No abstract

Outcomes COPD Assist was launched in March 2014, then publicised to all Salford's primary care clinicians supported by 5 training seminars with over 70 clinicians attending.Within 4 months following its launch, COPD assist was downloaded 622 times by different users, with an average use time of 7 min and average of 9 screens viewed per session. 52% of users have used the app more than once.Feedback was excellent, particularly around ease of use and simplicity. Conclusions This bespoke smartphone app to support the implementation of local primary care COPD guidelines appears to be widely acceptable to users and could potentially promote these guidelines. However, more research around clinically meaningful outcomes, such as adherence to guidelines and impact on prescribing, is required to assess the true impact of such technology on the management of COPD in primary care. P29IMPACT Introduction There is considerable variation in accuracy of diagnosis and long-term management of COPD in the UK. High rates of inhaled corticosteroid (ICS) prescribing have been reported, raising concerns about their over use, with less focus on high value interventions like stop smoking support/pulmonary rehabilitation. ICS are indicated in severe COPD patients (FEV 1 <50% predicted) with frequent exacerbations (>2 per year). Primary care data from SE London showed that 38% of COPD patients were over treated with high dose ICS, resulting in 12 additional cases of pneumonia, and costs >£500,000, annually. There is limited guidance on methods and feasibility of withdrawing ICS in these patients. Methods A responsible respiratory prescribing group including CCG medicines management, respiratory pharmacist and integrated respiratory team agreed COPD prescribing guidance across primary/ secondary care. GPs were supported with COPD review templates, written step down protocols and educational events. Virtual clinics with an integrated respiratory consultant/ GP respiratory lead were offered to support ICS withdrawal in primary care.

No abstract

Primary care networks (PCNs) are geographical networks consisting of 30,000 to 50,000 patients and groups of general practices working in a multidisciplinary team, including community pharmacists. Community pharmacy (CP) neighbourhood leads act as a conduit between pharmacy contractors and general practitioners (GPs) in these networks, sharing information and providing a voice for the community pharmacy locally. The Lambeth medicines team (NHS South East London Integrated Care Board) recognised the need to continue funding these leadership roles to address barriers to relationship-building between community pharmacies and general practices, the consistency of service delivery and effective communication. The aim of this study was to understand the current experience of CP neighbourhood leads to inform their further development. All eight CP neighbourhood leads individually completed a semi-structured interview over Microsoft Teams, which was then reviewed using content analysis. Ethical approval was received. Leads reported the use of common communication methods such as emails, text messaging applications and telephone calls to engage GPs and pharmacies in their neighbourhoods. Barriers to undertaking their roles included time constraints, delays in responses, high workloads and competing pressures. Other factors impacting their effectiveness and ability to undertake their roles included the scheduling of meetings outside of working hours, finding time during busy working days and organising locum cover on an ad hoc basis. The leads also reported they spent more time focussed on building relationships with their peers and less time focussed on general practice colleagues. Support for CP neighbourhood leads could include ensuring that funded time is protected; communication and technology training; and the provision of more structural support for communication with GPs. The findings of this study can be used to inform future work.

This study aimed to identify and determine the confidence level of community pharmacists in providing different interventions during asthma-targeted medicine use reviews (MURs). A self-administered questionnaire was posted to 487 pharmacies accredited to provide the service, across Greater London, Southampton, Cornwall, Sheffield and Norwich. A total of 122 responses were obtained, giving a response rate of 25% (122/487). Around half of the community pharmacists (51.6%) were providing more than 60 asthma-targeted MURs annually with inhaler technique being the most offered intervention and stepping up/down therapy being the least. The majority of community pharmacists (94.3%) were confident in providing inhaler technique advice, followed by smoking cessation (91%). However, confidence was less with relevant vaccination (61.5%) and stepping up/down patients’ therapy (56.6%). Confidence level can vary between community pharmacists regarding different interventions provided during respiratory MURs. The results stress the need to promote community pharmacists’ confidence in providing interventions such as stepping up/down therapy during asthma-targeted MURs. Additional research in this field is highly recommended in order to evaluate community pharmacists’ confidence level on a national scale and to determine the factors influencing it. The study also suggests that provision of different interventions during respiratory MURs can be related to how community pharmacists perceive their role.