07/09/2025
RESPIRATORY PHARMACY SPECIALISTS..
What do they do as specialists in healthcare ?
The high prevalence of both respiratory and non respiratory comorbidités ( diseases ), which lead to poorer results ( outcomes) in terms of quality of life and morbidity and deaths , makes it essential to understand the complexity of these ailments, not only in terms of medications but also in terms of the specific tests and techniques used in diagnosis and follow up.
According to Noe Garin et al, 2024, Pharmaceutical Care ( PC ) is key to the management of respiratory diseases due to complex treatments such as inhalers and nasal devices. These devices have been reported to be used correctly in one third of cases due to their complexity, variability, need for coordination, lung capacity, and use of chambers, among other factors.
Adherence is estimated to be 50% according to research, and records show that only 63% of prescriptions are filled. Other treatments should also be taken into account, such as biologics for asthma or polyposis, and oxygen therapy for chronic obstructive pulmonary disease ( COPD ) or interstitial lung disease ( ILD ).
A respiratory pharmacist is a specialist clinical pharmacist in respiratory care who provides medication treatment and management to patients with respiratory conditions such as asthma, cystic fibrosis, tuberculosis , interstitial lung disease, sleep medicine and COPD etc.
They review and amend medication plans and educate respiratory patients on the importance of following treatment regimens.
As the role of a respiratory pharmacist may differ day to day, the setting they work in, can frequently change too.
Members of the respiratory pharmacy team work in a variety of healthcare environments, such as hospitals, respiratory clinics, and community practices, to ensure safe and effective medication management for patients with respiratory conditions.
Alongside inhaled therapy, respiratory pharmacists can also focus on preventative measures for patients. This may include recommendations for seasonal immunizations, smoking cessation support, consideration of prophylactic antibiotics, rescue packs and medicines adherence education..
In the UK in 2003, the concept of Pharmacist Supplementary Prescriber was described by the UK Department of Health. It allowed an accredited Pharmacist to prescribe medicines to a patient within an agreed clinical management plan for a specific condition in collaboration with another prescriber such as physician or dentist.
In 2005, this was extended to offer PHARMACIST INDEPENDENT PRESCRIBING RIGHTS., which added the responsibility for the assessment, diagnosis and conséquent management of that patient.
To date , the independent prescribing course has only been completed by already qualified ( graduate ) pharmacists, but new standards mandate that all Pharmacists in the UK will be permitted to prescribe at the point of registration as a Pharmacist. That means that from year 2026, after successful completion of pharmacy degree and their foundation year training, all UK Pharmacists will have medicines prescribing authority.
A significant number of UK pharmacists, including those specializing in respiratory care, are already independent prescribers.
An independent prescriber can initiate, adapt, renew, or substitute prescriptions autonomously for patients within their clinical competency.
They can assess patient needs, check for drug interactions, ensure optimal drug administration, and provide support for non-pharmacological aspects of care, such as pulmonary rehabilitation.
While not all respiratory pharmacists are independent prescribers, those who have completed the necessary training are empowered to prescribe respiratory drugs independently, contributing significantly to patient care and medicines management in the UK.
Another important development for the pharmacy profession in the UK was the establishment of the CONSULTANT PHARMACIST CADRE introduced by the National Health Service (NHS ) in year 2005.
Consultant Pharmacists are recognized as leaders in the profession and clinical experts delivering care and driving change accross the healthcare system. Their purpose is primarily to undertake activities that use their extensive expert knowledge and skills to contribute to improving the health of individuals and the wider population.
The NHS in the UK promotes the integration of respiratory pharmacists into specialized services for conditions like severe asthma.
The British Thoracic Society ( BTS ) advocates for specialist respiratory pharmacists within the healthcare system and also has a pharmacist specialist advisory group.
In Australia, the respiratory pharmacy task force established by the Pharmaceutical Society of Australia ( PSA ), , as part of the respiratory care community of specialty interest, is made up of pharmacy Respiratory Experts, leaders within the pharmacy profession, consumers, respiratory physicians, GPs, and representatives from the lung foundation Australia. The task force will initially meet on asthma management and then extend to COPD etc.
According to Dr Anna Murphy, Consultant Respiratory Pharmacist ( NHS, UK) , community pharmacists in respiratory care have roles such as 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". Respiratory Pharmacists can actually help other pharmacists to identify and then to refer through to diagnosticians , and so on for diagnosis.
AFRICA, while specialist clinical pharmacy roles such as those in respiratory care are well established in Europe and North America, they are less common but emerging on the African Continent.
Clinical pharmacists in countries like South Africa are actively involved in managing respiratory conditions, focusing on areas such as COPD, and bronchiectasis.
The Doctor of Pharmacy program is a Postgraduate course in South Africa and the country is somewhat recognized as a leader of Clinical Pharmacy on the continent.
The Respiratory Pharmacist of Nigeria Specialty Group of the Clinical Pharmacists Association of Nigeria (CPAN) is also an example of a body of Pharmacists on the African Continent promoting the specialty area of Respiratory Pharmacy.
COURTESY.
African Society of Clinical Pharmacists (ASOCLIP).
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