The reliability and utility of spirometry performed on people with asthma in community pharmacies. (21st October 2015)

• Record Type: Journal Article
• Authors: Lei Burton, Deborah; LeMay, Kate S.; Saini, Bandana; Smith, Lorraine; Bosnic-Anticevich, Sinthia; Southwell, Phillipa; Cooke, Julie; Emmerton, Lynne; Stewart, Kay; Krass, Ines; Reddel, Helen; Armour, Carol
• Is Part Of: Journal of asthma. Volume 52:Number 9(2015)
• Page Start: 913
• Page End: 919
• Publication Date: 2015-10-21
• Subjects: Asthma -- forced expiratory volume -- pharmacy -- program evaluation -- spirometry; Asthma -- Periodicals; 616.238005
• DOI: 10.3109/02770903.2015.1004684
• Languages: English
• ISSNs: 0277-0903

Abstract

Abstract: Objective : To investigate the reliability and the utility of spirometry generated by community pharmacists participating in two large asthma intervention trials of 892 people. Methods : The Pharmacy Asthma Care Program (PACP) and the Pharmacy Asthma Management Service (PAMS) involved up to four visits to the pharmacy over 6 months for counseling and goal setting. Pharmacists performed spirometry according to ATS/ERS guidelines to inform management. The proportion of A–E, F quality tests, as per EasyOne™ QC grades, were recorded. Lung function results between visits and for participants referred/not referred to their general practitioner on the basis of spirometry were compared. Results : Complete data from 2593 spirometry sessions were recorded, 68.5% of spirometry sessions achieved three acceptable tests with between-test repeatability of 150 ml or less (A or B quality), 96% of spirometry sessions included at least one test that met ATS/ERS acceptability criteria. About 39.1% of participants had FEV1 /FVC values below the lower limit of normal (LNN), indicating a respiratory obstruction. As a result of the service, there was a significant increase in FEV1 and FEV1 /FVC and asthma control. Lung function values were significantly poorer for participants referred to their general practitioner, compared with those not referred, on the basis of spirometry. Conclusions : Community pharmacists are able to reliably achieve spirometry results meeting ATS/ERS guidelines in people with asthma. Significant improvements in airway obstruction were demonstrated with the pharmacy services. Pharmacists interpreted lung function results to identify airway obstruction for referral, making this a useful technique for review of people with asthma in the community.