Community pharmacy-based case finding for COPD in urban and rural settings is feasible and effective

Community pharmacy-based case finding for COPD in urban and rural settings is feasible and effective

Blog Article

Mariam Fathima,1 Bandana Saini,1,2 Juliet M Foster,1 Carol L Armour1,3 truvisionhealthftp.com 1Woolcock Institute of Medical Research, Sydney Medical School, 2Faculty of Pharmacy, The University of Sydney, 3Central Sydney Area Health Service, Sydney, NSW, Australia Background and objective: Case finding of patients at risk of COPD by community pharmacists could identify a substantial number of people with undiagnosed COPD, but little is known about the feasibility and effectiveness of pharmacy-based COPD case finding using microspirometry.The objective of this study was to assess the feasibility and effectiveness of COPD case-finding service provided by community pharmacists, utilizing a combination of risk assessment questionnaire and microspirometry.Methods: A 6-month service was conducted in 21 community pharmacies in Australia.Pharmacists trained in COPD case finding, including lung function test (LFT), invited their patients aged ≥35 years with a history of smoking and/or respiratory symptoms to participate.

High-risk patients were identified via a COPD risk assessment questionnaire (Initial Screening Questionnaire [ISQ]) and underwent LFT.Pharmacists referred patients with a forced expiratory volume in 1 second (FEV1)/forced expiratory volume in 6 seconds (FEV6) ratio <0.75 to their general practitioner (GP) for further assessment and diagnosis.Results: In all, 91 of 167 (54%) patients had an ISQ score >3 indicating high COPD risk.

Of the 157 patients who were able to complete LFT, 61 (39%) had an FEV1/FEV6 ratio of <0.75 and were referred to their GP.Patients with high ISQ symptoms scores (>3) were at a significantly higher risk of an FEV1/FEV6 ratio of <0.75, compared to patients with fewer COPD symptoms.

A total of 15 (10%) patients were diagnosed with COPD by their GP.Another eight (5%) patients were diagnosed with other medical conditions and 87% of these were initiated on treatment.Although only half of all screened patients lived in regional areas, 93% of those diagnosed with COPD were from regional areas.Conclusion: A brief community pharmacy-based COPD case-finding service utilizing the ISQ, LFT and GP referral is feasible and may lead to identification and diagnosis of a substantial number of people with COPD.

This might be an important strategy for reducing the burden of COPD, particularly for those living in rural locations.Keywords: COPD, community pharmacy, case finding, here case detection, screening.