We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. When you install the update, you will see that each toolkit has a small QR code icon the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.
You may need to actively install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits.
To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:
On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.
On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.
Please get in touch with ann.wales3@nhs.scot with any questions.
14/12/23 - SMC1274/17 indication added to Trimbow monograph.
22/12/23 - Formoterol fumarate with glycopyrronium and budesonide (Trixeo® Aerosphere) pressurised inhalation, suspension (Trixeo® Aerosphere) 5mcg/7.2mcg/160mcg SMC2321 added.
Note: Review the need for inhaled steroids in patients with COPD if an episode of pneumonia has occurred. High doses of inhaled corticosteroid have been associated with lower respiratory tract infections, including pneumonia, in older patients with COPD.
Please consider if a steroid emergency card needs to be given to the patient alongside the traditional steroid treatment card. This is to support the timely recognition and treatment of potential adrenal crisis and is suitable for some patients on oral, inhaled, topical or rectal steroids. For more information, including which patients should receive the card, see HIS for details. Steroid emergency cards have been distributed to, hospitals, GP surgeries and community pharmacies. Primary care can order replacement cards from 01463 706886.• inhaled corticosteroids, in combination with a long-acting bronchodilator, should be prescribed for patients with an FEV1 of 50% or less of predicted, who are having 2 or more exacerbations requiring treatment with antibiotics or oral corticosteroid in a 12-month period. Refer to NICE guidance on the management of COPD in adults in primary and secondary care.
• fluticasone with vilanterol (Relvar® Ellipta® 92/22) is cost-effective and offers the advantage of once-daily dosing.
• in patients with moderate to very severe COPD who are unsuitable for inhaled corticosteroid and in those who remain breathless or have exacerbations despite taking long-acting beta agonist plus inhaled corticosteroid consider a combination bronchodilator inhaler (LAMA/LABA).
See Peri-operative guidelines for patients with or at risk of adrenal insufficiency.
PREFERRED: Dry Powder Inhaler (DPI) (Inhalation powder)These are more environmentally friendly than MDIs and should be considered first line providing that the patient shows good inhaler technique with the chosen device.
COPD, by inhalation of powder, 92/22 inhaler, 1 puff once daily.
PREFERRED: Dry Powder Inhaler (DPI) (Inhalation powder)These are more environmentally friendly than MDIs and should be considered first line providing that the patient shows good inhaler technique with the chosen device.
COPD, by inhalation of powder (Fostair® NEXThaler), 2 puffs twice daily
ALTERNATIVE: Metered dose inhalers (MDI) (Pressurised inhalation)To be considered in the small proportion of patients who are unable to use a DPI.
COPD, by aerosol inhalation (Fostair®), 2 puffs twice daily.
PREFERRED: Dry Powder Inhaler (DPI) (Inhalation powder)These are more environmentally friendly than MDIs and should be considered first line providing that the patient shows good inhaler technique with the chosen device.
COPD, by inhalation of powder 500/50/blister, 1 blister twice daily.
PREFERRED: Dry Powder Inhaler (DPI) (Inhalation powder)These are more environmentally friendly than MDIs and should be considered first line providing that the patient shows good inhaler technique with the chosen device.
See step-down ICS guidance in COPD.
As per SMC 1303/18: maintenance treatment in adult patients with moderate to severe chronic
obstructive pulmonary disease (COPD) who are not adequately treated by a combination of an
inhaled corticosteroid and a long-acting β2-agonist.
SMC restriction: in patients with severe COPD (forced expiratory volume in one second [FEV1]
<50% predicted normal).
ALTERNATIVE: Metered dose inhalers (MDI) (Pressurised inhalation)To be considered in the small proportion of patients who are unable to use a DPI.
See step-down ICS guidance in COPD.
See SMC 1274/17: Maintenance treatment in adult patients with moderate to severe chronic obstructive pulmonary disease (COPD) who are not adequately treated by a combination of an inhaled corticosteroid and a long-acting beta2-agonist.
SMC restriction: severe COPD (forced expiratory volume in one second less than 50% predicted normal).
ALTERNATIVE: Metered dose inhalers (MDI) (Pressurised inhalation)
To be considered in the small proportion of patients who are unable to use a DPI.
Pressurised inhalation, suspension (Trixeo® Aerosphere) 5microgram /7.2microgram /160microgram /dose
As per SMC2321: maintenance treatment in adult patients with moderate to severe chronic obstructive pulmonary disease (COPD) who are not adequately treated by a combination of an inhaled corticosteroid and a long-acting beta2-agonist, or combination of a long-acting beta2-agonist and a long-acting muscarinic antagonist.
SMC restriction: in patients with severe COPD (forced expiratory volume in one second [FEV1] less than 50% predicted normal).
TAM (Treatments and Medicines) NHS Highland