Will LABAS end useless breathing treatments?

For the past several years one doctor orders Pulmicort BID instead the patient use his Qvar QID.  We RTs have hated it, because it makesk treatments last longer.  Now I'm wondering if this is the wave of the future, and that it's for the best.

Hear me out, folks, because Pulmicort BID treatments may be good for us.

Last fall I gave my first Brovana breathing treatment.  I had no idea what this medicine was, so I did a Google search.  After doing this I realized I had heard of Brovana before: it's Foracort.  This is a LABA: a long acting broncho dilator.

Think of this:  Both Brovana and Pulmicort only need to be taken twice a day!


You heard it here first, folks.  Remember a few years back I wrote about a talk I had with a doctor (you can view it here).  I asked her why she orders Q4 Ventolin treatments when the patient is not short of breath.  She said, "Because we want to prevent bronchospasm."  I said, "Then why don't you prescribe Serevent?"  She gave me a wry expression, hissed, and left the room.

That was ten years ago.  Yesterday a homecare representative visited me in the RT Cave, and he told me most of his patients now get Brovana and Pulmicort.  He said it's great because it improves compliance.  "Think of how much easier it is for patients to only take two breathing treatments a day, with Ventolin only if needed?" he said.  "Our doctors are buying it."

He convinced me.  If doctors truly believe all these patients need a bronchodilator, and all these procedures are burning us RTs out, and doing nothing for the patient, then why not at least try BID Brovana and Pulmicort with prn Ventolin or Xopenex?

Surely we can have further debates, such as will this put us out of a job?  Yet we'll delve into that in a later post.  Or, better yet, I'll leave it to you guys.  I just wanted to bring this subject up and let you know it's a possibility for the future.

This may be the RT Revolution we need?