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asthmaMIN

5check-up

WyMedical has a nation-wide program to train all pharmacy assistants, pharmacists

and other pharmacy staff with a unique 5 Minute Asthma Check-up for every asthma

pharmacy customer.

asthmaMIN

5check-up

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WyMedical has a nation-wide program to train pharmacy staff with a unique “5 Minute Asthma Check-up” for every asthma pharmacy customer. This asthma check-up is conducted whilst the customer is having their medication script filled.

With over 2.2 million Australians having asthma, and up to 90% of these people not using their devices correctly, the aim of the Able 5 Minute Asthma Check-up is to educate all asthma customers for a better health outcome. With many GP clinics having large patient loads and less time to spend with patients, the 5 Minute Asthma Check-up provides an opportunity for patients to ensure they are using their inhaler devices correctly, understand why they should use a spacer with their puffer medication, gain the maximim benefit from their medication, and possibly save lives.

Many pharmacy staff do not feel as though they have the knowledge or confidence to make the right recommendation to asthma customers. Quite often an asthma sufferer will visit a pharmacy several times for medication without having any questions asked about how well their asthma is being managed. The role of the pharmacy is to provide this service.

Pharmacy staff undergo a short training session to ensure all staff members feel they have the confidence to make the right recommendation and give the correct advice to their asthma customers.

The program explains:

1. How and why to recommend a spacer for all asthma patients

2. The correct use and technique for using a spacer

3. The three questions to ask a customer which indicate they need a review with a doctor

4. The correct technique for taking a Peak Expiratory Flow reading

5. The correct use of an In-Check Dial to assess and educate a patients speed of inhalation for various common inhaler devices

For further support or information, please contact your local Able Asthma representative.

Able Asthma Check Program

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Pharmacy Range

Able Spacer™Able Spacer™ with Child MaskAble Spacer™ with Infant MaskSpacer MasksA2A Anti-microbial SpacerLite-Aire™ Disposable Cardboard SpacerAirzone™ Peak Flow MeterMini-Wright™ Digital FEV1 Peak Flow MeterIn-Check™ DialMini-Wright™ Standard Peak Flow MeterMini-Wright™ Low Range Peak Flow MeterTriFlo Inspiratory ExerciserTurboforte™ Mucus Clearance Respiratory DeviceIn-Check™ Flo-Tone™Glow Cap™

Actineb MiniActinebAC4000EcononebWorld TravellerMicronebNebuliser KitsNebuliser BowlNebuliser TubingMouthpiece

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The role of the pharmacy in assisting customers to manage their asthma

Spacer facts

Recommend a spacer with all puffer medications (including relievers, preventers and combinations)

Why?

Asthma Australia strongly recommends that all people using a puffer, should be taking their medication through a spacer.

What should I explain to the customer?

• Using a spacer can enable them to get up to 90% more medication to the lungs.

• When a puffer is being used directly into the mouth a large amount of the medication will hit the back of the throat. This is where the majority of the medication is being absorbed rather than breathed into the airways of the lungs. This results in less effect of the medication and an increased risk of local side effects.

Where necessary, have the pharmacists engage customers in the ‘5 minute asthma check-up’

Why?

• Ensure patients are using their devices correctly

• It may help to identify patients who do not have their Asthma well managed

What should I explain to the customer?

• Follow the instructions on the ‘Peak Expiratory Flow Chart’ to record the patients PEF reading (page 6)

• Follow the instructions on the ‘In-Check Dial’ to assess and record the patients ‘Inhaler Technique’ (page 7)

90% of people aren’t using their devices correctly. This means they aren’t getting the right dose of medication, and may be at risk of an asthma attack.

55.4% of people with asthma who use reliever medication, only sometimes or never use a spacer.

Asthma Australia, Asthma Update 2011

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55%SOMETIMES OR

NEVER USE

90%USE

INCORRECTLY

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Peak expiratory flow normal ranges

How to use a peak flow meter

1 Attach a clean mouthpiece.

2 Sit or stand up. Hold the peak flow meter level, so that the indicator faces upwards.

3 Make sure the indicator is on zero and your fingers aren’t blocking the movement of the marker.

4 Take in a full deep breath before you place your lips tightly around the mouthpiece. Blow as hard and fast as you can (for about 2 seconds).

5 Check your score (where the marker has moved to). Repeat the steps above two more times to make sure you have the best possible score.

6 Record the highest score out of the three scores (The top two scores should be within 40L/min of each other).

Why use a peak flow meter

A patient can measure how good or bad their asthma is, rather than just guessing how they feel. Peak flow readings can be incorporated into an Asthma Action Plan so the patient will know if their treatment needs changing. A Peak Flow reading can assist in determining whether a patient’s asthma treatment is working. It is a record they can show to their doctor.

In men, readings of up to 100L/min lower than the predicted value are within ‘normal’ limits. For Women the figure is 85L/min. Values are derived from Caucasian populations.

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Clinically effective flow range

How to use the In-Check Dial

1 Reset the In-Check Dial

2 Align the scale with the desired inhaler device - an audible ‘click’ should be heard

3 Attach a clean mouthpiece

4 Ask the patient to exhale slowly and fully

5 Seal lips around the mouthpiece. According to the inhaler chosen, instruct the patient to inhale in the manner recommended by the manufacturer

6 Record the inspiratory flow from the position of the red cursor against the scale. Reset, and repeat two more times

7 Compare values achieved with target flows for that device. To operate an inhaler device optimally, the patient should be able to achieve a flow rate within the Optimal Range

8 If the patient is not able to achieve these values, then the healthcare professional may wish to assess the patient’s ability to use an alternative type of inhaler

Note about simulating the use of a pMDI with a Spacer

As the resistances of the valves of most chamber/spacer devices are low, the In-Check Dial can be set to ‘low resistance pMDI’ or Freeflow to provide an approximate resistance for inspiratory flow measurements to be made.

The optimum inhalation technique for using an MDI with a spacer is a slow inhalation (30 to 60 L/min).

Why use an In-Check Dial?

The In-Check Dial is an inhalation airflow meter that can help to educate and assess patients who use inhaler devices. Inhaler devices are designed to deliver medication to the respiratory tract, and the speed of inhalation through them can have a significant effect on the quantity of drug delivered and the clinical efficacy. The In-Check Dial is designed to simulate the internal resistance of several inhaler devices and measure inspiratory flow. These measurements enable pharmacy staff to encourage patients to modify their inspiratory technique (by inhaling with more or less effort) in order to achieve a flow rate consistent with clinical effacy. The green bars show the clinically affective flow ranges for each inhaler device.

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When a puffer is used directly into the mouth, most of the

medication is absorbed into the back of the throat. This can

increase the local side affects of the medication.

Benefits of using a spacer

If someone is having trouble breathing, using a spacer will enable them to get up to

...you should always use a spacer, regardless of whether you are taking a daily preventer or using

your blue reliever during an emergency

– Asthma Australia

USE ASPACER

...YOU SHOULD“

”

ALWAYS

AUSTRALIANS DIE EACH YEAR FROM ASTHMA

400OVER

90%more medication into their lungs

Suitable for adults and childrenStores puffer inside chamberUnique coaching whistle

– Asthma Australia

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How to use the Able Spacer

1 Remove puffer cap, shake puffer well, then attach puffer to the end of the spacer.

2 Seal your lips around the mouthpiece (or put the mask around the childs mouth and nose), and breathe out gently.

3 Fire one puff of medication into the chamber.

4 Take a normal breath in with a few seconds of firing the medication.

5 Keeping your lips around the mouthpiece (or the mask in position), breathe out into the spacer.

6 Take another 3 breaths in the same way.

OR

7 Repeat steps 1 and 2, and hold for 5 seconds.

8 Repeat if you require more medication.

Make sure you only put one puff of medication into the spacer at a time. If you put more than one puff in, the medication sticks together and then drops to the bottom of the spacer before you have time to breathe it in.

5 features of the Able Spacer

Designed for Adults and Children

Fits all shapes of medications

Coaching whistle ensures optimum inhaling rate

Stores medication inside the chamber

Use a Child or Infant Mask for children under 5 years

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5

OF MEDICATION AT A TIME

PUFFONE

Relievers

Airomir Inhaler 100mcg salbutamol

Asmol Inhaler 100mcg salbutamol

Ventolin Inhaler 100mcg salbutamol

Atrovent Metered Aerosol 21mcg ipratropium

Corticosteroid Preventers

Flixotide Junior Inhaler 50mcg fluticasone

Flixotide Inhaler 125mcg fluticasone

Flixotide Inhaler 250mcg fluticasone

Alvesco Inhaler 80mcg ciclesonide

Alvesco Inhaler 160mcg ciclesonide

QVAR Inhaler 50mcg beclomethasone

QVAR Inhaler 100mcg beclomethasone

Medications for Able Spacer

Non-steroidal Preventers

Intal Inhaler 1mg sodium cromoglycate

Intal Forte Inhaler 5mg sodium cromoglycate

Tilade Inhaler 2mg nedocromil sodium

Combination Medications

Seretide MDI 50mcg fluticasone & 25mcg salmeterol

Seretide MDI 125mcg fluticasone & 25mcg salmeterol

Seretide MDI 250mcg fluticasone & 25mcg salmeterol

Symbicort MDI 200mcg budesonide & 6mcg eformoterol fumarate dihydrate

Symbicort MDI 100mcg budesonide & 3mcg eformoterol fumarate dihydrate

Symbicort MDI 50mcg budesonide & 3mcg eformoterol fumarate dihydrate

These medications are suitable for use with an Able Spacer.

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WyMedical Pty Ltd 466 Fullarton Road Myrtle Bank SA 5064 Free call 1800 812 097 sales@wymedical.com.au wymedical.com.au