Pharmacists Successfully Screen for COPD

Case finding is an epidemiologic strategy used to proactively identify patients with certain conditions or exposures who have not received previous care. This screening program is especially important in conditions that are under-diagnosed, so public health officials can help connect patients to care.

Although case finding is often performed by nurses and social workers, a 2009 pilot study proposed using community pharmacies to identify patients with chronic obstructive pulmonary disease (COPD), based on the theory that community-based pharmacists often see patients at risk for COPD and could be trained to administer spirometry.

Following positive initial outcomes, researchers conducted an expanded investigation. Their results, which were published in the April 2015 edition of Respiratory Medicine, confirm that community pharmacies can successfully identify high-risk patients, increase COPD diagnosis rates, and become advocates for treatment.

In the study, pharmacists from 100 community pharmacies attended a 4-day workshop that provided an overview of COPD, the Global Initiative for Chronic Obstructive Disease (GOLD) questionnaire, and spirometry technique. Each pharmacy was given a spirometer to take lung function measurements over a 12-week period and then worked with customers to complete a GOLD questionnaire and record their data electronically. The program was enhanced by a quality-measuring, web-assistance element.

The community pharmacies invited 3121 customers to be screened for COPD, and uptake was robust, with 2295 (73.5%) accepting the invitation. Among those screened, 1456 (63.4%) were identified as “high risk” for COPD, as defined by GOLD criteria.

Reducing COPD under-diagnosis is a public-health priority. According to this study, well-trained pharmacists can successfully screen patients for COPD in the community setting.

The authors noted that the web-based element—a form of telemedicine—reinforced spirometry quality and enhanced training. To ensure high-risk COPD patients are linked to care, this model requires close collaboration between pharmacists and primary care providers.