Pharmacist-Provided Spirometry: Reducing Barriers to Better Asthma Care

Asthma and chronic obstructive pulmonary disorder (COPD) are chronic health conditions that need to be properly diagnosed to be managed effectively. Underdiagnosis leads to disease progression and exacerbations, while overdiagnosis causes unnecessary medication prescribing and increased health care costs.

Spirometry is the gold standard for both asthma and COPD diagnosis. Despite the importance of spirometry testing, prescribers don't use it as often as they should in the primary care setting. When family physicians use spirometry, only 50% of them are comfortable interpreting the results.

In a recent issue of in the Journal of Primary Care & Community Health, researchers at the Ohio State University College of Pharmacy and PrimaryOne Health Clinic took a closer look at the benefits of pharmacists providing spirometry services at Federally Qualified Health Centers (FQHCs).

This study examined the impact that a pharmacist-provided spirometry service had on referral completion when implemented in a FQHC. A representative from the medical device company trained clinical pharmacists and a pharmacy resident to perform spirometry tests and the researchers provided further on-the-job training. This is a tip for pharmacists who wish to pursue a spirometry program; the medical device company will often provide training for free. The researchers saw an increase in referral completion from 38.1% to 47% after the testing was implemented.

During the post-implementation timeframe, 68 more referrals were ordered and 47 more patients received spirometry results. Overall results suggest that having a pharmacist-lead spirometry testing on-site increases the rate of completed spirometry test referrals.

The benefit of providing on-site spirometry testing is that it reduces barriers that patients might face when required to complete testing at an outside facility. Barriers include insurance issues, finding a clinic, and scheduling the appointment.

Another benefit of testing on-site is having the results readily available to the ordering provider. This eliminates the chance for poor communication between the primary care provider and the specialist, since pharmacists update patients’ electronic medical records with the results.

Pharmacists are well-suited to offer this service and health care systems should consider engaging them in this task when looking for new ways to improve patients access to care.

Reference

Mueller LA, Valentino AS, Clark AD, et al. Impact of a pharmacist-provided spirometry service on access to results in a primary care setting. J Prim Care Community Health. 2018 Jan-Dec;9:2150132718759213.