Where do pharmacists work in respiratory medicine?

There are numerous opportunities for pharmacists to work in respiratory medicine across the whole spectrum of health care in a variety of roles, according to Dr Anna Murphy, Consultant Respiratory Pharmacist, University Hospitals of Leicester NHS Trust.

Working with people with respiratory disease is enjoyable and rewarding.  “The MDT [multi-disciplinary team] are often very welcoming to having pharmacists involved, which is always a good starting point,” says Dr Murphy.

Community pharmacist have a vital role in supporting people with respiratory disease including work as part of the New Medicines Service and health promotion activities such as smoking cessation services, exercise and weight-reduction advice.  “We hope to have a new contract which encourages community pharmacists to support more with inhaler technique because, of course, for them to check and optimise inhaler technique when a patient collects their inhalers – it’s the best time for that to happen”, she says.

Another important role for community pharmacists is identifying “red flags” in people with respiratory complaints. These might be patients receiving frequent courses of antibiotics and steroids who have not yet got a diagnosis or patients who are self-treating persistent coughs. “It could be lung cancer or it could be COPD or, indeed, could be asthma”, says Dr Murphy.  “We can actually help pharmacists to identify and then to refer through to the GP practice nurses and so on for diagnosis”, she adds.

Pharmacists working in GP practices are able to undertake structured medication reviews for people with respiratory disease and also deal with effective use of inhalers. In addition, “There’s obviously a big push at the moment with the NHS agenda to become carbon neutral, so there’s an incentive for GP practices to look at using ‘greener’ inhalers such as dry powder inhalers and a lot of GP practice pharmacists have been getting involved at the moment with that piece of work”, says Dr Murphy. There’s also a massive backlog of patients with asthma and COPD that have not been reviewed because of covid and a lot of GP practice-based pharmacists are working with their GP teams to help with reviewing some of these patients, she acknowledges.

There are also opportunities in respiratory medicine in hospitals including, for example, in specialist commissioning for high-cost therapies such as biologics.

“The last area is integrated care. So, pharmacists working across the integrated care system ….. trying to break down the barriers between primary [care], secondary care, community hospitals and councils to try and improve health and prescribing of respiratory care across the whole integrated care system…..So huge opportunities for pharmacists within respiratory”, says Dr Murphy.

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