Respiratory Super-useful Links!

We’ve asked our tutors to share their experience of working in primary care during the current pandemic, and to pass on any tips and advice.

Today we’d like to introduce you to Andrew Booth. Andrew is an experienced Respiratory Nurse Specialist working in a GP practice. In the first of a 2-part blog he shares his ‘RESPIRATORY SUPER-USEFUL LINKS’. There is a wealth of advice on how to support patients with asthma and COPD, including links to inhaler technique videos, and the Asthma Control Test. As a Diabetes Specialist Nurse this one caught my eye as he describes this as the ‘HbA1c for asthma’!

You can follow Andrew on Twitter: @AODBooth

We’d love to hear your thoughts, and any tips you’d like to share. You can email us on admin@pctc.co.uk, or just post on our Facebook page.

Respiratory Super-useful Links!

During a time when we have reduced face-to face contact with our patients, the following links may be useful if you have the facilities to text or e-mail your patients:

ASTHMA CONTROL TEST (ACT)

This is an essential way of monitoring and self-monitoring asthma control. Think of this as the ‘HbA1C for asthma’.

Suggested text to send with the link to your patients:

As part of your annual review I’d like you to complete some questions about your asthma via the link below. This will help us to monitor your condition, and to ensure you are receiving the best possible treatment. Please feel free to ask any other additional questions,or request a telephone call with me if you wish.
https://www.asthmacontroltest.com/en-gb/welcome/#

or

To keep an eye on your asthma, use the Asthma Control test:
https://www.asthmacontroltest.com/en-gb/welcome/#
If your score is below 20, your asthma may not be as well controlled. In which case, please contact us for advice.

You can ask them to complete the Asthma Control Test before and after changing or increasing their treatment. An increase of 3 or more in their ACT score shows significant clinical improvement.

The nice thing about asthmacontroltest.com is that it displays red, amber and green zones, along with an ACT score.  I‘ve used this in clinic to show patients their score, and then sent a text message with the link to help them manage their asthma at home. During the pandemic, when I have completed my phone call, I have been texting the link as part of a text message, along with simple reminder instructions such as “take more of your preventer” or just “contact the surgery” if your score is below 20.

INHALER TECHNIQUE VIDEOS

You can’t check inhaler technique over the phone. And I think it will be tricky to do it via video link or Zoom or Facetime. But you can send them a link to a video of their own inhaler, so at least they can see how to use it correctly.

RightBreathe has a video for just about every inhaler, and is a useful clinical resource for finding out about any inhaler you want.

My personal favourite inhaler videos are produced by AsthmaUK. Click this link, and then find the inhaler(s) your patient is taking. Then send them the link to their own inhaler(s).  Send this even if it sounds like their asthma is well controlled, as it might just make their technique more effective, or prevent them picking up a bad habit.

MAINTENANCE AND RELIEVER THERAPY (MART)

One of the very best ways of helping people with asthma keep control of their asthma is to use the MART approach. Maintenance And Reliever Therapy is a flexible approach to asthma management that enables people with asthma to take their important anti-inflammatory steroid when they are getting symptoms, as well as having the instant-relief of bronchodilation. You can use this with Symbicort, Fostair, DuoResp or Fobumix. It’s quite easy to explain to people: “Take this once in the morning, once in the evening, and then an extra dose whenever you get your symptoms. Take it instead of your blue inhaler.”

To back all this up, AsthmaUK have some great information about that you can send to your patients. You can find it here.

EXERCISE

We’re being told to isolate and stay at home, so people with COPD might not be able to exercise or attend pulmonary rehabilitation. So you can send them the links to some of the excellent videos produced by the British Lung Foundation:

https://www.blf.org.uk/exercise-video

The British Lung Foundation provides some great information for patients about how to manage their condition, about breathlessness, and what to do in the event of a flare-up:

https://www.blf.org.uk/support-for-you/copd/managing-my-copd

https://www.blf.org.uk/support-for-you/copd/flare-ups

DR HICKMAN’S VIDEO MASTERCLASS

Finally, a video has been produced by Dr Katherine Hickman, Respiratory Lead for West Yorkshire and Harrogate, a GP in Bradford, and Vice-Chair of the Primary Care Respiratory Society, about managing stable COPD and asthma patients over the phone, or via video conferencing. It’s only a couple of minutes long, has some really great ideas, and is well worth watching:

https://www.pcrs-uk.org/resource/telephone-triage-copd-and-asthma

Andrew Booth

Keep your eyes peeled for part 2 tomorrow!

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