Document resource
Introduction and Objectives Acute COPD exacerbations (AECOPDs) account for 11% of primary care antibiotic prescriptions & up to 40% of patients receive repeated oral corticosteroids (OCS). Without objective markers, prescribing decisions rely on symptoms and examination, without test corroboration. Drug rescue packs are usually issued without clinical assessment and obtained directly from pharmacists. Use of point-of-care blood tests (POCTs) of CRP and blood eosinophil count can decrease prescriptions of antibiotics & OCS by 22% and 33% respectively, without harm.This study aimed to explore the opinions of community pharmacists, GPs and practice nurses of the feasibility and acceptability of POCT COPD assessment in pharmacies.Methods Semi-structured interviews (pharmacists, GPs, practice nurses) to undertaken to determine the facilitators & barriers to implementing POCT COPD assessment within community pharmacies. Interviews were audio-recorded and transcribed verbatim for coding and inductive thematic analysis.Results 20 participants (11 pharmacists, 8 GPs, 1 nurse) in London and Kent were invited and agreed to being interviewed. Participants were recruited via Integrated Care Boards, Local Pharmaceutical Committees and support groups for community pharmacists. All supported the intervention and its feasibility. Pharmacists were enthusiastic about expanding their clinical scope and felt confident it fitted their current role. POCTs are established in community pharmacies. GPs and nurses were willing to support the pharmacists. Proposed benefits of the intervention included a decrease in unnecessary prescribing, the reassurance for patients and clinicians that would be obtained from objective results, the empowerment of patients and improvement in self-management of COPD, professional recognition of pharmacists’ clinical role, and an increased accuracy in the recording and monitoring of drug rescue packs. Key context implementation factors: Patient education (required patient behavioural changes), Clinical demand (time & pharmacist reimbursement), Communication (data sharing/storage, safety-netting).Conclusions Pharmacists, GPs and practice nurses support the development and implementation of a POCT COPD assessment pathway in community pharmacies, potentially improving patient medication stewardship.