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Standard inhaler colour needed to prevent asthma deaths, say respiratory nurses

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Patients’ lives could be put at risk if pharmaceutical companies stray away from the widely recognised colour coding of inhalers used to treat asthma, respiratory experts have warned.

The UK Inhaler Group has published findings from a survey of 3,000 clinicians and patients on coloured labelling on inhalers for treating asthma and chronic obstructive pulmonary disease.

“These results highlight the importance of colour”

Monica Fletcher

The group is calling for an official colour-code system for inhalers to prevent possible confusion over which inhaler to use in emergencies. The group said confusion could put patients’ lives at risk.

The survey, of 2,127 patients with asthma and COPD and 596 healthcare professionals, was published today in the journal Primary Care Respiratory Medicine.

“Reliever” inhalers are traditionally coloured blue. The survey revealed 89% of patients and 95% of healthcare professionals frequently referred to the colour when discussing reliever medication.

However, it remains an unofficial colour-coding system, noted those behind the survey.

“It is so important to have consistent simple health messaging”

Sonia Munde

With the increase in inhaler types available, they said there was concern that blue may be used for inhalers not designed for emergency relief, and other colours used for quick relief medications.

UKIG said it was concerned this could mean patients reach for the wrong inhaler in an emergency.

Lead study author Monica Fletcher, chief executive of charity Education for Health, and chair of the UKIG, said: “Inhalers that work rapidly to open up the airways are lifesaving, particularly for asthma.

Monica Fletcher

Monica Fletcher

Monica Fletcher

“With a range of inhalers and new treatments available, it is vitally important for not only patients but their families and carers such as schoolteachers to know which one to use in an emergency,” she said.

“Our survey revealed that it is important to know what medications people take, but definition by colour is by far the preferred way to do this and could save lives,” added Ms Fletcher, who is a nure by background.

Over the last two years two pharmaceutical companies that had planned to change the proposed colour of new inhalers decided not to after considerable lobbying from the group.

UKIG is calling for all interested parties to agree a formal industry-wide approach to colour coding so that in the future it would not be possible for a blue inhaler to obtain a licence unless it is a reliever and inhalers not for rapid symptom relief will not be licensed if they are blue.

Ms Fletcher said: “These results highlight the importance of colour and add to the debate about the need to formalise the colour coding of inhaled therapies. In particular, they show the need for using the colour blue for inhalers for rapid relief of symptoms.

“We believe this survey should provide the impetus for all interested parties to discuss and agree a formal industry-wide approach to colour coding of inhaled therapies for the benefit of patients, carers and healthcare professionals,” she said.

Asthma UK

Nurses urged to use new national asthma guidelines

Sonia Munde

Sonia Munde, clinical nurse manager and head of the Asthma UK helpline, said: “The term ‘blue inhaler’ has been synonymous with the reliever inhaler for years and is commonly referred to this way by clinicians and patients.

“It is so important to have consistent simple health messaging between people with asthma, their carers and healthcare professionals,” she said. “This is particularly the case during a life-threatening asthma attack when clear coherent instructions can save lives.

“For example, a 999 call operator may tell someone to take a number of puffs from their blue inhaler, while that person is waiting for an ambulance during an asthma attack. And our nurses will often refer to the ‘blue inhaler’ when they are giving advice on Asthma UK’s helpline,” she added.

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