Chronic Obstructive Pulmonary Disease (COPD) Case Finding
Community Pharmacy Future: Achievements and Results

The full results of this service evaluation have been published in the International Journal of Pharmacy Practice.

COPD Case Finding Service

  • Aimed at identifying patients with undiagnosed Chronic Obstructive Pulmonary Disease (COPD) for earlier interventions

    • A large number of cases remain undiagnosed, with estimates of 2.7 – 2.8 million patients proposed1,2

  • 238 patients screened by 21 pharmacies in Wirral over nine months, across all socio-demographic areas

  • The service has resulted in identifying potential COPD patients who might have otherwise remained undiagnosed and gone on to progress to severe disease states, including associated acute care costs

  • The service has been successful in offering advice and support to patients who smoke – the most effective intervention that can be delivered to those at risk



Potential annual saving* from diagnosing patients earlier.

Potential lifetime savings from stopping smoking.

All savings based on delivery of equivalent services from 11,100 pharmacies across England with similar results seen.
* Savings based on the differences between treating moderate-to-severe COPD and reduced productivity losses.

Supporting an early diagnosis of COPD
Aims and objectives:
  • Raise awareness of the risk factors associated with COPD.

  • Identify those potentially at risk of COPD.

  • Complete assessments to stratify risk of developing COPD.

  • Provide lifestyle advice required to decrease risk of developing COPD, including referral to appropriate services such as stop smoking.

  • Signpost to GP to provide timely diagnosis and management where appropriate.

  • To allow those with undiagnosed COPD to be identified and receive treatment so that disease progression can be slowed.

Patients are eligible for the service if they are over 35 years and they have not previously been diagnosed with COPD.

Patients are not suitable for the service if they have recently been diagnosed with a chest infection (they can be offered the service again in four to six weeks, once their chest infection has cleared).

Diagnosis of COPD
Population demographics for COPD Case Finding
Population demographics for COPD Case Finding

The Carstairs index is used to calculate deprivation quintiles for least and most deprived.

It is based on four census indicators:

  • low social class

  • lack of car ownership

  • overcrowding

  • male unemployment

COPD Case Finding Service: key results

  • 21 pharmacies in the Wirral screened 238 patients.

  • Of these, 135 were identified at risk of COPD (56.7%), of whom 88 were active smokers (37.0% of total cohort).

  • Based on the findings from the COPD Case Finding Service, we estimate that if the service was delivered from 11,100 pharmacies in England to 555,000 patients then the NHS could see benefits of:

    • Lifetime savings from stopping smoking of £214.7m, 96,000 life years, and 46,000 QALYs.

    • Annual benefits of £264.5m (from diagnosing patients earlier and reduction in productivity costs).

CPF - Wirral
"Done quite a lot for me health and changed me health for the better"

COPD patient
"Together, we were able to devise a process from screening patients for COPD all the way through to diagnosis. It was invaluable to have the pharmacy involved as it meant patients were no longer lost between the screening and diagnostic stages. The service also benefited the surgery by helping existing patients manage their condition."

1. British Lung Foundation. Invisible Lives. Chronic Obstructive Pulmonary Disease (COPD) – Finding the missing millions. 2007.
2. PCC Quality and Outcomes Framework (QOF) Management Guide (3). 2012.
3. PCC Quality and Outcomes Framework (QOF) Management Guide (3). 2012.
4. DiBonaventura M, Paulose-Ram R, Su J, McDonald M, Zou KH, Wagner JS, et al. The impact of COPD on quality oif life, productivity loss and resource use among elderly United States workforce. COPD 2012;9(1):46-57.
5. Stahl E, Lindberg A, Jansson SA, Ronmark E, Svensson K, Anderson F, et al. Health-related quality of life is related to COPD disease severity. Health Qual Life Outcomes 2005; 3:56.
6. Burney P Jarvis D. The burden of COPD in the UK. NHS National Library for Health: Respiratory Specialist Library. 2006.
The Community Pharmacy Future project is a collaboration between
Well Pharmacies
Lloyds Pharmacy
Rowlands Pharmacy a company of the PHOENIX group