Tools for Advancing Pharmacy Practice
Spirometry: Tool for pharmacy practitioners to expand direct patient care services
Michael J. Cawley; Jean Moon; Jennifer Reinhold; Vincent J. Willey; William J. Warning II
J Am Pharm Assoc (2003) 2013;53:307-315. doi:10.1331/JAPhA.2013.12134


Abstract  Objectives: To introduce pharmacy practitioners to spirometry testing and provide strategies for integrating this “value-added” tool with other direct patient care pharmacy services. Data sources: Spirometry literature and resources obtained through search strategies including Ovid, PubMed, and Google Scholar. Summary: Pharmacists are distinctive members of the multidisciplinary patient care team and can contribute by performing spirometry services for pulmonary patients. Pharmacists have been largely absent from performing this much needed service, perhaps as a result of lack of training or because this testing may be perceived as irrelevant to the pharmacist scope of practice. However, pharmacists are actively integrated with many aspects of pulmonary patient care, including recommending and adjusting inhaled pharmacological agents, monitoring for potential drug–drug and drug–disease interactions, recommending smoking cessation, assessing patient prescription insurance coverage, and educating patients, caregivers, and health care providers on use of prescribed respiratory delivery devices. Adding quality spirometry services, based on American Thoracic Society guidelines for accuracy, would increase the breadth and depth of services for pharmacy practitioners. Conclusion: Spirometry testing is an added tool for expanding direct patient care pharmacy services. Physician support, appropriate pharmacist training, and understanding of reimbursement of spirometry services are essential in providing quality spirometry testing. Future studies are needed to assess the role of pharmacists in performing spirometry and measuring the performance outcomes of pulmonary patients.


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National Heart, Lung, and Blood Institute.  Expert Panel Report 3 (EPR3): guidelines for the diagnosis and management of Asthma. www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm. Accessed  April 15, 2012.
Global Initiative for Chronic Obstructive Lung Disease.  Global strategy for diagnosis, management, and prevention of COPD. www.goldcopd.org. Accessed  April 15, 2012.
Han MK, Kim MG, Mardon R, et al.  Spirometry utilization for COPD: how do we measure up? Chest.  2007; 132( 2): 403– 9. [CrossRef][PubMed]
Kesten S, Chapman KR.  Physician perceptions and management of COPD.  Chest.  1993; 104( 1): 254– 8. [CrossRef][PubMed]
Chapman KR, Tashkin DP, Pye DJ.  Gender bias in the diagnosis of COPD.  Chest.  2001; 119( 6): 1691– 5. [CrossRef][PubMed]
Lange NE, Mulholland M, Kreider ME.  Spirometry: don't blow it!   Chest.  2009; 136( 2): 608– 14. [CrossRef][PubMed]
Barreiro TJ, Perillo I.  An approach to interpreting spirometry.  Am Fam Physician.  2004; 69( 5): 1107– 14. [PubMed]
Anonymous.  Spirometry technology guide.  RT Magazine.  2012;( Feb): 25– 31.
American Thoracic Society.  Standardization of spirometry, 1994 update.  Am J Respir Crit Care Med.  1995; 152( 3): 1107– 36. [CrossRef][PubMed]
Gudmundsson G, Cerveny M, Shasby DM.  Spirometric values in obese individuals: effects of body position.  Am J Respir Crit Care Med.  1997; 156( 3 pt 1): 998– 9. [CrossRef][PubMed]
Enright PL.  How to make sure your spirometry tests are of good quality.  Respir Care.  2003; 48( 8): 773– 6. [PubMed]
Miller MR, Hankinson J, Brusasco V, et al.  Standardisation of spirometry.  Eur Respir J.  2005; 26( 2): 319– 38. [CrossRef][PubMed]
American Association for Respiratory Care.  AARC Clinical Practice Guideline: spirometry, 1996 update.  Respir Care.  1996; 41( 7) 629– 36.
Pelligrino R, Viegi G, Brusasco V, et al.  Interpretive strategies for lung function tests.  Eur Respir J.  2005; 26: 948– 68. [CrossRef][PubMed]
American Pharmacists Association Foundation.  White paper on expanding the role of pharmacists in chronic obstructive pulmonary disease.  J Am Pharm Assoc.  2011; 51( 2): 203– 11. [CrossRef]
Castillo D, Guayta R, Giner J, et al.  COPD case finding by spirometry in high-risk customers of urban community pharmacies: a pilot study.  Respir Med.  2009; 103( 6): 839– 45. [CrossRef][PubMed]
Burton MA, Burton DL, Simpson MD, et al.  Respiratory function testing: the impact of respiratory scientists on the training and support of primary health care providers.  Respirology.  2004; 9( 2): 260– 4. [CrossRef][PubMed]
Cawley MJ, Pacitti R, Warning W.  Assessment of a pharmacist-driven point-of-care spirometry clinic within a primary care physician's office.  Pharmacy Practice.  2011; 9( 4): 221– 7. [CrossRef]
Townsend MC, Occupational and Environmental Lung Disorders Committee.  Spirometry in the occupational health setting: 2011 update.  J Occup Environ Med.  2011; 53( 5): 569– 84. [CrossRef][PubMed]
Centers for Disease Control and Prevention.  Spirometry training program. www.cdc.gov/niosh/topics/spirometry/training.html. Accessed  May 12, 2012.
Abramson MJ, Schattner RL, Sulaiman ND, et al.  Do spirometry and regular follow-up improve health outcomes in general practice patients with asthma or COPD? A cluster randomised controlled trial.  Med J Aust.  2010; 193( 2): 104– 9. [PubMed]
Stout JW, Smith K, Zhou C, et al.  Learning from a distance: effectiveness of online spirometry training in improving asthma care.  Acad Pediatr.  2012; 12( 2): 88– 95. [CrossRef][PubMed]
Landon BE, Gill JM, Antonelli RC, Rich EC.  Prospects for rebuilding primary care using the patient-centered medical home.  Health Aff (Millwood).  2010; 29( 5): 827– 34. [CrossRef][PubMed]
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