Community pharmacy screening project helps identify patients with COPD and emphysema
Screening model failed to find patients with lung cancer but helped identify other serious respiratory diseases
Community pharmacists taking part in an innovative lung cancer screening project have successfully identified patients who unknowingly had moderate or severe emphysema or chronic obstructive pulmonary disease (COPD), although they failed to find any patients with lung cancer, according to results from the second phase of the trial.
The initiative was developed in South and West London and was the first of its kind, enabling community pharmacists to refer patients direct to hospital, bypassing GPs.
The screening project was originally run as a three-month pilot in 2011 involving 18 pharmacies in Wandsworth and Croydon. The second phase of the scheme involved 43 pharmacies recruited from a wider area expanded to include Sutton and Merton.
As part of the initiative, counter staff offered a pharmacist consultation to any customer aged over 50 years who had a history of smoking, who visited the pharmacy to buy cough medicines or nicotine replacement therapy, or who was collecting a prescription for a respiratory complaint or seeking advice about a respiratory condition.
Pharmacists were able to refer patients suspected of lung cancer direct to a consultant-led hospital respiratory clinic during the project, the second phase of which ran for six months ending in March 2013.
Some 47 patients accepted a referral to the clinic. Of these, 66 per cent had a “significant” diagnosis, including 30 per cent who were found to have moderate to severe emphysema or COPD.
Patients found it easier to talk to their pharmacist about lung cancer risks
The results of the second phase “demonstrated very positive and promising results” about the acceptability of pharmacists directly referring to secondary care, according to the evaluation. Patients said it was easier to talk to a pharmacist than their GP about the risks of lung cancer and GPs welcomed the speed of chest clinic referral, the evaluation noted.
The future of the referral scheme is undecided following the reorganisation of the NHS. However, according to David Tamby-Rajah, community pharmacy lead for NHS South West London, the model could contribute to NHS England’s pharmacy call to action consultation because it illustrates “transformational” practice.
He told PJ Online: “In terms of professional support for the project, it brought in the College of Pharmacy Practice, the local pharmaceutical committees and the then primary care trusts and acute trusts working with the network of community pharmacists.
“During the course of the project it was clear that some of the pharmacists had identified COPD. However, we need to see the outcome of the evaluation and further evidence to see how best it can be taken forward.”
Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2014.11135044
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