162 A review of non-medical prescribing in an adult CF centre

Abstract

Background Two physiotherapists at Bristol Adult CF Centre have been supplementary Non-Medical Prescribers (NMPs) since November 2013, prescribing from a predefined list of medications, with patient and medical prescriber consent. Physio NMPs run an inhaled therapy clinic initiating and prescribing new treatments directly. Prescribing practice has changed with the introduction of dry powder inhalers (DPIs). We wished to review NMP practice whilst exploring patient opinions about DPIs. Methods A 1 day snapshot of current inhaled medication prescriptions from our clinical database, and review of NMP prescribing log for a 12 month period. An anonymous patient questionnaire distributed to in- and outpatients asked about experience of inhaled therapies. Results There were 428 prescriptions for inhaled therapies in 207 current patients: nebulised antibiotics 51, DPI antibiotics 149, nebulised mucolytics 205, DPI mucolytic (Bronchitol) 23. NMPs wrote 564 prescriptions for nebulised and DPI antibiotics and mucolytics, oral mucolytics, oral antibiotics (including antifungals), oral steroids, leukotriene receptor antagonists, nebulised and inhaled steroids and bronchodilators, pain relief, laxatives and IV fluids. 22 questionnaire respondents preferred DPI to nebulised treatments, and 8 did not. 24 respondents found DPI easier to take than nebulised therapies. Only 2 respondents wished to switch back from DPI to nebulised equivalents. Conclusions More DPI than nebulised therapies are now prescribed in our centre, facilitated by the ability of physiotherapists to prescribe therapies directly, within independent clinics and the NMP role is expanding. DPI treatments appear popular.