22nd January 2024
In this week’s blog, our Chief Executive, Dr Linda Edwards discusses …
Why are we still talking about inhaler technique?
The answer is sadly quite simple, despite the availability of Personal Asthma Action Plans (PAAP), evidence based asthma guidelines, and the publication of the National Review of Asthma Deaths (NRAD), many people are still not receiving the level of support they need to manage their asthma effectively.
The National Review of Asthma Deaths (NRAD) was published in 2014. It was the result of collating detailed data from medical records of people with asthma who had died during a twelve month period. It identified that two thirds of asthma deaths were potentially preventable. Tragically, of this group, asthma management was only judged to be good in less than 20% of the people in the study. This is a real concern as most people do not see asthma as something to be overly concerned about!
Stimulus for change
NRAD should have been a stimulus for change; I was working at Asthma UK at the time when it was published. We all saw the publication as a great opportunity to improve the treatment, care, and support available to people with asthma. However, looking at recent national statistics this has certainly not been the case and people with asthma are still at significant risk. They often describe their condition with phrases like, ‘I am just a bit wheezy’.
Inhaler technique is varied and a critical factor in asthma management; unfortunately, many people remain unaware that they are using their inhaler incorrectly. To add to the confusion, there are many different inhalers available all requiring a slightly different technique. Asthma and Lung UK have a series of short informative videos on their website; these are designed to show people how to use their inhalers correctly in three short minutes.
Adding a health coaching technique
Annual asthma reviews are an important opportunity to ensure patients are managing their condition well and to agree a Personal Asthma Action Plan (PAAP). These reviews enable healthcare professionals to gear the support and guidance to everyone’s individual needs, ensuring people have the tools and skills to manage their asthma effectively. It is a time to discuss all aspects of treatment and to check inhaler technique. People can often slip into bad habits, so these reviews provide an ideal opportunity to discuss and agree a Personal Asthma Action Plan for the following 12 months. They also provide the opportunity to really listen and understand what is important to the individual, their level of understanding about their condition and the type of support they need. To support this we have put together a package of training that combines a clinical refresher with a health coaching course. Find out more about the course here.
Combining PAAPs with a coaching approach is an excellent way to create a genuine person centred approach to care. The key is ensuring that as healthcare professionals we listen and hear what our patients are saying and equally what they are not saying. I had a consultation recently with a healthcare professional who started the conversation by telling me what she thought I should be doing, rather than finding out what I was doing! After a few minutes, I stopped her and pointed out – firmly but politely – that she hadn’t asked me any questions to find out how I was and how she could help me, before jumping to any conclusions! She was somewhat surprised but took my point, let’s hope this has translated into how she speaks with other patients.
References
The national review of asthma deaths: what did we learn and what needs to change? – PMC (nih.gov)
How to use your inhaler | Asthma + Lung UK (asthmaandlung.org.uk)