Changes in review regimes.: I had a... - Asthma UK communi...

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Changes in review regimes.

Wheezycat profile image

I had a curious experience, and probably a good one. My normal review time is April , once a year, except, of course, whend something is up. However, I was asked to do another one with a pharmacist just the other day. It turns out our surgery group (a big one in York) has decided to do 3-6 monthly medication reviews, and it seems triggered by the overuse of Ventolin./salbutamol/reliever. The person I spoke to, a pharmacist, was new to me (it was a phone call) but she then checks everything off with my favourite local asthma nurse, someone I know who really knows her stuff. I have always had good experiences with her. And the pharmacist didn't quibble with me when I said I am an under user of ventolin, that is often when I could benefit i forget there is ventolin. Many find that hard to take aboard, but if asthma has crept up on you gradually it can happen. I can expect to be contacted again in 3-6 months, I was told.

I got the impression there is a campaign to reduce asthma deaths? Are others also getting this?

20 Replies

We do not have an asthma nurse at all now. We have been told that a pharmacist will be taking over and we will have a telephone consultation with them. It is definitely not the same! I cannot imagine for one minute that they will be contacting us more than once a year!

Hi

I have to say I don’t have any faith at all..! The only place I get any kind of review ( if you could call it such😂) is tertiary care.

My GP doesn’t have an asthma nurse and as for my pharmacist - they dish out salbutamol like chocolate!😂 without question.

Just goes to show how the standard of asthma care varies so widely in the UK and thus the asthma death rate too..

Hold on to a good supportive asthma nurse! You are one of the fortunate ones.

😊👍

You bet ya! She isin fact not 'my' asthma nurse, just happen to be the best of a bunch in this rather large group of surgeries. And when I get to talk to her I am very happy as her knowledge and understanding is so good (she teaches about it at university level). others here are also good on the whole, but she is the best!

Wheesy profile image
Wheesy in reply to Pipsqueak77

I am one of the lucky ones I have 5 Asthma nurses and 4 specialists. Apart from one of my specialists who is about to retire. Thank God, {Stuck in his old ways and I always have to say to him look at me and listen to me and then tell me your verdict. I do not like the idea of a Pharmacist taking care of my 4 often critical problems, and I am sure that I am not the only one

Wheesy profile image
Wheesy in reply to Wheesy

OOPS I have duplicated my response, I am having a MAN Moment

I hope that my GP surgery keeps our Asthma on as I feel that a Pharmacist should stick to what a chemist should do and that is dispensing medication to those in need. Astma is a very complex issue it is bad enough the paramedics being undertrained in lung problems but a pharmacist goes against the grain with me. And also my specialist has to dig deep into his knowledge in order to help with my problems. Incidentally I have 4 Astma Nurses at my local hospital one at my GP surgery and not forgetting those wonderful asthma nurses available via this forum.

I wonder if pharmacists are being used to review meds to free up pressures on GPs. Reviewing to make sure ventolin isn't being overused is a good thing as maintenance/preventer meds should be optimised in order to prevent overreliance on ventolin. For some asthmatics this isn't possible despite optimising maintenance meds but it will be for most.

Wheezycat profile image
Wheezycat in reply to twinkly29

yes, it felt fine! I do believe it was to 'free up' opther parts of the gp service, but then I have never before had two reviews in 6 months unless there was a particular problem. And she will check and sign it off with a very competent asthma nurse. It felt safe.

I am reviewed as usual at the respiratory clinic at the hospital and I have a yearly review with the asthma nurse at my GP surgery. This year I also got reviewed by a pharmacist as well. The letter I got explained that this was funded by some pharmaceutical company, which one I can’t remember. I was expecting he would try to change me to one of this companies products, but no, he didn’t. He was very good.

Wheezycat profile image
Wheezycat in reply to Troilus

Yes, I was told it was funded by Astra Zeneca, but like you no hint of trying to change me on to some promoted product.

I've smiled at the posts and wonder if its not the over use of salbutamol but another government ploy to crawl back money they are doing it with pain medication my husbands pharmacist told him... She rings weekly to reduce his. They are possibly going to make 60 to retirement pay for medications to "help the NHS" so why not us with chest problems we cost money. My GP will certainly not give me extra medication unless I'm on my knees. Wheezycat you sound as if you have a wonderful practice and are lucky to have an asthma nurse. Mine was finished as they said a general nurse can deal with it all.. She does but is very overworked. I know I'm going to get grief but I worked in the NHS I know how cuts happen.

Wheezycat profile image
Wheezycat in reply to Spikedog66

You are certainly right about cuts!!! I have no idea at this point how that has hit our group of surgeries (twenty or so in all?) . Yes, when I get common sense response I am so happy and relieved, but it is rare I see the exemplary asthma nurse, and not all others are so good and at least one down right irritating - if they are still there even. I have not seen a gp or a nurse in 18 months, everything but one blood test has been by phone, so I don't know the overall state of our surgery in the group. I did have issues to the point of getting anxious about some other medications that got blocked (blood pressure) and had to contact, on the web of course, three times, and it was a couple of days before running out altogether before anything happened. And I only discovered by accident they had been blocked.

Whats GP?? I've been poorly since feb have chugged along with the help of the practice nurse who referred me back in May to hospital chest clinic who discharged me in January 21 who said "I can deal with myself and see my Gp they are overrun" I get it due to covid. Lots of people are being missed or neglected its a terrible situation but many health professionals like the system as it is and don't want it to reverse back. I'm still waiting for either a telephone appointment or face to face from clinic maybe 2022 if im lucky.

Wheezycat profile image
Wheezycat in reply to Spikedog66

Sorry to hear! That is not great! I have had reason to contact a GP twice since covid, once in early January following an asthma attack and once for a deterioration in a skin condition. I had to contact online, but on both occasions I got a call back pretty fast. Neither situation needed a 111 call (well, maybe the asthma attack, but I didn't). The follow ups is another matter. That can really take ages, and can be moved from one person to another behind the scenes so it can get really confusing.

This has been happening to me for approximately a year now.The pharmacist will send me out a survey link via text message regarding my asthma and then call me approx 1 week later to discuss the results. The first time that this happened it was completely out of the blue without any prior discussion with my GP.

Whilst a very nice lady, like others I feel a little uncomfortable and don't believe that it should be her desicion on whether patient's need changes to their medication - something which she's tried with me, only for it to be overturned by my respiratory consultant who agreed with me and not her.

On a couple of occasions during calls she has kindly advised that I really need an appointment to speak to my GP as it was obvious I was unwell, unfortunately we can never manage to get an appointment...only had one face to face in 2 years and that was three days after a telephone consultation and having to wait for a negative covid test before access to the surgery. Even for a telephone appointment the receptionist advises it has to be an emergency. That's a completely different issue though.

As I am sure many of you in the same position are told - as a 'complex case' with numerous conditions I can always just go to A and E.

Apologies..I've gone off track.

We don't have a dedicated asthma nurse at our surgery it has always been just seeing a GP when poorly or in the last few years my consultant at reviews or admissions, so like others in the group I very much self manage.

Take care everyone x

Wheezycat profile image
Wheezycat in reply to Joolstom

I am sorry to hear you have had so many difficulties. I have clearly on the whole been luckier than you! I wish you better times.

I have very little faith in my asthma nurse, it feels like she goes through a check list and prescribes on the score. If I say a drug seems to make me worse she just says that it can't be that and adds something else to it. One that she tried to change me to had bad common side effects but when I tried to speak to her about this she said I probably wouldn't get them and not to be swayed by the leaflet - these were listed as common side effects and included weakening bones making breaks more likely, I'm 53 and ride horses so found that unacceptable. But she only listened when I point blank refused to take it and after she'd tried telling me the side effects were the same for all inhalers! Trying to see a GP is a nightmare, I just get sent to the asthma nurse anyway unless I make up another problem.

To cap it all she told me during lockdown that rather than get a face to face appointment at the surgery I should go to A&E. No wonder A&E departments have problems.

Wheezycat profile image
Wheezycat in reply to Comeriding

I am sorry to hear your experiences have been so poor. As we know all medications have side effects, and I think all of have to weigh up the benefits versus the side effects. My daily inhaler does contain steroids, which do have side effects, but it most definitely improved my breathing! I hope you find something that feels right for you.

I have an annual asthma review with the asthma nurse but my drs surgery has been doing 6 month reviews with the pharmacist for a few yrs now but they’re optional.Too be honest I’m happy with him reviewing my meds it’s not like he’s actually replacing my dr as he can only recommend any change of meds back to my dr same as my asthma nurse does.I am one of those people who use my pharmacist as a first call if I’m not feeling to well etc as he has the experience of medicine and reactions etc that a lot of drs don’t

Yes, that is roughly how I feel. And, of course, if something isn’t working I do have the option of contacting the surgery.

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