Clinical Effectiveness Referral for asthma review
th and th 2017 Revi view dates es April il 24 th d Nov 28 v 28 th 2017 Available points = 10 per review point Total points in year is 20 Worth £1280
On the day of the review, the pharmacy can show evidence of certain asthma patients referred to an appropriate health care professional (HCP) for an asthma review These patients will have had more than 6 short acting bronchodilator (SABA) inhalers dispensed without any corticosteroid inhaler within a 6 month period.
National nal Revi view of Asthm thma a Deaths aths (NRAD) ) report ort recommended: mended: ◦ Asthmatics should have structured review at least annually ◦ Asthmatics prescribed more than 12 SABA inhalers in previous 12 months should have an urgent review of their asthma control ◦ Aiming to improve control via education and treatment change (if needed)
◦ Pharmacy professionals ideally placed to detect under and over usage ◦ Such interventions may already be commonplace ◦ QP Scheme aimed at using this info to trigger asthma review (as recommended in NRAD report) ◦ Further info in NHSE document – see handout
Aim of QPS criteri erion: on: ◦ contribute to reduction in asthma deaths by surveillance of inhaler use ◦ Ensure patients given appropriate advice ◦ Refer them for asthma review where appropriate
Surveil rveillance ance required uired – focus us on SABA BA inhal aler ers could be a combinati tion on of one or more of: ◦ Monitor how many SABA dispensed in rolling 6 months period PMR or SCR ◦ Monitor requests for emergency supply of SABAs ◦ Monitor OOH / urgent Rx for SABAs ◦ Monitor repeat Rx requests for SABAs ◦ Monitor SABAs as part of an MUR or NMS consult ◦ Monitor non-collection of Rx for steroid inhalers
◦ Pharmacy chooses how to engage and implement surveillance Should be a SOP in place to define the process Example of process is provided on handout 2 ◦ Minimum requirement: Review the historic dispensing of SABA and steroid inhalers for asthma patient if dispense Rx for a SABA inhaler and no inhaled steroid dispensed at same time. ◦ These tasks may be done by any appropriately trained team member ◦ Referral should be to an HCP with specialist asthma training (eg patient’s GP, GP practice based respiratory nurse specialist or “asthma nurse”
Re Reporting rting / Claimin ming ◦ Declaration required that pharmacy has: Identified patients with more than 6 SABA and 0 steroid inhalers within 6 month period Referred those patients to appropriate Health Care Professional Pharmacy must retain evidence of this process to prove compliance ◦ No patients identified? Pharmacy can claim points if: Evidence available to show they have been looking for patients (SOP and evidence this is followed) Pharmacy has process in place for referrals should a patient be identified
Re Reporting rting / Claimin ming ◦ No referrals because identified patient(s) refused referral for asthma review? Pharmacy can claim points if: Pharmacist discusses risks of uncontrolled asthma with patient Pharmacist discusses benefits of preventative treatment Pharmacist discusses benefit of attending for asthma review Pharmacy team supports to have best asthma control possible Patient who has had this intervention and refused referral should not be continually referred for review Evidence should be retained in pharmacy to show this process has happened
Summary mary th and th 2017 Revi view dates es April il 24 th d Nov 28 v 28 th 2017 Available points = 10 per review point Total points in year is 20 so Worth £1280
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