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  5. 4. Fostair pMDI to DPI (Nexthaler)

4. Fostair pMDI to DPI (Nexthaler)

The Fostair inhaler is available as both pMDI and DPI, meaning that changing between the two devices can be more straightforward as the medication and dose is the same, only the device changes.

The process

Step 1: Search for all patients with Fostair pMDIs on repeats

Create a list of all patients aged 12+ with asthma with Fostair MDIs on repeats.

Resource:

Step 2: Invite patients to consultations

Contact all patients to offer consultation to switch inhalers to a lower carbon option.

Contact patients to provide information on lower carbon options to read before their appointment.

Resources:

Alternative step 2: Set an alert on the patient record to show that lower carbon inhaler options are available

Create a visibility rule flagging patient for consideration of lower carbon options at next review. This is flagged on the Primary Care IT Asthma Template

If you are doing this, send patients information about inhalers and the environment so they are primed for their next review.

Resources:

Step 3: Perform consultations to discuss using a lower carbon inhaler

Use the Greener Practice Guide, the Approach to consultations video to support you.

Depending on how many patients are identified by your search consider workload, how this will be managed and by whom.

In this consultation, inhaler technique must be discussed and checked by a competent healthcare professional (preferably with a link to inhaler device information). Asthma UK videos on inhaler technique are an excellent resource to share with patients.

Resources:

Step 4: Follow-up patients

At the point you change a device you need to follow-up all patients at 4 – 6 weeks to review the change. You could code this in the notes.

TIP: add patients who have been switched to a waiting list for follow-up .

Step 5: Measure your impact

Measure your carbon savings, monitor your progress.

Resource:

  • Run-chart tool

Resources

SMS templates

Changing to a lower carbon inhaler (if inviting directly to appointment)

SMS 1 of 1:
You may be able to change to a lower carbon footprint inhaler that is better for the environment?  For more info, read this leaflet https://bit.ly/3fSys0h or watch this video https://bit.ly/3T90yTn or go to www.greeninhaler.org
 If you are interested, please book an asthma review.

AccuRx SMS 1 of 1:
We’re offering patients the opportunity to change their regular inhalers to a different type with a lower carbon footprint.  For more info, read this leaflet https://bit.ly/3fSys0h or watch this video https://bit.ly/3T90yTn or go to www.greeninhaler.org
If you’re interested, please contact reception to book an asthma review to discuss further.
OR
If you’re interested, please reply “YES” & we’ll contact you to make an appointment.

—–

Changing to a lower carbon inhaler (if setting visibility alert)

SMS 1 of 2:
You may be able to change to a lower carbon footprint inhaler that is better for the environment. If interested, discuss at your next asthma review.

SMS 2 of 2:
For more information on asthma, inhaler devices and the environment, read this leaflet https://bit.ly/3fSys0h or watch this video https://bit.ly/3T90yTn or go to www.greeninhaler.org

AccuRx SMS 1 of 1:
We’re offering patients the opportunity to change their regular inhalers to a different type with a lower carbon footprint. For more info, read this leaflet https://bit.ly/3fSys0h or watch this video https://bit.ly/3T90yTn or go to www.greeninhaler.org
If you’re interested, please speak to the nurse or doctor at your next asthma or medication review.

—–

Follow-up after change in inhaler

SMS 1 of 2:
We hope you are getting on well with your new inhaler. If there are any issues, please [book a review with asthma nurse/ doctor].

SMS 2 of 2:
Remember, if you’re needing your blue inhaler 3 or more times per week, this means your asthma treatment could be improved and you should book an asthma review as soon as possible.

AccuRx SMS:
We hope you are getting on well with your new inhaler. If there are any issues, please book a review. Remember, if you’re needing your blue inhaler three or more times per week, this means your asthma treatment could be improved and you should book an asthma review as soon as possible.

Letter templates

Fostair MDI to NEXThaler

Dear Patient,

As part of our practice commitment to provide excellent care and protect our planet, we are offering patients the opportunity to change their inhaler to a more environmentally friendly device.

Which of my inhalers does this affect?
Your pink “Fostair” inhaler, which you take every day to prevent you from having symptoms. This may appear on your prescriptions as one of the following:

  • Fostair 100/6 micrograms pMDI
  • Fostair 200/6 micrograms pMDI
  • Luforbec 100/6 micrograms pMDI
  • Beclometasone 100 micrograms/puff + formoterol 6 micrograms/puff pMDI
  • Beclometasone 200 micrograms/puff + formoterol 6 micrograms/puff pMDI

Why would I want to change my inhaler?
The Fostair you are using now is a metered dose (or spray) inhaler. It uses a propellant gas to deliver medication to your airways. This propellant  is a powerful greenhouse gas and contributes to climate change. Your inhaler may say it is CFC free and this means the gases do not damage the ozone layer, however they still contribute to climate change.

The company that makes Fostair also makes an inhaler which doesn’t use a propellant gas, called the Fostair NEXThaler. This is a dry-powder inhaler. Because it doesn’t use gas, it has a much lower carbon footprint. Dry-powder inhalers can be effectively used by most patients and don’t need to be used with a spacer, which can make them more convenient. Here is a short video showing you the technique needed for a NEXThaler. https://www.asthma.org.uk/advice/inhaler-videos/nexthaler/

Where can I get more information?
Read this leaflet https://bit.ly/3fSys0h or watch this video https://bit.ly/3T90yTn or go to www.greeninhaler.org

What do I do now?
If you would like to speak to our healthcare professionals about changing your Fostair inhaler to a Fostair NEXThaler, please contact reception to make an appointment.

OR

Please have a read of the information provided and write down any questions you may have. You will be contacted in the usual way for your asthma medication review, and at this time your nurse/ doctor will discuss changing your inhaler prescription with you if appropriate.

Many thanks,

[Practice name/ lead clinician]