Think Health: Pharmacists as Respiratory Health Advocates

Pharmacists stand at the forefront of healthcare, including the management of prevalent respiratory conditions like asthma and Chronic Obstructive Pulmonary Disease (COPD) in the Philippines. As we approach World Pharmacists Day, it is timely to recognize your crucial role in improving public health outcomes in these areas.

In this article, let us discuss the significant challenges posed by chronic respiratory conditions in the country and highlight the indispensable contributions of pharmacists in addressing these issues.

Challenges in managing chronic respiratory conditions in the Philippines

Respiratory conditions like asthma and COPD continue to be a significant health issue for millions of Filipinos. Reports from 2019 indicate that 5.2 million people were affected by asthma in the Philippines^{1, 2}. COPD also remains a leading cause of death in the country³. These conditions also pose a significant financial burden on many patients.

Health system challenges

This cycle of poor respiratory health and high costs is fueled by some risk factors that are difficult to modify or avoid^5,6 such as:

•    Smoking and exposure to second-hand smoke 
•    Air pollution and occupational exposure to dust, chemical fumes, coal smoke, etc. 
•    A history of tuberculosis, asthma, and childhood respiratory conditions

Significant health system challenges likewise magnify the problem. Many Filipinos, particularly in rural areas, face limited access to specialists and essential diagnostic tools, like spirometry, leading to underdiagnosis or late detection of asthma and COPD symptoms.

The role of pharmacists in patient care

In these challenges, pharmacists are in a unique and accessible position to help bridge gaps in patient care. As trusted healthcare professionals, you can provide vital support in disease management, education, and treatment adherence.

GINA and GOLD: 4 ways pharmacists champion asthma and COPD care^7,8

Following established guidelines from the Global Initiative for Asthma (GINA) and the Global Initiative for Chronic Obstructive Lung Disease (GOLD), you can provide crucial support in several ways:

1. Early detection and ongoing assessment

As a healthcare practitioner, you help patients take the first steps in identifying and addressing their health needs. This gives you the opportunity to spot early warning signs of respiratory problems in patients, such as^9,10:

• Cough

• Shortness of breath
• Chest tightness
• Wheezing
• Fatigue 
• Recurring infections like pneumonia or acute bronchitis

You can also answer general concerns about potential asthma and COPD symptoms, risk factors, and treatment options such as salbutamol nebule, inhaled corticosteroids (ICS), or even over-the-counter options like Carbocisteine + Zinc, which helps reduce the number of exacerbations associated with COPD. Most importantly, you are in the best position to provide informed counsel and ensure patients are directed to the appropriate course of care.

2. Educate and empower with healthcare plans

Pharmacists may educate patients on their condition, the importance of long-term treatment, and how to use their personalized asthma or COPD treatment plan. This plan details their daily medications and outlines clear steps to take when symptoms worsen, including when to seek urgent care.

Pharmacists may also help determine if the regimen is appropriate for the patient, and if their prescribed medications have interactions with other medications the patient is currently taking. You can also direct patients to trusted resources or quick guides to manage their asthma or COPD.

3. Support medication adherence

Pharmacists engage in shared decision-making to select the best medication and devices for the patient, considering their lifestyle, abilities, and preferences. Empathetic conversations about adherence also help uncover and solve barriers that prevent patients from taking their medication as prescribed.

4. Provide holistic support and follow-up

As a pharmacist, you may advise on essential non-pharmacological strategies like smoking cessation, physical activity, managing other health conditions, and having frequent follow-up appointments with their doctors.

You may advise patients on vaccination recommendations outlined in GOLD, such as vaccination against flu, COVID, and pneumonia.

Key pharmacist-led interventions

Let's look at four crucial interventions pharmacists lead to directly improve respiratory health, and empower patients:

1. Mastering the use of an asthma inhaler: Since incorrect inhaler use is extremely common, pharmacists often provide essential hands-on training. 

2. Advice on smoking cessation: Pharmacists may act as accessible health coaches, strongly encouraging patients who smoke to quit. Consider providing direct access to counseling and resources to support them on their journey to becoming smoke-free. For example, the Lung Center of the Philippines offers a Smoking Cessation Program with face-to-face sessions or live phone call counselling.¹¹ 
3. Adherence support: Missing doses of controller medication is a major risk for exacerbations. Pharmacists can identify barriers to adherence (costs, forgetfulness, etc.) and work with patients to find practical solutions.
4. Triage and guidance: Pharmacists are a critical safety net. You can help patients recognize the signs of a severe exacerbation that requires urgent medical attention and ensure they understand their personalized written treatment plan to manage worsening symptoms at home.

Strategies behind pharmacist support

For a stronger patient rapport, you can employ specific communication strategies that foster understanding and trust. 

• Consider the teach-back method, where you ask the patient to explain instructions in their own words to check for understanding and encourage information retention. 

• Motivational interviewing helps pharmacists partner with patients, exploring their personal goals to decide on the best treatment plan collaboratively.
• Showing empathy creates a safe, judgment-free space for patients to honestly discuss challenges with their medication.

These powerful techniques transform the pharmacy counter into a safe space for collaborative and effective patient care.

Key Takeaways

As a pharmacist, you are uniquely poised to significantly impact respiratory health in the country. Through targeted interventions and the strategic use of communication techniques, you can contribute to measurable improvements in patient outcomes, ultimately fostering a healthier future for Filipinos grappling with conditions like asthma and COPD.

General Disclaimer

Your doctor will always be in the best position to give the appropriate medical advice for your condition. For suspected undesirable drug reaction, seek medical attention immediately and report to the FDA at www.fda.gov and UNILAB Inc. at 8-UNILAB-1 or productsafety@unilab.com.ph. Always buy your medicine from your trusted drugstores and retailers.

References:

1. Optimizing asthma care in low-to-middle income countries through multisectoral collaboration: recommendation report of the first Philippine Asthma Assembly https://www.tandfonline.com/doi/full/10.1080/17476348.2024.2389948?scroll=top&needAccess=true#d1e331 Accessed August 26, 2025
2. Pediatric asthma in the Philippines: risk factors, barriers, and steps forward across the child's life stages, https://pmc.ncbi.nlm.nih.gov/articles/PMC10326682/ Accessed August 19, 2025
3. WHO Data - Philippines, https://data.who.int/countries/608 Accessed August 19, 2025
4. PhilHealth Caserates - https://www.philhealth.gov.ph/circulars/2024/0037/AnnexA-ListofMedicalCaseRates.pdf Accessed August 19, 2025
5. COPD: Causes and Risk Factors | American Lung Association, https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/what-causes-copd Accessed August 19, 2025
6. What Causes Asthma? | American Lung Association, https://www.lung.org/lung-health-diseases/lung-disease-lookup/asthma/learn-about-asthma/what-causes-asthma Accessed August 19, 2025
7. GINA: 2024 Summary Guide for Asthma Management and Prevention, https://ginasthma.org/wp-content/uploads/2024/12/GINA-Summary-Guide-2024-WEB-WMS.pdf Accessed August 19, 2025
8. GOLD Pocket Guide 2024, https://goldcopd.org/wp-content/uploads/2024/02/POCKET-GUIDE-GOLD-2024-ver-1.2-11Jan2024_WMV.pdf Accessed August 19, 2025
9. Asthma Signs and Symptoms, https://aafa.org/asthma/asthma-symptoms/ Accessed August 20, 2025
10. Early Warning Signs of COPD, https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/symptoms-diagnosis/early-warning-signs Accessed August 20, 2025
11. Smoking Cessation Program, https://lcp.gov.ph/smoking-cessation/ Accessed August 20, 2025