Home' Australian Pharmacist : June 2011 Contents Vol. 30 -- June #06
Continuing Professional Development
The articles in this series are independently researched and compiled by PSA commissioned authors and peer reviewed.
health professionals themselves are
deficient in demonstrating appropriate
inhaler technique.18,19 The first step to
tackling inhaler technique education
is to revise our own understanding
of correct inhaler technique (see
the Resources section for access
to free video tutorials). The second
step is to then go out and revise
the technique of patients. Providing
inhaler technique education has been
demonstrated to improve adherence
in patients with asthma as well
as improving clinical markers.18,20
Although the link between correct
inhaler technique and reduced
morbidity has yet to be demonstrated
in COPD, it is considered good
practice and is part of the Australian
• Australian guidelines for the
management of COPD (the COPDX
• Australian Lung Foundation
-- COPD management plans,
-- Better living with chronic
obstructive pulmonary disease:
A patient guide.
• National Asthma Council
(video tutorials for inhaler
• International resources
-- GOLD guidelines
-- UK COPD guidelines
• Placebo inhalers
Pharmacists can actively participate in
health promotion for COPD. Smoking
cessation and early intervention
with inhaled long-acting medication
have been demonstrated to limit
disease progression. By undertaking
campaigns to reduce smoking rates
as well as identifying patients for
spirometry assessment, pharmacists
can provide an important contribution
to both primary and secondary
prevention strategies to reduce the
burden of COPD in Australia.
1. Global Initiative for Chronic Obstructive Lund Disease
(GOLD). Global strategy for the diagnosis, management
and prevention of COPD. 2010.
2. McKenzie DK, Abramson M, Crockett AJ, et al. The
COPD-X Plan: Australian and New Zealand guidelines
for the management of chronic obstructive pulmonary
disease. The Australian Lung Foundation, 2010.
3. Australian Institute of Health and Welfare. Australia's
health 2010, Australia's health series no.12. Cat No.
AUS 122. Canberra: AIHW, 2010.
4. Buist AS, McBurnie MA, Vollmer WM, et al.
International variation in the prevalence of COPD (The
BOLD Study): a population-based prevalence study.
5. Access Economics Pty Ltd. Economic impact of COPD
and cost effective solutions. Access Economics Pty Ltd,
6. Frith PA, Cafarella PA, Duffy JM. Chronic obstructive
pulmonary disease (COPD) is a major personal and
public health burden in Australia. Aust N Z J Public
7. Dent LA, Harris KJ, Noonan CW. Tobacco interventions
delivered by pharmacists: a summary and systematic
review. Pharmacother 2007;27:1040--51.
8. Mansell K, Jorgenson D. Pharmacist interventions:
Tobacco cessation in 3 minutes or less. Can Pharm J
9. Tyler E. Smoking cessation interventions by community
pharmacy: a rapid review of the evidence. National
Public Health Service for Wales, 2009.
10. Saba M, Saini B. Episode 3 - information for
pharmacists dispensing nicotine replacement therapy
Australian Pharmacist 2011;30:202--7.
11. Dang L. Cardiovascular monitoring. Australian
12. Jones R, Østrem A. Optimising pharmacological
maintenance treatment for COPD in primary care. Prim
Care Respir J 2011;20:33--45.
13. Vogelmeier C, Hederer B, Glaab T, et al. Tiotropium
versus salmeterol for the prevention of exacerbations
of COPD. NEJM 2011;364:1093--103.
14. van der Molen T, Schokker S. Primary Prevention of
Chronic Obstructive Pulmonary Disease in Primary Care.
Proc Am Thorac Soc 2009;6:704--6.
15. Vestbo J, Anderson JA, Calverley PMA, et al.
Adherence to inhaled therapy, mortality and hospital
admission in COPD. Thorax 2009;64:939--43.
16. Horne R. Compliance, adherence, and concordance:
implications for asthma treatment. Chest
17. George J, Kong DC, Thoman R, Stewart K. Factors
associated with medication nonadherence in patients
with COPD. Chest 2005;128:3198--204.
18. Basheti I, Reddel H, Armour C, Bosnich-Anticevich
S. Improved asthma outcomes with a simple inhaler
technique intervention by community pharmacists. J of
Allergy and Clin Immunol 2007;119:1537--8.
19. Fink J, Rubin B. Problems With inhaler use: A call for
improved clinician and patient education. Respir Care
20. Takemura M, Kobayashi M, Kimura K, et al. Repeated
instruction on inhalation technique improves adherence
to the therapeutic regimen in asthma. J Asthma
1. What is the estimated
prevalence of COPD in
a) 5.6% of the population.
b) 15.6% of the population.
c) 12.2% of the population.
d) 2.2% of the population.
2. What is the main primary
prevention strategy for COPD?
a) Inhaler technique education.
b) Discussing adherence.
d) Smoking cessation.
3. COPD patients that have high
adherence to their medication
a) are more likely to prefer natural
b) rate themselves as having
sufficient knowledge regarding
COPD and their treatment.
c) rate themselves as having a say
in the way their treatment is
d) are more likely to be confused
about their medication regimen.
A score of 3 out of 4 attracts 0.75 CPD credits.
4. The POET-COPD trial found:
a) salmeterol superior to tiotropium in
prevention of COPD exacerbations.
b) tiotropium superior to salmeterol in
prevention of COPD exacerbations.
c) fluticasone superior to budesonide
in prevention of COPD
d) budesonide superior to
fluticasone in prevention of COPD
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