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COPD case finding by spirometry in high-risk customers of urban community pharmacies: A pilot study

2009; Elsevier BV; Volume: 103; Issue: 6 Linguagem: Inglês

10.1016/j.rmed.2008.12.022

1532-3064

Diego Castillo, Rafael Guayta, Jordi Giner, Felip Burgos, Cristina Capdevila, Joan B. Soriano, Mercè Barau, Pere Casán,

Respiratory and Cough-Related Research

BackgroundCOPD case finding is currently recommended at primary and tertiary care levels only.AimTo evaluate the feasibility of a community pharmacy program for COPD case finding in high-risk customers by means of spirometry.MethodsPilot cross-sectional descriptive study in 13 urban community pharmacies in Barcelona, Spain, from April to May 2007. Customers >40 years old with respiratory symptoms and/or a history of smoking were invited to participate in the study during pharmacists' routine work shifts. High-risk customers were identified by means of a 5-item COPD screening questionnaire based on criteria of the Global Initiative for Chronic Obstructive Lung Disease, and were invited to perform spirometry accordingly. Those with an FEV1/FVC ratio less than 0.70 were referred to the hospital for a repeat spirometry.ResultsOf the 161 pharmacy customers studied, 100 (62%) scored 3 or more items in the COPD screening questionnaire, and after spirometry, 21 (24%) had an FEV1/FVC ratio<0.7. When these subjects with airflow limitation were offered referral to a hospital respiratory function laboratory for further assessments, 11 (52%) attended the appointment. Over 70% of spirometries were rated as being of acceptable quality. No significant differences were observed in lung function parameters between the pharmacy and hospital measurements.ConclusionsCOPD case finding by spirometry in high-risk customers of urban community pharmacies is feasible. Similarly to primary care practitioners, pharmacists have access to high-risk, middle-aged subjects who have never been tested for COPD. Pharmacists can help with early detection of COPD if they are correctly trained.