Chronic Obstructive Pulmonary Disease (COPD) Support
Community Pharmacy Future: Achievements and Results

The full results of this service evaluation have been published in the International Journal of Pharmacy Practice.

COPD Support Service

  • Aimed at diagnosed patients with COPD

    • Prevalence of COPD in the UK is substantial, with 898,989 diagnosed cases in England in 2011 3

    • COPD is associated with a substantial impact on patient quality of life 4,5
    • COPD is the most common reason for emergency admission to hospital due to respiratory disease, accounting for the most finished consultant episodes of care (80% of them in those aged over 60 years of age) and is second only to pneumonia in total bed-days per year 6

  • 306 patients recruited by 34 pharmacies across Wirral in three months, across all socio-demographic areas

  • The service has been successful in supporting patients with diagnosed COPD to get the most from their

  • medicines through improved understanding, adherence and technique

  • Patients have reported having improved quality of life, and confidence to get involved in additional activities as a result of feeling better

  • Exacerbations have been better managed through the use of rescue packs (antibiotics and steroids)



£139m

£86m

Potential annual savings** in NHS costs. Potential lifetime savings from stopping smoking.

All savings based on delivery of equivalent services from 11,100 pharmacies across England with similar results seen.
** Savings through reduced costs to NHS, social services, societal costs and improved flu vaccination uptake.
Our support for patients

Aims and objectives:

  • To support people with COPD so that they are better able to manage their condition, and improve their quality of life by:

    • Helping them to recognise when their symptoms are worsening and how to manage this (preventing unnecessary use of NHS resources – such as hospital admissions)

    • Helping them understand and use their medications properly – leading to improved medicines adherence

  • Helping people with COPD reduce risk factors associated with worsening of their condition by promoting and providing the following services where appropriate:

    • Flu vaccination
    • Smoking cessation

    • Healthy lifestyle (diet, alcohol, physical activity, weight management)

  • Service is provided to patients diagnosed with COPD - patients with asthma or other respiratory conditions are excluded from the service


COPD - Support Service
Population demographics for COPD Support Service
Population demographics for COPD Support Service
Legend

The Carstairs index is used to calculate deprivation quintiles for least and most deprived.

It is based on four census indicators:

  • low social class

  • lack of car ownership

  • overcrowding

  • male unemployment

pharmacy service

COPD Support Service: key results

The services have been independently evaluated (comparing patient data before and after the serviceincluding:

  • Health economic evaluation

  • Patient outcomes

  • Qualitative interviews with patients

Highlights of the results after six months show:

  • Significant increase in medicines adherence

  • Reductions in overall NHS resource use by patients

  • Significant increase in patients quality of life

Based on the findings from the COPD Support Service, we estimate that if the service was delivered from 11,100 pharmacies in England to 749,000 patients then the NHS could see annual benefits of:

  • £125.8m in reduced use of NHS and social services resources

  • £4.5m in societal costs

  • £9m resulting from an additional 180,000 people with COPD receiving flu vaccinations

  • £86.3m disease-related cost savings from supporting people to stop smoking (lifetime value)

  • 15,000 QALYs

What patients are saying...
“I understand the importance of taking the medications on time and as prescribed, and the things that go together or do not go together, which I didn’t know before” 

COPD patient
“Done quite a lot for me health and changed me health for the better” 

COPD patient
“I went to hospital once this winter to go on the nebuliser, whereas before I would have been kept in for two or three days”

COPD patient
“I’ve proved to myself that [COPD] is not as life-stopping or debilitating as I had allowed it to be” 

COPD patient
What professionals are saying...
“Together, we were able to devise a process from screening patients for COPD all the way through to diagnosis. It was invaluable to have the pharmacy involved as it meant patients were no longer lost between the screening and diagnostic stages. The service also benefited the surgery by helping existing patients manage their condition”  

COPD GP
“They’re now being given rescue packs more readily and that’s definitely helped stopped people going to hospital”  

COPD pharmacist
“Patients view you now as having a broader knowledge both clinically and professionally… you don’t just do their prescriptions” 

COPD pharmacist
“[Patients] feel that it has definitely been worthwhile. One man told me that this is the first year he has never had a chest infection. That’s the best feedback” 

COPD pharmacist
1. British Lung Foundation. Invisible Lives. Chronic Obstructive Pulmonary Disease (COPD) – Finding the missing millions. 2007.
2. PCC Quality and Outcomes Framework (QOF) Management Guide (3). 2012.
3. PCC Quality and Outcomes Framework (QOF) Management Guide (3). 2012.
4. DiBonaventura M, Paulose-Ram R, Su J, McDonald M, Zou KH, Wagner JS, et al. The impact of COPD on quality oif life, productivity loss and resource use among elderly United States workforce. COPD 2012;9(1):46-57.
5. Stahl E, Lindberg A, Jansson SA, Ronmark E, Svensson K, Anderson F, et al. Health-related quality of life is related to COPD disease severity. Health Qual Life Outcomes 2005; 3:56.
6. Burney P Jarvis D. The burden of COPD in the UK. NHS National Library for Health: Respiratory Specialist Library. 2006.
The Community Pharmacy Future project is a collaboration between
Boots
Well Pharmacies
Lloyds Pharmacy
Rowlands Pharmacy a company of the PHOENIX group