Airflow obstruction case finding in community-pharmacies: A novel strategy to reduce COPD underdiagnosis

Castillo, Diego; Burgos, Felip; Guayta, Rafael; Giner, Jordi; Lozano, Paz Vaquero; Estrada, Maria Dolors; Soriano, Joan B.; Flor, Xavier; Barau, Mercè; Casán, Pere

doi:10.1016/j.rmed.2015.02.009

Cited by 30 publications

(52 citation statements)

References 36 publications

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“…This accreditation process will devise uniform activities and documents that will serve as measurable criteria for the institutions that train health professionals in spirometry. In addition, there are valid alternatives that help clinical identify those patients at high risk, including questionnaires, different screening tools , and in different point of care settings , …”

Section: Disability‐adjusted Life Year (Daly)mentioning

confidence: 99%

Global burden of COPD

2015

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It is estimated that the world population will reach a record 7.3 billion in 2015, and the high burden of chronic conditions associated with ageing and smoking will increase further. Respiratory diseases in general receive little attention and funding in comparison with other major causes of global morbidity and mortality.In particular, chronic obstructive pulmonary disease (COPD) has been a major public health problem and will remain a challenge for clinicians within the 21st century. Worldwide, COPD is in the spotlight, since its high prevalence, morbidity and mortality create formidable challenges for health-care systems. This review emphasizes the magnitude of the COPD problem from a clinician's standpoint by drawing extensively from the new findings of the Global Burden of Disease study. Updated,distilled information on the population distribution of COPD is useful for the clinician to help provide an appreciation of the relative impact of COPD in daily practice compared with other chronic conditions, and to allocate minimum resources in anticipation of future needs in care. Despite recent trends in reduction of COPD standardized mortality rates and some recent successes in anti-smoking efforts in a number of Western countries, the overarching demographic impact of ageing in an ever-expanding world population, joined with other factors such as high rates of smoking and air pollution in Asia, will ensure that COPD will continue to pose an ever-increasing problem well into the 21st century.

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Section: Disability‐adjusted Life Year (Daly)mentioning

confidence: 99%

Global burden of COPD

2015

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“…As shown in a COPD case finding a program in community pharmacists as a new strategy to reduce COPD underdiagnosis [13], community pharmacists were able to select and assessed patients using a questionnaire and spirometric testing. Also, when pharmacists have been trained, results of their intervention in educational programs were similar to those obtained by physicians and/or nurses [3,4].…”

Section: Introductionmentioning

confidence: 99%

Knowledge, Attitudes and Preferences Among Spanish Community Pharmacists Regarding Inhaled Therapy (The Optim Pharmacy Study)

Giner

Roura

Torres³

et al. 2016

Int J Pharm Pharm Sci

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Objective: To assess knowledge, attitudes, and preferences regarding inhaled therapy among Spanish community pharmacists.Methods: An 11-item questionnaire was developed and distributed to community pharmacists throughout the country. Data collected included demographics, the source of knowledge of inhaler use, known and preferred devices, steps for correct use of metered-dose (pMDI) and dry-powder (DPI) inhalers, important variables when prescribing an inhaler device, patient education, and checking inhaler technique.Results: Of a total of 3000 questionnaires delivered, 1722 (57.4%) were returned. The most common source of knowledge was the package insert (46.9%) followed by personal experience (33.3%). Diskus TM and Turbuhaler TM Conclusion: In spite of the increasing involvement of Spanish community pharmacists in patients' care, their knowledge of inhaler use and attitudes towards inhaled therapy needs to improve, so that they can provide better patient education.were the best-known devices (96.4% and 93.4%), and DPIs the preferred inhalers. Although more than half of the surveyed pharmacists were aware of the most important step for correct inhalation with pMDI and DPI, only 18% identified the correct answer 'Patient's preference' as the most important variable when prescribing an inhaler device. Most of the respondents had inadequate knowledge of inhaled therapies. Statistically, significant differences were found according to geographical areas. Moreover, the mean score on inhaled therapy with one knowledge source was higher than for those with none (P<0.05). Additionally, patient education was poor.

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“…Studies showing that trained community pharmacists are able to perform accurate and reproducible spirometry screenings are supported by a recent evidence‐based review demonstrating acceptable repeatability of spirometry testing (based on the American Thoracic Society/European Respiratory Society guideline standards) by pharmacists in all eight studies included in the analysis . Moreover, two recent publications showed that trained community pharmacists are able to detect individuals at high risk of COPD effectively via COPD case‐finding services . Indeed, UK findings revealed that targeted screening could identify one patient with moderate COPD for every two individuals screened, and that early identification led to cost savings .…”

Section: Resultsmentioning

confidence: 83%

“…Role of the community pharmacist in an integrated patient care pathway for chronic obstructive pulmonary disease (COPD) publications showed that trained community pharmacists are able to detect individuals at high risk of COPD effectively via COPD case-finding services [26,27]. Indeed, UK findings revealed that targeted screening could identify one patient with moderate COPD for every two individuals screened, and that early identification led to cost savings [26].…”

Section: Figurementioning

confidence: 99%

Optimizing identification and management of COPD patients – reviewing the role of the community pharmacist

Molen

Boven

Maguire

et al. 2016

Brit J Clinical Pharma

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The aim of this paper was to propose key steps for community pharmacist integration into a patient care pathway for chronic obstructive pulmonary disease (COPD) management. A literature search was conducted to identify publications focusing on the role of the community pharmacist in identification and management of COPD. The literature search highlighted evidence supporting an important role for pharmacists at each of the four key steps in the patient care pathway for COPD management. Step 1 (primary prevention): pharmacists are ideally placed to provide information on disease awareness and risk prevention campaigns, and to encourage lifestyle interventions, including smoking cessation. Step 2 (early detection/case finding): pharmacists are often the first point of contact between the patient and the healthcare system and can therefore play an important role in the early identification of patients with COPD. Step 3 (management and ongoing support): pharmacists can assist patients by providing advice and education on dosage, inhaler technique, treatment expectations and the importance of adherence, and by supporting self‐management, including recognition and treatment of COPD exacerbations. Step 4 (review and follow‐up): pharmacists can play an important role in monitoring adherence and ongoing inhaler technique in patients with COPD. In summary, pharmacists are ideally positioned to play a vital role in all key stages of an integrated COPD patient care pathway from early disease detection to the support of management plans, including advice and counselling regarding medications, inhaler technique and treatment adherence. Areas requiring additional consideration include pharmacist training, increasing awareness of the pharmacist role, administration and reimbursement, and increasing physician–pharmacist collaboration.

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Airflow obstruction case finding in community-pharmacies: A novel strategy to reduce COPD underdiagnosis

Abstract: This study shows that adequately trained and supported community pharmacists can effectively identify individuals at high risk of having COPD and can thus contribute to ameliorate underdiagnosis in this disease. Links between PC and CP should be improved to achieve a useful program.

Cited by 30 publications

References 36 publications

Global burden of COPD

Global burden of COPD

Knowledge, Attitudes and Preferences Among Spanish Community Pharmacists Regarding Inhaled Therapy (The Optim Pharmacy Study)

Optimizing identification and management of COPD patients – reviewing the role of the community pharmacist

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