Hampshire & Isle of Wight ICB Asthma & COPD Guidelines Update
Written by AlisonFreemantle on Friday 23rd August 2024
GP practices to switch patients to dry powder inhalers
The ICB Asthma and COPD guidelines have been updated and no longer recommend the use of fluticasone/salmeterol combination inhalers (Seretide and alike alternatives).
The ICB are asking GP practices to prioritise the review of patients over 12 years of age receiving these inhalers, with a view to switching to (preferably) a dry powder inhaler using the Maintenance and Reliever Therapy (MART) approach. This aligns to the guideline’s focus on medicine optimisation whilst reducing the environmental impact of inhalers and supporting the HIOW ICB Prescribing Savings Plan.
For patients unable to change treatments or who are not planned to have an annual review before April 2025, should be switched to the lower cost acquisition formulations.
- Avenor® or Combisal® inhaler: Intervention brief if requiring pressurised aerosols, or
- Fixkoh® Airmaster: Intervention brief if requiring dry powder inhalers
Pharmacies should be aware of these changes as it will potentially affect your stock holding of Seretide and equivalent inhalers.
Stock expected to reduce in prescribing volume:
- All formulations of Seretide Evohaler® and Accuhaler®,
- Aloflute®,
- Sereflo®,
- Sirdupla®,
- Airflusal®,
- Airflusal Forspiro®,
- Generic DPI or pMDI of fluticasone/salmeterol combinations.
ACTION: Reduce any current stock holding of these products.
Patients switched to lower cost acquisition alternatives by the GP practice are eligible for NMS as it is for a new device. Whilst the change in the delivery device might seem minor (for example, not having a dose counter), these changes can have a significant impact on patient adherence and drug effectiveness, pharmacists should use their clinical judgement whether to include or not.
Useful resources and support tools are available either at RightBreathe or the manufacturer’s websites:
- Avenor: Avenor switching document
- Combisal: RightBreathe (links to pMDIs inhalation technique)
- Fixkoh Fixkoh (inhalation technique – video)
Latest ICB respiratory webinars can be viewed here:
- Asthma masterclass - adults
- Paediatric asthma masterclass