Our medicines optimisation working group

The Taskforce medicines optimisation working group was set up to drive forward Taskforce recommendations around ensuring that people diagnosed with lung disease are getting the best medicines and getting the best use out of them.

The group has a wide membership of patient representatives, professional bodies, patients, organisations and industry partners. The group’s chairs can be found on our about page.

As a group, we are currently working on three main areas of work, which were identified as priorities in the Taskforce’s five-year plan. These are:  

  • Improving inhaled therapy by making sure patients and health care professionals are well versed in inhaler technique best practice. 
     
  • Increasing awareness of community pharmacists with patients and their role in reviewing medications, prescriptions and the wellbeing of patients. Plus raising awareness with pharmacists of the needs of respiratory patients. 
     
  • Working to ensure the right people have access to the right medication for their specific respiratory conditions, such as antifibrotic drugs for people with idiopathic pulmonary fibrosis (IPF).

Improving understanding of correct inhaler technique

Inhalers are a vital part of treating chronic obstructive pulmonary disorder (COPD) and asthma but there are significant problems with their use. We know that many people make errors when using their inhaler, which means they do not take in the medication they need. This puts them at risk of their symptoms worsening and of them experiencing an exacerbation. We also know that people often overuse their (blue) reliever inhalers, which has can sometimes increase the risk of death in people with asthma.

Currently, too few people receive an annual inhaler technique check from their GP surgery, which means that they are at risk of their condition getting worse.

It is vital that all relevant health care professionals are trained on inhaler technique so they can coach their patients on how to use them effectively. Evidence suggests that this is not currently the case, with many practitioners lacking the confidence to support patients. A study on non-respiratory specialist healthcare professionals found that 88% agreed receiving training on inhaler technique assessments would improve patient care. 

 We have been working with the UK Inhaler Group to review and disseminate its Inhaler Standards and Competency Document and are working on signposting healthcare professionals to useful and accurate resources. This includes Taskforce member Asthma + Lung UK’s inhaler technique videos, which an audit by Taskforce identified as illustrating best practice.

In 2021 we ran a patient survey of people with lung disease on their experience of inhaler technique checks. We found more than three quarters of people had not had an inhaler technique check in the previous 12 months. Yet for those we had had one, almost 9 in 10 said it was at least somewhat helpful. 

We will continue to drive forward our recommendations on inhaler technique and as part of this we have produced and distributed regional information packs for the respiratory clinical networks on overuse of reliever inhalers in asthma, an example of which can be found here.

 Promoting the role of community pharmacists

In a survey conducted by the Taskforce in 2020 almost all (95%) respondents said that they regularly used one or more community pharmacy services and considered them to be valuable or essential. Nearly half (46%) said they used community pharmacies once a month, with 38% using them more frequently.

If properly resourced and integrated with other parts of the health service, community pharmacies provide an excellent opportunity to talk to people about their lung health, pick up on warning signs to ensure early intervention, and support those living with a lung condition to better manage their health. The sector is well placed to improve care quality and outcomes for everyone living with a lung condition, as community pharmacies are more accessible compared to GP practices including for more deprived areas. 

Our survey also revealed opportunities to make better use of existing services and expand services to better meet the needs of people with lung disease. For example, 29% of survey respondents were unaware of the availability of face-to-face medication reviews – an intervention which is proven to improve health outcomes. 15% were also unaware inhaler technique checks could be conducted at a community pharmacy.

Taskforce is working with senior influencers in the health and care system to ensure that community pharmacy can best support people living with lung health conditions.

The group is also represented on the advisory panel for the Pharmaceutical Services Negotiating Committee’s (PSNC) Vision Project. With the support of Nuffield Trust and The King’s Fund, this vision project will set out its ambition for the future role of community pharmacy as a key part of primary care services. This will include how community pharmacy can contribute to population health goals, help with primary and secondary prevention and respond to rising demand in primary care.

Improving access to appropriate drugs for specific respiratory conditions

Improving access to life-changing drugs for respiratory patients is a Taskforce priority.

After successful and sustained campaigning by Taskforce member The Cystic Fibrosis Trust, we are delighted that NHS England announced in October 2019 it had approved access to precision drugs for people with cystic fibrosis.

Another Taskforce member, Asthma + Lung UK, is leading on increasing access to biologic treatments called monoclonal antibodies (mAbs). At least five of these life-changing treatments have been approved for use in the UK, but more work needs to be done on enabling patients to access these sooner, including increasing the number of appropriate referrals to specialist centres were these are most often prescribed.

Taskforce supported member Action for Pulmonary Fibrosis to achieve a review of the eligibility guidelines for the anti-fibrotic drug Nintedanib. This resulted in the National Institute of Health and Care Excellence (NICE) extending its eligibility criteria to enable patients to access this drug sooner to slow progression of idiopathic pulmonary fibrosis (IPF).