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Responsible Respiratory Prescribing (RRP)

This page is for key responsible respiratory prescribing tools and messages from the London Respiratory Clinical Leadership Group. Seven messages were agreed in March 2014. The rationale for the responsible respiratory prescribing movement is presented in the pdf of Vince Mak's presentation to the IPCRG 2014 world conference, and the high dose inhaled corticosteroid alert card order form, sample and guidance for prescribers is available to download.

Seven responsible respiratory prescribing messages

1.  Respiratory medicines are expensive

Doing the Right Things:

2.  When prescribing any new respiratory inhaler, ensure that the patient has undergone NICE-recommended support to stop smoking

3.  Pulmonary rehabilitation is a cost-effective alternative to stepping up to triple therapy and should be the preferred option if available and the patient is suitable.

Doing the Right Things Right:

4.  When prescribing any inhaled medication, ensure that the patient has undergone patient-centred education about the disease and inhaler technique training by a competent trainer.

5. When prescribing an MDI (except salbutamol), ensure that a spacer is also prescribed and will be used.

6. When prescribing high dose inhaled corticosteroids (>1000ug BDP equivalent?), ensure that the patient is issued with an inhaled steroid safety card. (Note that the CLG is finalising a card, having tested it with prescribers over the last year).

7.  No Prednisolone EC prescribing without good clinical reason.

Responsible Respiratory Prescribing (RRP) presentation to IPCRG 2014 Athens


High dose inhaled corticosteroid alert card:
Steroid alert cards are an NHS requirement, but this is updated, and provides patient information about the risks.  The guidance for prescribers assists prescribers to decide if the high dose is necessary (and therefore issue an alert card) or if a lower dose is sufficient (and therefore no alert card is necessary). Over 100,000 packs have been bought by NHS colleagues from across the NHS.

Order form with sample alert card

Guidance for prescribers

Responsible oxygen prescribing

LRN has produced a number of practical documents to reduce the potential harm caused by misuse of oxygen.  The messages are here, for other documents, go to the Documents section, as well as the resources from the event on 14 November 2016 in Events.