CHRONIC DISEASE MANAGEMENT MODULE

ASTHMA & COPD

UNDERSTANDING ASTHMA & COPD

Aims To develop a good understanding of Asthma/COPD in the context of primary care To highlight the difference between Asthma and COPD To use web based resources for information.

Method 1-2 private study sessions

ASTHMA/COPD THE PATIENTS PERSPECTIVE

Aims To gain understanding about patient awareness of asthma/COPD related issues To understand the impact of a diagnosis of asthma/COPD on peoples lives

Method 2-3 private study sessions Interview of a patient about the impact of asthma/COPD on their lives Interview of a partner/relative/parent of their knowledge and understanding of asthma/COPD

ROUTINE ASTHMA/COPD CARE IN PRIMARY CARE

Aims To understand current ‘Best Practice’ for asthma/COPD in Primary Care To understand the role of various members of the PHCT in effective delivery of best practice.

Method 1-2 Private study sessions Time spent with relevant members of the PHCT and Secondary Care Providers.

CLINICAL AUDIT ASTHMA/COPD

Aims To examine clinical audit of asthma/COPD within the context of Primary Care Look at Quality and Outcome Frameworks of New GMS contract Look at previous practice based audits in the last 24 months Undertake a mini audit if possible

Method 1-2 private study sessions

ASTHMA/COPD & EVIDENCE BASED MEDICINE

Aims To examine the importance and value of EBM in the management of asthma/COPD Use of EBM in treating acute exacerbations and chronic maintenance and control Use of EBM in the effectiveness of different medication delivery systems i.e. oral vs inhaled, dry powders vs aerosol spacer devices vs nebulisers home oxygen systems etc.

Method 1-2 private study sessions

Surahi Xavier July 2005 CHRONIC DISEASE MANAGEMENT MODULE

ASTHMA & COPD

1. UNDERSTANDING ASTHMA & COPD

AIMS

. To develop a good understanding of Asthma/COPD in the context of primary care

. To highlight the difference between Asthma and COPD

. To use web based resources for information.

METHOD

. 1-2 private study sessions

RESOURCES

. Asthma/COPD NICE guidelines

. British Thoracic Society Guidelines

DEFINITIONS

. Define the differences between Asthma/COPD

. Look at Spirometry : obstructive vs restrictive

. Look at relevance of the PEFR

. Look at reversibility testing

AETIOLOGY

. Underlying problems in Asthma/COPD

. Importance of smoking

. Importance of atopy

. Importance of workplace/environmental factors as triggers MORBIDITY AND MORTALITY

. Look at current levels.

TREATMENT OF ASTHMA/COPD

. Importance of addressing lifestyle issues i.e. smoking

. Importance of addressing treatment compliance

. Use of inhalers/oral medications

. Use of spacer devices and volumatics and different delivery systems

. Acute emergency management vs chronic management.

. Treatment of childhood asthma vs adult asthma or COPD

. Importance of patient education to recognise worsening asthma/COPD control

SERVICES AVAILABLE

. Primary Care/Community: GP’s Nurses Patient Support Groups Smoking Cessation Pharmacists

. Secondary Care: Consultants Asthma/COPD Specialist Nurses 2. ASTHMA/COPD THE PATIENTS PERSPECTIVE

AIMS

. To gain understanding about patient awareness of asthma/COPD related issues

. To understand the impact of a diagnosis of asthma/COPD on peoples lives

METHOD

. 2-3 private study sessions

. Interview of a patient about the impact of asthma/COPD on their lives

. Interview of a partner/relative/parent of their knowledge and understanding of asthma/COPD

INTERVIEWING A PATIENT WITH ASTHMA/COPD

. Select a suitable patient after discussion with your clinical supervisor

. Spend up to 30 minutes discussing issues related to the impact of asthma/COPD on their lives i.e. issues related to home/work/lifestyle.

. Write a report based on your interview

INTERVIEWING A PARTNER/RELATIVE/PARENT ABOUT ASTHMA/COPD

. Select a suitable candidate preferably someone without any medical background

. Spend up to 30 minutes discussing their knowledge of asthma/COPD and what their immediate concerns are.

. Ask about availability of resources and information at the surgery and in the community and how things can be improved to better meet their needs. 3. ROUTINE ASTHMA/COPD CARE IN PRIMARY CARE

AIMS

. To understand current ‘Best Practice’ for asthma/COPD in Primary Care

. To understand the role of various members of the PHCT in effective delivery of best practice.

METHOD

. 1-2 Private study sessions

. Time spent with relevant members of the PHCT and Secondary Care Providers.

RESOURCES

. NSF for asthma/COPD

. NICE Guidelines

. BTS Guidelines

. GMS Quality & Outcome Frameworks

BEST PRACTICE

. Use web based resources to draw up a picture of what you believe reflects current best practice in the treatment of patients with asthma/COPD

. Best practice will differ between treatment of an acute/emergency situation and chronic management

. Best practice will also differ in the treatment of children vs adults.

. Identify who within the PHCT and Secondary Care are necessary in the delivery of best practice

. Identify the use of annual reviews and Nurse led clinics in Primary Care

. What structures are in place within your own practice to deliver care to asthma/COPD patients.

. Spend time attending Nurse and Doctor reviews within the practice.

. Investigate the role of the asthma/COPD Specialist Nurses and spend time with them. . Attend a hospital asthma/COPD clinic session and look the role of the secondary care team.

. Do other team members have anything to offer i.e. Pharmacists, Smoking Cessation Clinics/Advisors 4. CLINICAL AUDIT ASTHMA/COPD

AIMS

. To examine clinical audit of asthma/COPD within the context of Primary Care

. Look at Quality and Outcome Frameworks of New GMS contract

. Look at previous practice based audits in the last 24 months

. Undertake a mini audit if possible

METHOD

. 1-2 private study sessions 5. ASTHMA/COPD & EVIDENCE BASED MEDICINE

AIMS

. To examine the importance and value of EBM in the management of asthma/COPD in Primary Care

. Use of EBM in treating acute exacerbations and chronic maintenance and control

. Use of EBM in the effectiveness of different medication delivery systems i.e. oral vs inhaled, dry powders vs aerosol, spacer devices vs nebulisers, home oxygen systems etc.

METHODS

. 1-2 private study sessions

RESOURCES

. NICE Guidelines

. NSF

. BTS Guidelines

. EBM Websites – Prodigy, Cochrane Library