Forstair runs out before I can get the next prescription. The next installment

[Ts777]

I’m being prescribed a forstair every 30 days. I’ve spoken to the pharmacist at the practice and she says:

There are 120 doses in an inhaler, 120/4 =30, therefore a new inhaler every 30 days is sufficient. Plus, inhalers have 10% leeway so it’s fine.

I’m saying:

. it takes 3 to 4 actuations to prime it

. the doses fall away when the counter gets below 20 so needs replacing then

This means that an inhaler has just 24 days of doses. I said the inhalers definitely didn’t have 10% leeway in them.

Also, on the occasions that my asthma plays up, with pollen and with, recently, covid I increase my dose by 1 puff a day, before bothering the dr. I’ve done this for years and all have been happy. It’s happened once in the last six months, when they were fully aware that I had covid!!

The solution, I’m told, is that I have an asthma review. The pharmacist can do this over the phone.

I’m sorry, does anyone from asthma Uk read these posts? I can’t imagine I’m the only person who has encountered this? How many people use these inhalers until the count gets to zero and struggle as a result? This problem has been discussed on this forum many times.

Also, I’m being forced to have an asthma review for no reason whatsoever. It sometimes is useful to discuss my asthma with an asthma nurse. But if everything is fine, then it’s a waste of time. I was taught to manage my asthma more than 50 years ago. A spot check is pointless if everything is good.

Also, if I am going to have an asthma review, I like to have it with an experienced asthma nurse. Not a nursing assistant (yes, that’s happened to me) or a pharmacist! I think asthma reviews have been a GP revenue generating exercise for a long time. Why do asmatics have to deal with this?

Of course, reviews should be offered. But should be carried out by appropriate staff and should be done to empower patients to take control of their own conditions. I’ve never had an asthma plan, despite attending many of these things. I will have one after the next, and will demand it in writing!!!

I think the way asthmatics are treated, by the nhs generally, is hugely disrespectful and goes against the nhs principles of empowering people to do self care.

Sorry about the rant, I’m more than not happy about this.🤯

[Pipsqueak77]

Hi Ts777

I couldn’t agree more! And I would rant if I were you too.. so don’t apologise! 😊

Maybe it’s time to flag this with your GP.. and if that means getting an urgent appointment then so be it!

The whole system seems to have gone mad and on the one hand we are told to pretty much manage our own condition but we are not given the meds and tools to do it… 🤔

I think some surgery’s play the system to suit themselves I’m afraid.

I hope you can speak to a GP and get them to give you x2 inhalers - I think this is the general rule and is of no inconvenience to them. I always have x2 prescribed no problem.

Good Luck🤞🤞

[Ts777 in reply to Pipsqueak77]

Hi,

Yes, I started with the GP and he said to talk to the prescribing administrator, as it’s a repeat prescription issue not a medical one. I expect it’s going back to the gp, I think they will have to change me over to a dry powder inhaler 😒

[Gareth57 in reply to Ts777]

unfortunately going to dry powder will not fully solve the problem, on the one hand you will get a months worth of "actuations" but if you self medicated as I did when using the 100/6 (with the gp's approval) some months you with use more so will not get the full month. This way of prescribing works well for tablets but some leeway is needed for inhalers.

[Homely2 Administrator]

I quite agree that the NHS can be extremely irritating to deal with, like all bureaucracies.

I also have no current asthma plan, despite being diagnosed in January with asthma with poor control.

[Poobah]

If you're on an MDI then the propellant isn't as strong as they used to be and it's necessary to shake them well before every inhalation for at least 5 seconds and clean them every week. Otherwise, the mix of propellant and medicine won't be effective and the propellant could run out leaving the inhaler spent at an early stage even though there's medication remaining. The canister holder can also clog up easily with dried meds and not work, hence the need to keep it clean.

I would say that a review with the pharmacist should be face to face so they can witness exactly what you're saying has happened with your inhaler. Then they can raise the issue on the yellow card scheme. I've had reviews with the pharmacist and they can check that the patient is sticking to the correct inhaler technique without picking up bad habits (it happens) and that all prescribed meds are being administered as expected.

After the pharmacist review you can talk with the GP or asthma nurse who prescribes your meds in order to discuss your need to take additional inhaler doses on occasion. This needs to be agreed and your medical notes updated. They are more likely to agree with prescribing two Fostair inhalers every 6 weeks to cover any shortfall etc once the pharmacist has reported your issue through the yellow card scheme.

The alternative option is to request a dry powder inhaler from your GP. These don't have any propellant and work purely by the patient inhaling the meds. I can cope with DPI and my peak flow is around 260 to 300 and get a good dose every time . I've noticed they have more than the 120 doses and never fail in delivery.

[Ts777 in reply to Poobah]

Hi,

I’ve been taking inhalers since I was a kid. I do know how to shake, take and care for inhalers!

I don’t agree that an asthma review should be carried out by a pharmacist. If I had a problem then I’d prefer to talk to an asthma nurse or a GP. I have had an amazing asthma nurse in the past and not found a nurse lacking ever.

I’ll speak to a pharmacist when I have a medication specific issue. Which of course this is, it’s about an inhaler shortfall not my asthma.

A forstair inhaler has “120” doses, which does equal 30 days worth of doses. However, I think that if you check the instructions, you’ll find that each inhaler has to be primed by 3 or 4 actuations I believe. This means that each inhaler has less than the stated 120 doses. At best it has 29 days.

Then, as many have already said, the inhaler doesn’t seem to have the 120 full doses in it. This is my experience as well.

Failing all that, the nhs has a belief that patients should be empowered to self manage their conditions. This is not allowed in my situation.

I’m sorry to rant again but I really have had enough of this. Why should I move to a powder inhaler when the one I’m using seems to suit me. I do agree that powder inhalers are accurate in their dosages, the delivery mechanism on them is very precise.

[Pipsqueak77 in reply to Ts777]

Hi

I completely agree…

You should not have to change to a different inhaler to suit your surgery and doctors lack of flexibility!

There are many many people on here who are taking Fostair and I bet virtually none of them are prescribed only one inhaler at a time….?

Personally I would ask to see another doctor and request the reason why your meds are being so restricted.

Good Luck🤞🤞

[ReedB]

I'd be ranting too. I have the same issue with the fostair. By the time the counter gets to 20 it stops working. Sometimes I can proggle the hole but usually it doesn't work and I need to start using a new one. Like you, if I've had Covid, a cold or pollen issues I up the dose too so get through it quicker.Strangely enough I had a phone call from someone who I think was from my GP surgery (not the pharmacy). They wanted to ask questions regarding all my prescriptions, how often I was using etc, including prednisolone. Thought it was a little odd but was happy to tell them how things were and that I knew my asthma well enough to get on with it or talk to the doctor. Unfortunately, the nurse at my practise is hopeless with her knowledgr of asthma, or at least the non wheezing, minimal peak flow change types, so I declined the offer to speak with her too. I don't see the point of a review with someone who has no proper knowledge or understanding.

I'm starting to rant now too but just to say I also think we have to put up with too much as asthmatics. Too often I've been left to figure things out by myself. Thank goodness for this forum and the asthma nurses!

[TeachKat in reply to ReedB]

Irrelevant to the discussion, but I love the word ‘proggle’ and I’m going to adopt it. You’ve improved my day!

[Albertdog in reply to TeachKat]

from my part of the world - to 'proggle' is the action to make a 'clippie' mat from old clothing torn into strips - with a 'proggle/proggler'.

A design was drawn onto Hessian which was stretched over a wooden 'frame' and all the family took turns to 'proggle' when they had a spare minute.

Some beautiful rugs/carpets were achieved.

[TeachKat in reply to Albertdog]

Thank you - it’s a great word and I shall add it to my personal lexicon. In return, I can offer you the Devonshire word ‘dimpsy’ for twilight/dusk and ‘backalong’ for ‘a while ago’.

[Patk1 in reply to ReedB]

My surgery has their own pharmacist who does the medication reviews.i wash my inhalers,incl for hair as can get blocked.

[Patk1]

Yr gp prescribes.id simply insist on 2.if you've to follow protocol, its bit of a wasste of theirs+ yr time,but worth it to get what u need.gd luck x

[Venta55]

I don’t blame you if this is the case you need a spare one