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 practise

  • Increasing awareness of community pharmacists and their role of reviewing medications, prescriptions and the wellbeing of 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

Improving understanding of correct inhaler technique

 Inhalers are a vital part of treating COPD and asthma but there are significant problems with their use. We know that many people make errors when using their inhaler devices which puts them at risk, and that overuse of reliever inhalers in asthma has been linked to asthma deaths. Currently, too few people receive an annual inhaler technique check, which means that they are at risk of their condition getting worse.

It is vital that all relevant health care professionals are trained and always up to date in inhaler technique so they can coach their patients effectively. Evidence suggests that this is not currently the case, with many practitioners lacking the confidence to support patients. We have been working with the UK Inhaler Group to review and disseminate Inhaler Standards and Competency Document, and are working on signposting healthcare professionals to useful and accurate resources, such as the Asthma + Lung UK inhaler technique videos, which were selected as illustrating best practice in an audit conducted by the Taskforce.

With support from the NHS England and Improvement Consolidated Inhaler Working Group, we have produced a position paper on how to optimise inhaler technique remotely. Currently, the way in which inhaler technique is checked needs to adapt to be able to reach more people with respiratory disease. While a face to face consultation is considered the most effective way to confirm if a patient can use their inhaler device(s), COVID-19 has meant this has been impossible to do and even before the constraints of COVID-19, many people did not have their inhaler technique checked . Therefore, virtual consultations may help expand the total number of inhaler technique checks carried out. 

There is a limited amount of data about the number of people with lung disease receiving an inhaler technique check and what their experiences are of them, so we have run a patient survey to gather insight. We will be using this valuable insight to drive forward our recommendations over the coming year. We have also produced regional information packs for the respiratory clinical networks on overuse of reliever inhalers in asthma. An example pack can be found here.

 Promoting the role of community pharmacists

More than 1.6 million people visit a community pharmacy each day, providing a huge opportunity to pick up on warning signs for lung disease, which can then be assessed by GPs. 

Pharmacists are in a good position to talk to people about their wider lung health when they visit the pharmacy for stop smoking services or flu vaccinations. As a group, we are working on promoting the role of the pharmacist in the community, making the case to NHS England that community pharmacists are well placed to offer medicines reviews and inhaler technique checks. We are especially keen to make this case as Medicines Use Reviews are being phased out and will be de-commissioned as a service in 2021. 

We have conducted a survey of over 2,000 people with lung disease to better understand how people use and value community pharmacy services. Overall, many services are considered valuable and essential, but there is plenty of opportunity to make more of existing services and expand services to better meet the needs of people with lung disease. Full results and methodology can be found here.  

We held a joint workshop with NHS England in November 2020 to explore what patients want from community pharmacy services and how we can achieve this in future. We are using the themes emerging from this workshop to try to influence the future development of community pharmacy services. 

Improving access to appropriate drugs for specific respiratory conditions

As a group, we have made improving access to life-changing drugs for respiratory patients a priority. We have been working to improve access to antifibrotic drugs for idiopathic pulmonary fibrosis (IPF), cystic fibrosis transmembrane conductance regulator (CFTR) modulators for cystic fibrosis, and monoclonal antibodies (mAbs) for severe asthma.

After successful and sustained campaigning by the Cystic Fibrosis Trust, a Taskforce member, we are delighted that in October 2019, NHS England announced they have approved access to precision drugs for people with cystic fibrosis. Another Taskforce member, Asthma + Lung UK, is leading on ensuring an increase in the number of appropriate severe asthma referrals to specialist centres and increasing access to mAbs. We were pleased to see a new mAB called dupilumab approved across the UK in 2021.

The Taskforce is collaborating with member Action for Pulmonary Fibrosis on making sure that prescribing criteria for antifibrotic drugs change in NICE guidelines to match European patient eligibility. We have written a joint letter to NICE and are supporting Action for Pulmonary Fibrosis in their efforts to change the guidelines where we can.