Pharmacist-Driven Spirometry Screening to Target High-Risk Patients in a Primary Care Setting

Area of Science:

• Primary Care Medicine
• Clinical Pharmacy Practice
• Pulmonary Medicine

Background:

• Spirometry testing is crucial for diagnosing and managing respiratory conditions like chronic obstructive pulmonary disease (COPD).
• Identification and referral of high-risk patients for spirometry can be suboptimal in primary care settings.
• Federally Qualified Health Centers (FQHCs) serve diverse populations, necessitating efficient screening and diagnostic pathways.

Purpose of the Study:

• To evaluate the impact of proactive pharmacist identification of high-risk patients on spirometry referral and completion rates.
• To assess the effectiveness of pharmacist-led spirometry screening initiatives in an FQHC setting.
• To determine if pharmacist intervention improves appropriate diagnostic spirometry utilization.

Main Methods:

• A prospective, comparative study was conducted across intervention and control sites within an FQHC over 12 weeks.
• Pharmacists proactively recommended spirometry to eligible high-risk patients prior to their primary care provider (PCP) appointments at the intervention site.
• Chart reviews were performed at both sites to determine spirometry referral and completion rates among qualifying patients.

Main Results:

• A total of 190 patients were eligible for spirometry testing (125 intervention, 65 control).
• The percentage of spirometry referrals ordered was significantly higher at the intervention site (47.2%) compared to the control site (7.7%), P < .001.
• Spirometry test completion rates were also significantly higher in the intervention group (23.2%) versus the control group (3.1%), P < .001.

Conclusions:

• Proactive pharmacist identification of high-risk patients significantly increases appropriate spirometry referrals and test completion in FQHCs.
• Pharmacists can play a vital role in primary care by enhancing COPD management through increased spirometry utilization and patient counseling.
• This population health approach demonstrates an emerging, valuable role for pharmacists in primary care settings.