Pharmacists as accurate as doctors at identifying those at risk of COPD
Posted Jun 09 2009 11:28pm
By Philip Ford
Training pharmacists to perform spirometry testing on individuals with respiratory symptoms is an accurate way to identify those at high risk for chronic obstructive pulmonary disease (COPD), say researchers.
“Recently, the US Preventive Services Task Force made a grade D recommendation against screening the general population for COPD using spirometry,” write Daniel Castillo (Hospital del Mar, Barcelona, Spain) and co-workers in the journal Respiratory Medicine.
“However, the same document recognized that individuals presenting respiratory symptoms (chronic cough, increased sputum production, wheezing, or dyspnea) should be tested,” the authors note.
Previous studies have shown that community spirometry testing improves the likelihood of lung function testing among individuals in rural communities. For the current study, Castillo and colleagues tested whether the same is true for urban communities.
The researchers asked pharmacists in 13 urban pharmacies to identify any customers aged over 40 years with a history of smoking. The 161 individuals identified were asked to complete a five-question COPD survey based on the Global Initiative for COPD recommendations. This included questions on breathlessness, cough, and chronic sputum production. Those with three or more answers suggesting COPD were offered spirometry testing, and those with a ratio of FEV1 to forced vital capacity (FVC)of <0.7 were referred to a lung function clinic.
Of those tested, 62% scored three or more on the COPD screening test. Spirometry among these individuals revealed a low FEV1:FVC ratio in 24% and successful referral to a hospital laboratory in 52% of cases. Spirometry carried out by experts at the hospital suggested that over 70% of the original spirometry tests had been accurate and had successfully identified individuals at high risk for COPD.