COPD Reviews: When should pharmacists refer?

Pharmacists play a crucial role in the ongoing care of Chronic Obstructive Pulmonary Disease (COPD) patients, providing medication management, lifestyle advice, and monitoring disease progression. However, there are specific situations where a pharmacist must consider referring a patient to a specialist or other healthcare professional. This guide outlines the key indicators for when to refer, ensuring patients receive comprehensive and specialised care when needed.

When to refer:

It’s crucial for pharmacists to consider referring to a specialist if:

• The diagnosis is unclear

• New onset of severe COPD is suspected

• COPD patient has requested a second opinion

• Onset of Cor pulmonale

• Assessment for oxygen therapy

• Assessment for long-term non-invasive ventilation

• Assessment for long-term nebuliser therapy

• Assessment for Oral corticosteroid therapy

• Suspected bullous lung disease

• A rapid decline in FEV1

• Assessment for pulmonary rehabilitation

• Assessment for lung volume reduction procedure

• Assessment for Lung transplant

• Dysfunctional breathing

• Onset of symptoms under 40 years or a family history of alpha-1 antitrypsin deficiency

• Symptoms disproportionate to lung function deficit

• Frequent infections

• Haemoptysis

Referrals to other professionals:

Pharmacists should consider referring to these healthcare professionals for:

• Pulmonary Rehab: For patients with MRC score more than 3 who may also experience excessive sputum production to learn to use positive expiratory pressure devices and active cycle breathing techniques.

• Social Prescriber: If the patient has trouble with activities of daily living or functional disability. Patient can then be referred onto Social Services / Occupational Therapy if appropriate.

• Dietician: If the patient’s BMI is abnormally low or high changing over time (3kg in older person).

• Psychological services: For managing Anxiety or Depression related to COPD

In Summary

In the management of COPD, pharmacists must be vigilant and proactive in identifying when to refer patients to specialists or other healthcare professionals. Recognising the signs and symptoms that necessitate further evaluation ensures that patients receive the most appropriate and effective care, addressing all aspects of their condition comprehensively.

To learn more, please access our comprehensive training programme on COPD Reviews here.