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

Background: COPD case finding is currently recommended at primary and tertiary care levels only. Aim: To evaluate the feasibility of a community pharmacy program for COPD case finding in high-risk customers by means of spirometry. Methods: Pilot cross-sectional. descriptive study in 13 urban community pharmacies in Barcelona, Spain, from April to May 2007. Customers >40years 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. Results: Of 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 tung function parameters between the pharmacy and hospital. measurements. Conclusions: COPD 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. (C) 2009 Elsevier Ltd. All rights reserved.