title: Airflow obstruction case finding in community-pharmacies: a novel strategy to reduce COPD underdiagnosis.
abstract: BACKGROUND
  Community pharmacies (CP) have access to subjects at high-risk of suffering Chronic Obstructive Pulmonary Disease (COPD). We investigated if a COPD case finding program in CP could be a new strategy to reduce COPD underdiagnosis.
  
  
  METHODS
  Prospective, cross-sectional, descriptive, uncontrolled, remotely supported study in 100 CP in Barcelona, Spain. Pharmacists were trained in a four-day workshop on spirometry and COPD, and each was provided with a spirometer for 12 weeks. The program included questionnaires and forced spirometry measurements, whose quality was controlled and monitored by web-assistance.
  
  
  RESULTS
  Overall 2295 (73.5%), of 3121 CP customers invited to participate in the program accepted, and 1.456 (63.4%) were identified as "high risk" for COPD using the GOLD questionnaire. Only 33 could not conduct spirometry, and a pre-bronchodilator airflow limitation (FEV1/FVC ratio <0.7) was confirmed in 282 (19.8%); 244 of these were referred to their primary care (PC) physician for further diagnostic and therapeutic work-up, but only 39 of them (16%) fed-back this information to the pharmacist. Clinically acceptable quality spirometries (grade A or B) were obtained in 69.4% of the cases.
  
  
  CONCLUSIONS
  This study shows that adequately trained and supported community pharmacists can effectively identify individuals at high risk of having COPD and can thus contribute to ameliorate underdiagnosis in this disease. Links between PC and CP should be improved to achieve a useful program.
authors.affiliation: Hospital de la Santa Creu i Sant Pau, Department of Respiratory Medicine, Institut d'Investigació Biomèdiques Sant Pau (IB-Sant Pau), Universitat Autònoma de Barcelona, Facultad de Medicina, Barcelona, Spain. Electronic address: dcastillo@santpau.cat.
authors.forename: D
authors.initials: D
authors.lastname: Castillo
authors.affiliation: Respiratory Diagnostic Center, Department of Respiratory Medicine (ICT), Hospital Clínic i Provincial, IDIBAPS, Universitat de Barcelona, CIBER Enfermedades Respiratorias, Barcelona, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Burgos
authors.affiliation: Pharmaceutical Council of Catalunya, Barcelona, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Guayta
authors.affiliation: Hospital de la Santa Creu i Sant Pau, Department of Respiratory Medicine, Institut d'Investigació Biomèdiques Sant Pau (IB-Sant Pau), Universitat Autònoma de Barcelona, Facultad de Medicina, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Giner
authors.affiliation: Pharmaceutical Council of Catalunya, Barcelona, Spain; Official College of Pharmacists of Barcelona (COFB), Barcelona, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Lozano
authors.affiliation: Official College of Pharmacists of Barcelona (COFB), Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Estrada
authors.affiliation: Instituto de Investigación Hospital Universitario de la Princesa (IISP), Universidad Autónonoma de Madrid, Cátedra UAM-Linde, Madrid, Spain.
authors.forename: J B
authors.initials: JB
authors.lastname: Soriano
authors.affiliation: Centre d'atenció primaria Chafarinas, Institut Catalá de la Salut, Respiratory Group Societat Catalana Medicina Familia i Comunitaria (CAMFIC), Universitat Autònoma de Barcelona, Facultad de Medicina, Barcelona, Spain.
authors.forename: X
authors.initials: X
authors.lastname: Flor
authors.affiliation: Official College of Pharmacists of Barcelona (COFB), Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Barau
authors.affiliation: Instituto Nacional de Silicosis, Hospital Universitario Central de Asturias, Universidad de Oviedo, Facultad de Medicina, Oviedo, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Casan
mesh_terms: D000328:Adult; D017076:Computer-Aided Design; D003430:Cross-Sectional Studies; D003951:Diagnostic Errors / Q000517:prevention & control*; D004493:Education / Q000379:methods; D005260:Female; D006801:Humans; D007318:Inservice Training / Q000379:methods*; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000458:organization & administration; D008875:Middle Aged; D010594:Pharmacies; D010595:Pharmacists; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis*; D018570:Risk Assessment / Q000379:methods; D013030:Spain; D013147:Spirometry / Q000295:instrumentation / Q000379:methods; D011795:Surveys and Questionnaires
keywords: COPD; Case finding; Comunity-pharmacies; Forced spirometry