COPD Rescue Pack

NICE states “Patients at risk of having an exacerbation of COPD should be given a course of antibiotic and corticosteroid tablets to keep at home for use as part of a self-management strategy.”

A survey of member practices was carried out to identify what practices are currently doing in relation to prescribing COPD Rescue medications. Here are the results of the survey which shows the range of CURRENT practice.. We would like to thank all those who participated in the survey and hope this informs practices to improve delivery of care to patients. At the bottom of the page, you can see some of the forms that patients share with records and a protocol that has been agreed at Haughton Thornley Medical Centres. We share this simply as an example and would be happy to hear your thoughts.

We received 41 replies back from a variety of GPs, nurses and practice managers. (Some replies came back from different people from the same practice)

Practices that responded:

Saddleworth Medical Practice

Town Hall Surgery

Saddleworth

The Brooke Surgery

Cottage Lane

Greenbank Medical Practice

Lindley Medical Practice

Lambgates Health Centre,Hadfield

Market Street Medical Practice Droylsden

Waterloo medical center

Donald Wilde medical centre

Haughton Thornley Medical Centre

Springfield House Medical Centre

Awburn house

Haughton Thornley Medical Centres

St Andrews House

Manor House Surg

West end

Lambgates

Brooke

Droylsden Medical Practice

Grosvenor Medical Practice

Haughto/Thornley

Donneybrook Medical Centre

Littletown family medical practice

Grosvenor

Albion Medical Practice

Staveleigh Medical Centre

Ashton medical group

Droylsden medical

Medlock vale Droylsden

Saraf Medical Practice

Quayside Medical Practice

Cottage Lane Surgery

Quayside Medical Practice

Grosvenor

Kapur family care

St andrews House

Leesbrook

Hopwood House

Any comments:

• Advice when to use, try & advise when to start either abx or pred or both re IECOPD / non-IE COPD. Reinforce issues with cumulative effects of pred.
• Local Guidance would be helpful
• Hard to be black and white about things when we have a high prevelance of AB resistance
• we have a telephone advice line for all patient including those with copd It is thee patients can order rescue meds/advice as well as GP tel consultations
• We have some COPD self management plans we give to patients to help recognise changes and how to manage. I have emailed to the attached address.
• we do not put them on repeat but they are on acute and prescribed to patients when requested, advised to request when used previous prescription
• We give our patients a COPD passport to promote self care, this includes their most recent FEV1 %, written exacerbation guidance and general education and signposting
• We advise patients TCI review after they have taken their rescue meds but sooner if the symptoms do not improve when they start to take them.
• we select pts who had had 2 or more excasabations and issue rescue packs with information leaflet then ask them to phone and book review after 1 week
• If patient request rescue pack they are invited to see the practice nurse for a review one week after exacerbation
• Occasionally repeat rescue pack is issued on request due to clinician availability but will be followed up by a clinician (nurse). Routinely exacerbations are seen within 2 weeks of the incident assessed and rescue pack issued with advice.
• patients have usually attended Pulmonary rehab prior to having rescue meds prescribed. the rescue meds come with clear instructions of when to use and dosages.. patients at the practice with COPD are well known to the clinicians and are prioritised for triage and to be seen and overall are treated at home and kept out of hospital
• We use one OLDHAM care plan
• initially started this 10 years ago to help with the winter bed crisis but now find the benefits throughout the year- but we closely monitor pt demand for acute rescue meds
• Care plan states see ANP or GP if no better within 3 days and once treated see GP ANP within 2 weeks of rescue medications

COPD Passport action plan

Self Care leaflet COPD

Winter Plan Leaflet

COPD Rescue Medications protocol at Haughton Thornley Medical Centres

It is encouraging to see 15 responses showed practices that are already enabling patients to see what the doctor or nurse has written in the electronic health records with a further 3 planning to do this and 6 who would like help to get started. Below you can see screenshots from the Test Patient for both Evergreen Life and Patient Access to see what patients can see when they log into the record and read what is in their electronic health records as the suggested text agreed at Haughton Thornley Medical Centres. Currently 60% of all COPD patients at Haughton Thornley Medical Centres have signed up for this facility and encourage patients and carers to visit COPD care to learn more for themselves about what is available in the practice and locally to provide that wider understanding beyond just access. As patients / carers become more activated, we see greater interest in the use of such information and online services alongside the care they receive from their doctor or nurse. Health champions in the practice could ideally support ongoing discussions in the community helping to raise health literacy further.