Using community pharmacies to seek out undiagnosed cases of early-stage chronic obstructive pulmonary disease could save the National Health Service and society a whopping £264 million a year, research shows.

According to data from the COPD Case Finding Service, a project run by Community Pharmacy Future (a collaboration between Boots, The Co-operative Pharmacy, Lloyds Pharmacy and Rowlands Pharmacy), out of 238 people screened by 21 pharmacies, 135 (57%) were identified as being at higher risk of the disease.  

Further analysis revealed 88 active smokers in the high risk group, who were then offered smoking cessation advice by the pharmacy teams. Thirty-nine percent declined but 18% took part in pharmacy-based services, and 34% were referred to other stop smoking support. Sixty-three percent of those screened were also offered general lifestyle advice about smoking, diet and nutrition, physical activity, alcohol consumption, and weight management.

The evidence, published in the International Journal of Pharmacy Practice, shows that case finding of COPD patients by community pharmacy is possible, noted David Wright, School of Pharmacy, University of East Anglia and lead author of the paper. 

“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”, he argues.

Around 900,000 people are diagnosed with COPD in England and a further 2.7 million cases remain undetected. The research suggests that, if the service were extended to 11,100 pharmacies in England, an annual benefit to the NHS and wider society could be £264 million from diagnosing patients earlier and reducing lost productivity. Also, additional lifetime savings from stopping smoking are estimated at £215 million, the group noted.

Growing problem

Meanwhile, a global COPD survey by GlaxoSmithKline shows that the disease is a growing problem in the US and in one decade has risen from the fourth leading cause of death to the third, after heart disease and cancer.

It also found that the burden of COPD on patients and the US healthcare system is high, with 25% having reported visiting the emergency room as a result of their disease, and an additional 17% hospitalised within the last year, similar levels to that seen in Mexico and higher than those reported in most European countries surveyed.

Interestingly, the survey also revealed that many patients could be underestimating the severity of their symptoms. Fifty-four percent of US participants reported clinically significant dyspnea (shortness of breath), but 70% classified their COPD as only mild or moderate in severity, “demonstrating a disconnect between the level of symptoms and their own subjective assessment of the disease”, GSK noted.