The answer

Shamma is aware that the local GP surgery have been switching lots of patients from pMDIs to dry powder inhalers (DPIs). She has previously had a chat with the primary care network (PCN) pharmacy technician about this, and the pharmacy have agreed to support these patients in conjunction with the surgery. Shamma takes the patient into the consultation room as the pharmacy is very busy.

Firstly, Shamma should explain the reason behind the switch, and discuss how pMDIs, like the inhaler he was previously using, have a much higher carbon footprint than his new inhaler.

Next, Shamma should show the patient how to use the new Nexthaler device. If she has a placebo device available, this should be used to aid the consultation. Firstly, Shamma should show how to prime the inhaler, and then she should demonstrate how to inhale the dry powder. pMDIs and DPIs are used in very different ways. pMDI inhalers require users to inhale slowly and steadily for three to five seconds. DPI inhalers require a patient to inhale quickly and deeply.

Having shown him how to use his inhaler, and watched him demonstrate use successfully, Shamma gives some further information and safety netting advice. “You might want to download the RightBreathe app or go on to the Asthma UK website – it has videos showing how to use your new inhaler. If your asthma symptoms get any worse than normal, or if you’re having trouble using your inhaler, don’t hesitate to get in touch with us at the pharmacy or the surgery.”