Frequently Asked Questions
Adult Asthma Guidelines – Usage
Adult Asthma Guidelines – Education
Paediatric Asthma Guidelines – DiagnosisIncentive Scheme
Where do we stand with infection control rules for use of peak flow meters and in check devices now?
We have been advised for in check devices that the filters are safe for multi patient use. For peak flow meters, one way to do it is for practices to have a meter for demonstration only and ask patients to use their own to practice on.
Spirometry waiting lists are lengthy. Would you advise diagnosing and coding with PEF diary, FeNO and excellent history taking?
Excellent history taking is key. Yes, we must be pragmatic and if can demonstrate variable air flow limitation with significant variability in peak flow plus air way inflammation with feno and got a consistent history then that is consistent. Where you are not sure spirometry is useful.
Incentive Scheme
We have had several reports of pharmacies unable to source luforbec. How does the enhanced service stand if there are shortages?
These will be looked into to ensure supply is available. Not aware of any specific shortages.
With regards the lower cost inhalers – where do we stand here with the license – these would be used off license for AIR? Also Luforbec is currently unavailable from pharmacies – will this be considered when we’re not achieving?
We have had several reports of pharmacies unable to source luforbec. How does the enhanced service stand if there are shortages?
We have not been made aware of actual shortages of Luforbec but will monitor. It was suggested that Fobumix was also not available but the does not seem to be the case. But please liaise with local pharmacies on timing and numbers to allow them to plan for stock holding.
We have a lot of patients whose care has been transformed by using Fostair Nexthalers. So starting Luforbec pMDI would be a massive step backwards, and Fobumix DPI is a different agent and might unsettle things.
If a patient’s asthma is well controlled with a low carbon dry powder inhaler, there is no need to change their treatment. The cost-saving element of the scheme requires only relatively low use of Fobumix and Luforbec. These combination inhaler choices can be considered where they are a good fit for the patient. Luforbec should only be considered if the patient cannot use a low carbon ICS/Formoterol inhaler.