References

Newer and Common Inhaled Therapy for Asthma and COPD. 2020. https://www.primarycaretraining.co.uk/resource/respiratory-disease (accessed 2 February 2020)

Bousquet J, Winchester C, Papi A Inhaled Corticosteroid/Long-Acting β2-Agonist Combination Therapy for Asthma: Attitudes of Specialists in Europe. International Archives of Allergy and Immunology. 2012; 157:(3)303-310 https://doi.org/10.1159/000329519

British Thoracic Society/Scottish Intercollegiate Guideline Network. British guideline on the management of asthma. 2019. https://www.brit-thoracic.org.uk/quality-improvement/guidelines/asthma (accessed 2 February 2020)

Capstick T, Khachi H, Murphy A, d'Ancona G, Meynell H, Wilson P. Generic prescribing is not appropriate for inhaled drugs. The Pharmaceutical Journal. 2015; 294:(7845)

Cohen S, Taitz J, Jaffe A. Paediatric prescribing of asthma drugs in the UK: are we sticking to the guideline?. Archives of Disease in Childhood. 2007; 92:(10)847-849 https://doi.org/10.1136/adc.2007.119834

Creedon R, Byrne S, Kennedy J, McCarthy S. The impact of nurse prescribing on the clinical setting. British Journal of Nursing. 2015; 24:(17)878-885 https://doi.org/10.12968/bjon.2015.24.17.878

Electronic Medicines Compendium. Latest medicine updates. 2020. https://www.medicines.org.uk/emc/ (accessed 2 February 2020)

General Medical Council. List of Registered Medical Practitioners. 2016. http://www.gmc-uk.org/doctors/register/search_stats.asp (accessed 15 April 2016)

Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention. 2018. http://ginasthma.org (accessed 4 February 2020)

Kew KM, Karner C, Mindus SM, Ferrara G. Combination formoterol and budesonide as maintenance and reliever therapy versus combination inhaler maintenance for chronic asthma in adults and children. Cochrane Database of Systematic Reviews. 2013; https://doi.org/10.1002/14651858.cd009019.pub2

National Institute for Health and Care Excellence. Asthma: diagnosis, monitoring and chronic asthma management. 2017. http://www.nice.org.uk/guidance/ng80 (accessed 2 February 2020)

Right Breathe. Inhaler prescribing information. 2020. https://www.rightbreathe.com (accessed 2 February 2020)

Shrewsbury S. Meta-analysis of increased dose of inhaled steroid or addition of salmeterol in symptomatic asthma (MIASMA). BMJ. 2000; 320:(7246)1368-1373 https://doi.org/10.1136/bmj.320.7246.1368

The Prescription Medicines Code of Practice Authority. Prescription Medicines Code of Practice Authority. 2016. http://www.pmcpa.org.uk/thecode/InteractiveCode2016/Pages/default.aspx (accessed 8 April 2016)

Wathen B, Dean T An evaluation of the impact of NICE guidance on GP prescribing. British Journal of General Practice. 2004; 54:(499)103-107

Prescribing inhaled therapy in asthma: health professionals' habits and beliefs

02 April 2020
Volume 2 · Issue 4

Abstract

National and international asthma guidelines provide the evidence base for prescribing growing array of different inhaled therapies. However, the advice given is generic. The influence of nurses in prescribing inhaled therapy continues to grow, yet there is little published to help understand how and why nurses prescribe or advise on the prescribing of inhaled therapy in asthma. The aim of the study was to gain a better understanding of how health professionals make prescribing decisions in inhaled therapy, which was done by taking a survey. The survey gathered data of the habits and beliefs on prescribing inhaled corticosteroid/inhaled long-acting B2 agonist therapy in asthma, from 100 primary healthcare professionals. As a result of the study, patient preference, dose counter and maintenance and reliever therapy were reported to be considered the most important elements by health professionals. The device was considered more important than the drug, and there is an ongoing need for further education of health professionals in this area. Comparing responses from this study with similar responses from people with asthma may bring together the thinking of patients and professionals.

Inhaled therapy remains the mainstay of asthma pharmacology, with inhaled steroids (ICS) treating airway inflammation, and both short-acting and long-acting beta2 agonists (SABA and LABA) treating bronchoconstriction (British Thoracic Society (BTS)/Scottish Intercollegiate Guideline Network (SIGN), 2019; Global Initiative for Asthma (GINA), 2018).

While national and international guidelines support the use of ICS and LABA therapy (The National Institute for Health and Care Excellence) (NICE), 2017), the advice given is mostly generic. Yet conversely, generic prescribing should be avoided, and inhaled medication should only be prescribed by the brand name (Capstick et al, 2015; BTS/SIGN, 2019).

The number of ICS/LABA combination inhalers available for the treatment of asthma in the UK has increased to a total of 20 different brands, including generics. These combinations are available in 10 different inhaler devices, which, with the individual doses, represent forty different ways in which the health professional can prescribe inhaled ICS/LABA combination therapy for asthma (Booth, 2020; Electronic Medicines Compendium (EMC), 2020). When combined with inhaled therapy for chronic obstructive pulmonary disease (COPD), and the many individual mono-components and generics, there are currently 119 different ways that health professionals can prescribe inhaled therapy (Right Breathe, 2020).

Register now to continue reading

Thank you for visiting Journal of Prescribing Practice and reading some of our peer-reviewed resources for prescribing professionals. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month