Pharmacists Successfully Perform Spirometry for COPD

Respiratory diseases affect millions worldwide and greatly burden the global health care system financially. In fact, the combined estimated annual cost of asthma and chronic obstructive pulmonary disorder (COPD) is $88 billion.

Increased testing may help prevent asthma and COPD hospitalizations, improve patient outcomes, and decrease health care costs. Spirometry is a preferred method of diagnosing and managing respiratory diseases, but missed diagnoses are common, and the result is an increase in otherwise avoidable hospitalizations.

One study reported that up to 68% of patients hospitalized with a new COPD diagnosis had not undergone spirometry testing. Now, a recent study published in the International Journal of Clinical Pharmacy indicates pharmacists can use spirometry to improve COPD outcomes.

Spirometry testing has historically been the purview of respiratory therapists and pulmonary function technologists in hospital labs. Advancing technologies have increased spirometry devices’ portability, expanding the possibilities for testing locations. Because pharmacists are highly accessible to the public, they may be able to play a useful role in outpatient spirometry testing.

For the study, Michael J. Cawley of the Philadelphia College of Pharmacy at the University of the Sciences and William J. Warning of the Family Medicine Residency Program at the Crozer-Keystone Center for Family Health reviewed published evidence of pharmacists performing quality spirometry testing based on American Thoracic Society/European Respiratory Society (ATS/ERS) guidelines.

These researchers employed 5 databases and identified 6 prospective, multicenter trials and 2 retrospective, single-center studies for inclusion in their analysis. In these studies, pharmacists received spirometry training that ranged from 3 to 96 hours in duration. Testing quality was determined based on device results interpretation, professional results interpretation, and pharmacists’ training time.

The researchers confirmed that pharmacists performed quality spirometry testing, with ATS/ERS quality grades ranging between 66% and 99%.

Benchmark data obtained from 13,599 spirometry sessions found that experienced respiratory technicians maintained an ATS/ERS quality rating between 70% and 88%—a result very similar to the one reported for pharmacists.

While these findings help validate that pharmacists can successfully provide outpatient spirometry testing, standardized training methods are needed to further establish pharmacist competency.