Hi Siobbhan – I am interested because I think I might be aware of this project from another perspective. And I’d love to hear how it is getting on. Is Munro a member of Q? I can’t find him in the members list… I’m going to come on over and join the Sustainable Healthcare SIG anyway…

This is really interesting Siobhan – where can we find more info on this? We recently had a drug rep come to talk to us at our practice about SMART therapy, and having looked into it myself, there seems to be good evidence that if patients use SMART regimes, then their compliance is better, and it more or less removes the need for a short acting B2 agonist in many patients (except in emergencies). I can see how this might be the case… As usually patients always report back that their blue inhaler is the only one that helps them and the brown one doesn’t do anything. So patients naturally keep taking more salbutamol, which is far from ideal, as it won’t help in terms of their overall control, their frequency of exacerbations etc. Whereas combination regimes that can be used for both maintenance and as a reliever help keep things simple and it means that patients get their inhaled steroid alongside the B2 agonist. I wonder whether this is an area to focus on as part of the aim of reducing salbutamol prescriptions. It would be good to hear from pharmacists in the group, who I am sure have done work on this in many areas.