Optimising Inhaler Technique Through Early Pharmacy Technician Intervention

Abstract

Background: Inhaler therapy remains an essential aspect in the management of respiratory conditions. Approximately 80% of people worldwide are prescribed inhalers they are unable to use correctly, leading to preventable exacerbations, increased healthcare use and unnecessary medication waste. At Leeds Teaching Hospitals, inhaler technique assessments are often delayed until discharge, which can result in waste and missed opportunities for early interventions. Aims: To evaluate how interventions to optimise inhalers can be incorporated into the drug history, and how prioritising early inhaler technique assessments can reduce waste and the carbon impact associated with inappropriate prescribing in line with the NHS green agenda. Methods: The project was carried out across five respiratory wards at St. James’s University Hospital (SJUH). Baseline data was collected over a 12-day period whereby inhaler technique assessments were not conducted during the drug history and showed 40% of patients required intervention at the point of discharge. On average, an inhaler assessment at discharge took 12.5 minutes to undertake. Pharmacy technicians then incorporated inhaler technique assessments into the drug history stage over a period of 40 days documenting interventions made and time to undertake. Results: During the audit period, 277 patients (71%) were prescribed inhalers prior to admission, including 74 (19%) who were using a combination of non-standardised inhaler devices (a mixture of metered dose inhalers and dry powder inhalers). Pharmacy technicians were able to conduct 140 inhaler technique assessments (50.5%) during the drug history stage, and most assessments added fewer than 5 minutes to the process. 34% of patients had good technique, 26% of patients showed improved technique following intervention and 25% of patients had their inhaler devices optimised following intervention. Conclusion: Early assessment provides meaningful opportunities to optimise therapy, minimise errors and to reduce medication waste. Integrating inhaler technique assessments into the drug history process is both feasible and efficient.