Screening for COPD in pharmacy
Case-finding using a Chronic Obstructive Pulmonary Disease (COPD) screening device aims to identify people who are at risk of COPD, and avoid unnecessary spirometry in those with normal lung function. People identified as ‘at risk’ should be referred to their doctor or specialist for further investigation and diagnosis.
When screening for COPD, people who have respiratory symptoms but show normal results at the time of testing may be at risk of other lung disease or of developing COPD in later life. These individuals should also be referred to their doctor for further assessment and, if appropriate, encouraged to commence preventative strategies, such as smoking cessation, that may stop or slow the onset of COPD. This approach has the added benefit of raising awareness of lung health in the community and ensuring that people take the symptoms of lung disease seriously.
The video to the right is used with permission of The Pharmacy Guild of Australia.
What is a COPD screening device?
COPD screening devices are simple lung function testing tools that assist practitioners to identify individuals who are at risk of COPD. They enable easy and cost-effective screening of respiratory conditions, helping to rule out patients that are unlikely to have COPD.
It is important to note that COPD screening devices should not be used to diagnose COPD as they can result in an overestimation of airflow obstruction. Formal diagnosis of COPD by spirometry allows the severity and progression of the disease to be monitored objectively, and the most appropriate interventions identified for each patient.
There are a number of COPD screening devices available including the AirSmart and COPD-6. They are easy-to-use and require basic training in order to conduct the procedure and interpret the results. They are also less physically demanding than spirometry as they do not require individuals to completely empty their lungs of air.
COPD is formally diagnosed through clinical assessment and presence of fixed airway obstruction detected via spirometry. Spirometry measures how quickly and effectively a person can empty their lungs after inhaling as much air as possible before measurement. It is commonly undertaken in the primary care setting by trained General Practitioners, Nurses, and Respiratory Scientists. When performed correctly, spirometry can distinguish COPD from asthma, and other conditions which affect breathing.
Benefits of using spirometry
Diagnostic spirometry is the ‘gold standard’ for diagnosing fixed airway obstruction and is essential for the early staging and treatment of COPD. It can also be used to assess and/or monitor:
- Respiratory symptoms such as cough or shortness of breath
- Disease severity
- If a medicine is working
- Intervention outcomes e.g. pre- and post- pulmonary rehabilitation
- Occupational health impacts
- Suitability for scuba diving
Accurate spirometry requires skill and health professionals should be trained appropriately to administer the test and interpret the results. Lung Foundation Australia provides access to a range of spirometry training and resources (featured below).