FEV6 assessment in spirometric abnormalities screening: the first population-based study in italian pharmacies.

Aim: In recent years, the FEV1/FEV in six seconds ratio has been proposed and validated as a parameter for screening of airways obstruction and restriction. In this context an electronic spirometry screening of pharmacy customers could lead to significant benefits such as improving the appropriateness of diagnostic test prescription and facilitating the early diagnosis of asthma and chronic obstructive pulmonary disease (COPD). Methods: Customers of 500 pharmacies in the italian Piemonte region were proposed to test their ventilatory function by an electronic spirometer, PiKo-6®, to find out probably obstruction (pO) and probably restriction (pR). All tests have been carried out by purposely trained pharmacists. Moreover, data regarding sampled subjects' gender, age, height, weight, smoke, pharmacology and therapies used were registered. A web application has been created to collect and analyze the data. Results: Male smokers confirmed a percentage of pO similar to the one predicted in obstructive lung disease (OLD) in international literature (7%); higher percentages of pO (8%) and pR (35%) were instead found in underweight people. When the data are broken down into therapeutic categories, the highest number of pO (12%) and pR (38%) was found in patients in therapy with bronchodilators, in diabetis patients (pR 41%), and in people treated with diuretics (pO 7%, pR 46%) Conclusion: Data seem to suggest the six-second spirometry as a valid screening tool for the detection of possible airway obstruction and restriction in pharmacies setting. Results point out the possibility of rationalizing the access to medical visits and of optimizing prescriptive appropriateness. The above mentioned points will lead to save public money and will strengthen the role of the Community Pharmacy as health posts of Italian Health National System.