  
• Encouraging self-management to reflect patients’ known triggers.