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J Asthma. 2015;52(9):913-9. doi: 10.3109/02770903.2015.1004684. Epub 2015 Jun 1.

The reliability and utility of spirometry performed on people with asthma in community pharmacies.

Author information

1
a Department of Biomedical Science , Charles Sturt University , Orange , NSW , Australia .
2
b Woolcock Institute, the University of Sydney , Sydney , Australia .
3
c Faculty of Pharmacy, The University of Sydney , Sydney , Australia .
4
d Sydney Local Health District , Sydney , NSW , Australia .
5
e Faculty of Health, University of Canberra , Canberra , ACT , Australia .
6
f School of Pharmacy, Faculty of Health Sciences, Curtin University , Perth , Australia , and.
7
g Centre for Medicine Use and Safety, Monash University , Monash , VIC , Australia.

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.

KEYWORDS:

Asthma; forced expiratory volume; pharmacy; program evaluation; spirometry

PMID:
25563059
DOI:
10.3109/02770903.2015.1004684
[Indexed for MEDLINE]

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