Evaluating usability of the Reliever Reliance Test as a patient support tool in community pharmacy in England

Aim: The Reliever Reliance Test (RRT) is a self-reflection test that can help asthma patients determine and modify their reliance on SABA. Community pharmacists (CPs) in NW London are evaluating the usability of the test as a starting point for providing support to asthma patients using ≥6 SABA inhalers over 12 months. Outline of context: English CPs currently support asthma patients via brief interventions and consultations, in line with good practice and contractual obligations. Key elements are ensuring correct inhaler technique and reducing SABA over-reliance. We have previously reported the design of a support pathway for patients starting with the RRT plus the offer of a follow-up consultation, and of an evaluation. Focus groups assisted with the preparation. The evaluation forms part of the IPCRG Asthma Right Care project to test the RRT. Strategy for change See Table 1 Impact of changes: Initial analysis has enabled partial answers concerning: the proportion of patients receiving RRTs who opted for consultations; benefits that patients identified from using the support pathway; how realistic CPs considered routine use of the pathway would be; benefits CPs thought the pathway offered; difficulties encountered. Lessons learned: 91 patients received RRTs, of whom 74% attended support consultations. Of patients reporting on value of RRT in association with the consultation (n=61), 79% reported positively; 15% unsure; 6% negative. Of patients providing any feedback (n=65), 68% spontaneously reported improved knowledge of asthma and inhaler roles. CPs were universally positive about the RRT usefulness, but many seemed uncomfortable with the opt-in arrangement for consultations. These may have been over-promoted. Messages for others: When used by community pharmacies as described, the RRT has the capacity to provide patients with a better understanding of asthma and its management. The most common practical difficulty encountered was RRT completion by patients with English language difficulties.