Implementation of a pharmacist-led spirometry clinic

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is one of the most common chronic conditions, with spirometry serving as the gold standard for diagnosis. However, a lack of available resources, providers, and time limits appropriate diagnosis of COPD and disease staging. These factors culminate in suboptimal therapeutic management of the disease and often pharmacotherapy regimens that are not supported by Global Initiative for Chronic Obstructive Lung Disease guidelines.

Objectives: The primary objective of the study was to develop and implement a pharmacist-led spirometry clinic to assess the confirmation of COPD diagnosis and pharmacotherapy management.

Practice description: Two federally qualified health centers (FQHCs) in Ohio: Family Health Services of Darke County (FHS) and Rocking Horse Community Health Center (RHCHC). Both FQHCs have clinical pharmacists on staff who provide disease state management services for chronic disease states through a collaborative practice agreement.

Practice innovation: At each FQHC, a pharmacist-led COPD and spirometry management service was implemented. This service consisted of disease state education, therapy modifications, and spirometry services for annual and confirmation of diagnosis for COPD patients.

Evaluation methods: A retrospective chart review was conducted. Data collection occurred from December 2021 to May 2022. Patients included were 18 years and older with a confirmed diagnosis of COPD. Therapies before spirometry services, COPD assessment test scores, age, gender, and history of exacerbations within the last 12 months were collected.

Results: Eight patients at FHS and 1 patient at RHCHC were included in the data analysis. Two patients had their disease state confirmed after postbronchodilator spirometry. Five pharmacotherapy modifications were made for patients evaluated in the analysis.

Conclusion: Pharmacists in FQHC's are crucial resources to design, implement, and lead spirometry services for the management of COPD within the primary care setting, therefore increasing adherence to guideline recommendations.