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42 RESPIRATORY HEALTH FROM PAGE 41 This reduced lung capacity means asthmatics are among those at greater risk when air quality is poor. Planning ahead In June, the results of an Asthma Australia survey1 on the effects of the bushfires were published. We asked one of the report’s authors, Asthma Australia CEO Michele Goldman, what pharmacists can learn from the findings. “We know that any exposure to smoke and small particulate matter is harmful to health and the larger the concentrations and the longer the period of exposure, the more harmful it can be,” she said. “Essentially, this means if our population is going to be exposed to periods of bushfire smoke more often and with greater intensity, we’re setting ourselves up for more respiratory disease in the future. “However, we can become better at being able to differentiate when air quality is OK, when it’s poor and when it’s hazardous. Hopefully, people will know to stay indoors when conditions are really hazardous, and to only go about the life activities which involve being outdoors and exposed when conditions are less harmful.” The pharmacy’s role The Asthma Australia bushfire survey showed people will go to pharmacies in the first instance because they are the most accessible outlets, confirming not only pharmacy’s place on the frontline but also underscoring the importance of pharmacies being able to advise patients towards achieving better health outcomes. “Those visits are usually to buy reliever medication because the patient is experiencing symptoms,” Ms Goldman said. “Either they’ve had really mild asthma and don’t normally carry reliever medication but are now having some trouble, or their regular medications are running short and they know that they need to be diligent at this time. “I think pharmacists can anticipate ahead of the summer season and make sure their stock levels are above normal, given the experience of last season when one of the big issues was that stock just ran out so quickly. With life-saving medication like reliever medication, that just can’t happen. “Pharmacists can also play a valuable role by questioning the person coming in to buy a reliever, to try and understand a number of things: • Has the patient seen a GP recently? • Do they have a diagnosis? • Have they been prescribed a preventer? • If so, are they using it regularly?” The worst thing that can happen is for a patient to continue to come into a pharmacy and buy multiple reliever medications over a long period of time. “The pharmacy can disrupt that process and, through questioning, identify they really should be going back to their doctor.” Certainly, the clear message today is not to simply rely on OTC reliever medication when symptoms flare up, but to use preventer therapy, as the long-term health benefits are greater. “We also encourage those in pharmacy to advise patients with asthma and hay fever to get the hay fever under control,” Ms Goldman said. “This is especially important in spring months, with extreme weather patterns and high pollen levels. They’ll find with hay fever under control, their asthma is better controlled too.” It’s not what but how Skill is a funny thing. We can develop a high degree of excellence in something but, over time, as we continue to do it regularly, that excellence loses its shine and slips back into the mediocrity zone. Driving a vehicle is a good example, with most experienced drivers admitting they can be somewhat blasé about certain road rules, particularly when nobody is watching. Ms Goldman says this is also true of patient technique in the use of asthma devices, and suggests pharmacists and their staff are well placed to help maximise the benefits of those devices for their patients. “A key pharmacy role is looking at the way patients are using their medications because so often people aren’t using their devices correctly,” she said. “This of course means they’re not going to be getting the full benefit of the medication, so they’ll be symptomatic. “The importance of technique is one of our core messages, and not just in bushfire season, because up to nine out of 10 people aren’t using their devices correctly. The research shows device technique should be reviewed regularly, at least every few months. “Asthma devices are really complex, and with so many different types, the chances of knowing how to use a device intuitively are very low. Even if your health professional, or your doctor, or your pharmacist has shown you how to use it first time round, you’re not RETAIL PHARMACY ASSISTANTS • AUG 2020