Why This Inhaler ?

Title: Why This Inhaler ?
Author(s): P. Hallahan, L. McLeod, C. Sheridan. L. Fox, C. O’Grady, E. Twomey.
Institution: Mater University Hospital
Poster: Click to view poster
Category: Asthma and COPD
Abstract: COPD hospitalisations in Ireland appear to be the highest for all OECD countries In February 2020 the Respiratory Clinical nurse specialist (CNSp) service undertook a four week audit of COPD patients. Included were patients from both the inpatient and outpatient setting as well as nurse-led clinics. The aim of the audit was to assess if the patient’s inhaled therapy was in line with the recommendations as per GOLD Guidelines and the ABCD assessment tool (GOLD 2020).
Respiratory nurse specialists follow guidelines in order to ensure patients receive the most appropriate therapy for their disease stage. We wished to investigate, by means of audit, that we were adhering to these guidelines and that the appropriate therapy was prescribed.
A number of reasons for changing inhaled therapy were identified. These included inappropriate therapy, increased exacerbation rates, inhaler technique optimisation and up-titration of treatment. Additional reasons for changes to patients inhaled therapies were unintentional non-adherence and prescribing errors.
It was noted during the audit that 65% of the patients seen required a change of therapy, highlighting the importance of the role of the respiratory CNSp in the optimisation of inhaled therapy for COPD patients. Unfortunately due to the Covid-19 pandemic we were obliged to cut the audit short. We intend to revisit this audit when feasible.