The future hospital: integrated working and respiratory virtual clinics as a means of delivering high-value care for a population

Patel, Irem; d’Ancona, G; Baxter, Noel; Saleem, Azhar; Royle, Finlay; Burgess, Vanessa; Lord, Victoria; Taylor, Kevin

doi:10.7861/futurehosp.3-2-s28

Cited by 3 publications

(2 citation statements)

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“…One option that might help ICS withdrawal in general practice is to offer more guidance to the GPs. For example, the first results on virtual case reviews of COPD patients prescribed high doses of ICS in the UK were promising but need to be verified by scientific studies 28 .…”

Section: Discussionmentioning

confidence: 99%

Pragmatic trial on inhaled corticosteroid withdrawal in patients with COPD in general practice

Bemt¹,

Nieuwenhof²,

Rutjes³

et al. 2020

npj Prim. Care Respir. Med.

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The therapeutic value of inhaled corticosteroids (ICSs) for COPD is limited. In published RCTs, ICS could be withdrawn in COPD patients without increasing exacerbation risk when bronchodilator treatment is optimized. Here we report on the feasibility and risks of ICS withdrawal in Dutch general practice for COPD patients without an indication for ICSs. In our pragmatic trial, general practitioners decided autonomously which of their COPD patients on ICS treatment could stop this, how this was done, and whether additional bronchodilator therapy was needed. We recruited 62 COPD patients (58 analysed) who were eligible for ICS withdrawal in 79 practices. In 32 patients (55.2%, 95% CI: 42.5–67.3%) ICS was withdrawn successfully, 19 (32.8%, 95% CI: 22.1–45.6%) restarted ICS treatment within six months, 12 patients (20.7%, 95% CI: 12.3–32.8%) had a moderate exacerbation, and one patient had a severe exacerbation. ICS withdrawal was successful in just over half of the patients with COPD without an indication for ICS.

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Section: Discussionmentioning

confidence: 99%

Pragmatic trial on inhaled corticosteroid withdrawal in patients with COPD in general practice

Bemt¹,

Nieuwenhof²,

Rutjes³

et al. 2020

npj Prim. Care Respir. Med.

View full text Add to dashboard Cite

show abstract

“…Integrated respiratory care requires insight into care delivery across the hospital and primary care settings. Increasingly, pharmacists are adopting roles that see them embedded in secondary care teams and general practice [33][34][35], delivering expert care and intervention to people with airways disease and complex pharmaceutical needs. These could be patients with adherence issues or polypharmacy, or those taking medicines that require monitoring or careful counselling prior to initiation, e.g.…”

Section: Copd and Integrated Carementioning

confidence: 99%

The role of the clinical pharmacist in the respiratory or sleep multidisciplinary team

Clements,

Bowman,

Tolhurst

et al. 2023

Breathe

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The role of the pharmacist has evolved significantly, not least over the last 20 years. It delivers a skilled profession with a vital role in medicines optimisation and the management of patients with a respiratory or sleep disorder. While pharmacists are capable of acting as independent practitioners delivering direct patient care, this article explores their contribution to multidisciplinary teams within asthma, COPD, cystic fibrosis, tuberculosis, interstitial lung disease and sleep medicine. Having identified patient cohorts needing specialist medicines support, notably those with poor medicines adherence or specific medicines-related needs (for example during adolescence, or women who are pregnant or breastfeeding), these pharmacists work within primary, secondary and specialist tertiary care. The aim of this review is to share and inspire innovative models of working to include more pharmacists in respiratory and sleep medicine.

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Integrated respiratory care

Patel¹

2021

Clinics in Integrated Care

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The future hospital: integrated working and respiratory virtual clinics as a means of delivering high-value care for a population

Cited by 3 publications

References 0 publications

Pragmatic trial on inhaled corticosteroid withdrawal in patients with COPD in general practice

Pragmatic trial on inhaled corticosteroid withdrawal in patients with COPD in general practice

The role of the clinical pharmacist in the respiratory or sleep multidisciplinary team

Integrated respiratory care

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