1. Falls Prevention & Inhaler Service Update Training Claire Thomas

2. Agenda 7.15pmIntroduction 7.20pmFalls Prevention Service Evaluation 7.30pmPractice Scenarios 8.10pmFeedback and Q&A Session 8.20pmInhaler Check Service Evaluation 8.30pmPractice Scenarios 9.10pmFeedback and Q&A Session 9.20pmSummary & Close

3. Falls Service Experiences so far Please write down 3 things/key words you would like to share/address regarding your experiences so far of delivering the falls prevention service.

4. Falls Prevention Service Evaluation Background Service description Aims & objectives

5. Setting and Methods Setting: 23 community pharmacies across Doncaster. Methods: Audit of 414 consultations, analysis of 353 patient satisfaction questionnaires & a face-to-face meeting with a Falls Co-ordinator. Analysis involved descriptive statistics & qualitative comments a thematic approach.

6. Results

7. Results

8. Results >50% of patients who had suffered a fragility fracture were not prescribed bone-sparing medication 37% reported compliance problems Majority of consultations resulted in interventions provided by the pharmacist Feedback from patients & Falls Co- ordinator was positive

9. Future Service Development Extend service to include domiciliary consultations Referral of patients presenting at A&E following a fall into the service Introduce an element to the service to try & reduce the number of medicines being taken by patients Develop a community pharmacy osteoporosis screening service

10. Evaluation Conclusion Pharmacists can successfully identify patients at risk, provide patient education and make appropriate referrals to the specialist falls clinic. This new and unique service should continue. Patient satisfaction with the service is high, it is supported by the specialist falls service and it is accessing patients who are not accessing other services.

11. Practice Scenario 4 questions to discuss in groups 5 mins to agree group answer 5 mins for debate

12. Feedback and Q&A “Support was amazing after poor service from DRI A&E. The pharmacy has done more to support my falls and reduce readmission to A&E which is for me a step in the right direction” Falls Service Patient “The service is beneficial, it is accessing a group of patients that might not be accessing other services”. Falls Co- ordinator SFS

13. Additional Resources Consultation skills for pharmacy practice: taking a patient-centered approach. CPPE Falls: assessment and prevention in older people. NICE guideline 161 available at: http://www.nice.org.uk/guidance/cg161 http://www.nice.org.uk/guidance/cg161 Medicines and Falls in Hospital: Guidance Sheet available at: https://www.rcplondon.ac.uk/sites/default/file s/documents/medicines-and-falls2.pdf https://www.rcplondon.ac.uk/sites/default/file s/documents/medicines-and-falls2.pdf Age UK www.ageuk.org.ukwww.ageuk.org.uk

14. Inhaler Service Experiences so far Please write down 3 things/key words you would like to share/address regarding your experiences so far of delivering the falls prevention service.

15. Inhaler Check Service Evaluation Background Service description Aims & Objectives

16. Setting and Methods Setting: 29 community pharmacies across Doncaster. Methods: Audit of 616 consultations and analysis of 577 patient satisfaction questionnaires. Audit and questionnaire results were analysed using descriptive statistics, qualitative comments using a thematic approach.

17. Results Cost: £7561.50 8.6% of patients unsure of their diagnosis Majority of patients prescribed a MDI 400 patients had an initial IR out of the target range for their device Over 98% of patients achieved target range by the end of their consultation

18. MDI Inspiration rate Results

19. MDI Use & Previous Instruction

20. Results cont. Condition Control: high reports of regular preventer use. Almost half of patients needed to use their reliever inhaler once or twice daily or more. Interventions: Most common intervention was inhaler instruction. Little need to contact the GP/practice nurse Patient feedback: Extremely positive

21. Future Service Development Supply of spacers with/without masks Include full assessment of condition control (ACT/CAT) Follow-up consultations to monitor performance and outcomes See patients after asthma attacks/exacerbations ?referral from A&E COPD exacerbation management

22. Evaluation Conclusion Results demonstrate the need for regular inhaler technique checks Community pharmacists have a key role in improving inhaler technique, complying with current guidelines The service is beneficial to patients & the NHS; improving inhaler use can improve condition control improving quality of life, reducing hospital admissions & even deaths, funding should continue

23. Practice Scenarios 4 questions to discuss in groups 5 mins to agree group answer 5 mins for debate

24. Feedback and Q&A “Thought I was good using inhalers but learnt a lot from the pharmacist that will help me” Inhaler Check Service Patient “Pharmacist was exceptionally helpful and explained everything in detail. This made me feel more confident” Inhaler Check Service Patient

25. Additional Resources Inhaler technique videos available at: https://wessexhiecpartnership.org.uk/wires/video- series/inhaler-technique/ https://wessexhiecpartnership.org.uk/wires/video- series/inhaler-technique/ COPD guidelines available at: http://www.nice.org.uk/guidance/CG101 http://www.nice.org.uk/guidance/CG101 COPD learning resources available at: http://www.thelearningpharmacy.com/content/learnin gtopics.asp http://www.thelearningpharmacy.com/content/learnin gtopics.asp Asthma guidelines available at:https://www.brit- thoracic.org.uk/guidelines-and-quality- standards/asthma-guideline/https://www.brit- thoracic.org.uk/guidelines-and-quality- standards/asthma-guideline/ National review of asthma deaths available at: https://www.rcplondon.ac.uk/projects/national- review-asthma-deaths https://www.rcplondon.ac.uk/projects/national- review-asthma-deaths