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

Deborah Lei Burton, Kate S. Lemay, Bandana H K Saini, Lorraine Smith, S Bosnic-Anticevich, Phillipa Southwell, Julie COOKE, Lynne M Emmerton, Kay Stewart, Ines Krass, Helen Kathryn Reddel,, Carol Armour

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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.
Original languageEnglish
Pages (from-to)913-919
Number of pages7
JournalJournal of Asthma
Volume52
Issue number9
DOIs
Publication statusPublished - 2015

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Pharmacies
Spirometry
Asthma
Pharmacists
Airway Obstruction
Lung
General Practitioners
Guidelines
Pharmaceutical Services
Counseling
Referral and Consultation

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Lei Burton, D., Lemay, K. S., Saini, B. H. K., Smith, L., Bosnic-Anticevich, S., Southwell, P., ... Armour, C. (2015). The reliability and utility of spirometry performed on people with asthma in community pharmacies. Journal of Asthma, 52(9), 913-919. https://doi.org/10.3109/02770903.2015.1004684
Lei Burton, Deborah ; Lemay, Kate S. ; Saini, Bandana H K ; Smith, Lorraine ; Bosnic-Anticevich, S ; Southwell, Phillipa ; COOKE, Julie ; Emmerton, Lynne M ; Stewart, Kay ; Krass, Ines ; Reddel, Helen Kathryn ; Armour, Carol. / The reliability and utility of spirometry performed on people with asthma in community pharmacies. In: Journal of Asthma. 2015 ; Vol. 52, No. 9. pp. 913-919.
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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.",
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Lei Burton, D, Lemay, KS, Saini, BHK, Smith, L, Bosnic-Anticevich, S, Southwell, P, COOKE, J, Emmerton, LM, Stewart, K, Krass, I, Reddel, HK & Armour, C 2015, 'The reliability and utility of spirometry performed on people with asthma in community pharmacies', Journal of Asthma, vol. 52, no. 9, pp. 913-919. https://doi.org/10.3109/02770903.2015.1004684

The reliability and utility of spirometry performed on people with asthma in community pharmacies. / Lei Burton, Deborah; Lemay, Kate S.; Saini, Bandana H K; Smith, Lorraine; Bosnic-Anticevich, S; Southwell, Phillipa; COOKE, Julie; Emmerton, Lynne M; Stewart, Kay; Krass, Ines; Reddel, Helen Kathryn; Armour, Carol.

In: Journal of Asthma, Vol. 52, No. 9, 2015, p. 913-919.

Research output: Contribution to journalArticle

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T1 - The reliability and utility of spirometry performed on people with asthma in community pharmacies

AU - Lei Burton, Deborah

AU - Lemay, Kate S.

AU - Saini, Bandana H K

AU - Smith, Lorraine

AU - Bosnic-Anticevich, S

AU - Southwell, Phillipa

AU - COOKE, Julie

AU - Emmerton, Lynne M

AU - Stewart, Kay

AU - Krass, Ines

AU - Reddel,, Helen Kathryn

AU - Armour, Carol

PY - 2015

Y1 - 2015

N2 - 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.

AB - 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.

KW - Asthma

KW - forced expiratory volume

KW - pharmacy

KW - program evaluation

KW - spirometry

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Lei Burton D, Lemay KS, Saini BHK, Smith L, Bosnic-Anticevich S, Southwell P et al. The reliability and utility of spirometry performed on people with asthma in community pharmacies. Journal of Asthma. 2015;52(9):913-919. https://doi.org/10.3109/02770903.2015.1004684