COPD case finding in pharmacies would save £264m a year

Friday, 7 November 2014
Publication of results from CPF project demonstrates value of pharmacy in addressing diseases at an early stage.

Using community pharmacies to identify undiagnosed cases of chronic obstructive pulmonary disease (COPD) at an early stage would provide “significant NHS and societal benefits” and save the NHS more money than the service costs to deliver, a new study shows.

The full results of the Community Pharmacy Future (CPF) project’s COPD Case Finding Service have been published in the peer-reviewed International Journal of Pharmacy Practice on 5 November 2014. They show that of 238 people screened by 21 pharmacies on the Wirral, 135 (57%) were identified as being at higher risk of COPDView full article online here  

A detailed analysis of the results shows that there were 88 active smokers in the high risk group. They were offered smoking cessation advice by the pharmacy teams - over a third (39%) declined, just under a fifth of participants (18%) took part in pharmacy-based services and a third (34%) were referred to other stop smoking support. A further 9% were deemed unsuitable for other reasons.

In addition, two thirds (63%) of those screened were offered general lifestyle advice – two fifths (41%) about smoking, 13% on diet and nutrition, a fifth (21%) on physical activity, 7% on alcohol consumption, 5% on weight management and 8% on other topics.

Professor David Wright, School of Pharmacy, University of East Anglia and lead author of the paper, said: “Our evidence from this service evaluation shows that case finding of COPD patients by community pharmacy is possible. Targeted screening identifies one patient with moderately severe COPD risk for every two who are screened.A simple cost analysis based on the smoking cessation element alone suggests that providing the cost per patient screened is less than £400, then the service should be adopted by the NHS, i.e. the costs are less than the current model of doing nothing.”

In the service, customers were identified by pharmacy teams for screening on the basis of smoking status, frequency of purchases of cough medicines and use of medicines to manage exacerbations of chest infections. Customers completed a risk assessment questionnaire and had a microspirometry test. Those with a high risk score and/or a low test result were referred to their GP for further investigation, as well as being offered lifestyle advice in the pharmacy, where appropriate.

There are approximately 900,000 people diagnosed with COPD in England and a further 2.7 million people living with undiagnosed COPD. The research suggests that if rolled out across 11,100 pharmacies in England, an annual benefit to the NHS and wider society could be £264 million from diagnosing patients earlier and a reduction in lost productivity costs.  Additional lifetime savings from stopping smoking are estimated at £215 million.

Speaking on behalf of the CPF project team, Clare Kerr, Head of External Affairs, Lloydspharmacy, and a member of the CPF Management Committee, said: “Our work has shown that pharmacies are an ideal place to undertake COPD case finding. Our work complements that of GPs, as many of our customers are not in regular contact with other health services. It uses the whole pharmacy team to identify the most appropriate people for screening and delivers significant benefits for the NHS and society as a whole, as a result. We have also demonstrated that this service can be delivered by pharmacies in a wide range of settings.

“We are very pleased that our CPF work has resulted in this robust addition to the evidence base supporting the commissioning of services from community pharmacies."

The Community Pharmacy Future project is a collaboration between
Well Pharmacies
Lloyds Pharmacy
Rowlands Pharmacy a company of the PHOENIX group