Community-based intervention project for the management of stable COPD: protocol for care coordination and patient referral between community pharmacies and Primary Health Care centres

Chronic obstructive pulmonary disease (COPD) is a common and progressive disease, but it also is preventable and treatable. However, important areas of improvement in its diagnosis, treatment and follow-up have been detected, as well as therapeutic adherence. In order to enhance early detection of COPD and its appropriate management in Spain, a community intervention plan (CIP) for collaboration between community pharmacies (CP) and primary care health care centres (PHC) has been designed. 

The CIP includes a standardized operating procedure (SOP), which has been devised by a group of professionals of CP, primary care medicine, pulmonology medicine and primary care nursing. The SOP reports the algorithm to guide the performance of the community pharmacists, comprising tests and devices for population-based triage of COPD, disease evaluation, adherence to inhalers, and detection of critical errors in inhaler use, among other aspects. The SOP also includes a form for patient referral to the pertinent PHC, where a series of actions, pre-established in the performance plan, will be carried out according to the clinical scenario. Furthermore, it is proposed to evaluate the intervention effectiveness using indicators collected at the PHC and CP office. Finally, it is recommended creating an education programme in COPD to achieve optimal CIP implementation, and to undertake a survey for patients to ascertain their satisfaction level with the intervention. 

To conclude, the CIP implementation could reduce COPD under diagnosis and optimize the management of diagnosed patients in Spain, where community pharmacists would play a key role in the management of these patients.