Study: Acceptability and Utility of Spirometry
Measurement in the Pharmacy Asthma Care Program.
Authors: D Burton1, M Simpson1, J
Wettenhall1, C Armour2, S Bosnic-Anticevich2, B Saini2, I
Krass2, L Smith2, M Brillant2, L Emmerton3, J Bond3, S
Johnston4 and K Stewart4.
Study Centres: 1 School of Biomedical Sciences,
Charles Sturt University, NSW 2650, 2 Faculty of Pharmacy,
University of Sydney, NSW 2006, 3 School of Pharmacy,
University of Queensland, QLD 4072, 4 Victorian College of
Pharmacy, Monash University, VIC 3052.
Presentation and Publication: This study was
presented as an ANZSRS Poster at the TSANZ / ANZSRS Conference
in Canberra in March 2006 and published as an abstract in
Respirology March 2006 - Vol. 11 Issue s2 Page A1-A76.
Background: This paper reports the utility of
spirometry measurement by community pharmacists as a component
of patient assessment in the Pharmacy Asthma Care Program
(PACP). The overall aim of the PACP was to identify people
with poor asthma control and improve their management.
Methods: The study was implemented in 57 pharmacies
in New South Wales, Victoria and Queensland during 2005.
Community pharmacists were trained by respiratory scientists
in spirometry technique using the EasyOne spirometer. The PACP
included assessment of asthma severity and spirometry
measurement for both Intervention and Control patients over a
6-month period. Intervention patients attended 3-4 visits with
a cycle of assessment, goal setting and monitoring, while
Control patients attended 2 visits 6 months apart, with no
interventions beyond standard care.
Results: A total of 351 patients (165 Intervention
and 186 Control) completed the study, completion rates of
86.4% and 90.7% respectively, 83% of Intervention patients'
tests and 85% of Control patients' tests were of acceptable
quality (i.e. A, B or C) and were included in the analysis.
Criteria for the acceptability and reproducibility rating is
included in Table 1 (click on the link below) . The
spirometry results at baseline indicated reduced lung function
in both groups with FEV1 % predicted at 79.3 +- 22.8
(Intervention) and 75.4 +- 22.2 (Control) (mean +-SD) Table
2 (click on the link below). There were no significant
differences (p>0.05) in spirometry measures between groups
at any time in the study. FEV1 values less than 80% predicted
were highlighted to pharmacists on the spirometry report and
61 patients received a written referral to their general
practitioner for review on the basis of their spirometry.
These patients may not have seen their GP if they had not been
reviewed in the PACP.
Conclusions: Spirometry measurement is a reasonable
and reliable test for community pharmacists to use. Spirometry
measurement in community pharmacy provides an additional basis
for referral to the physician.
Acknowledgement: This project was funded by the
Australian Government Department of Health and Ageing as part
of the Third Community Pharmacy Agreement.
