Community Pharmacists Interventions for Health Promotion

Pharmacist Interventions Promote Health

A Cochrane review was published this week on the role of pharmacist interventions for health promotion.  They included interventions in community pharmacies targeted at, or delivered by, pharmacy workers that aimed to improve the health-related behaviour of people attending the pharmacy compared to no treatment, or usual treatment received in the community pharmacy.  I was happy to see this paper as community pharmacy is the most common method of delivery pharmacist interventions.

Types of Intervention

They included 57 randomized trials with 16,220 participants. Most interventions were educational, or incorporated skills training. Interventions were directed at pharmacy workers (n = 8), pharmacy users (n = 13), or both (n = 36). The clinical areas most frequently studied were diabetes, hypertension, asthma, and modification of cardiovascular risk.

Results

The authors report that these health promotion interventions:

  • Improve pharmacy worker behaviours. Pharmacists did more to promote healthy behaviours. This change in behaviour was assessed by a simulated patient.
  • Lead to a slight improvement in health-related behaviours of pharmacy users when compared to usual treatment (standardized mean difference (SMD) 0.43, 95% CI 0.14 to 0.72; I2 = 89%; 10 trials; 2138 participants; moderate-certainty evidence).
  • Lead to a slight improvement in intermediate clinical outcomes, such as levels of cholesterol or glycated hemoglobin, for pharmacy users (SMD -0.43, 95% CI -0.65 to -0.21; I2 = 90%; 20 trials; 3971 participants; moderate-certainty evidence).
  • Are likely cost-effective

What Does this Mean?

  • There is increasing evidence that pharmacist interventions can promote health-related behaviours in patients in a cost-effective manner
  • The author’s suggested a standardized approach across different disease states could further improve these results
  • Increased research on long-term outcomes (e.g MI, diabetes complications) would be beneficial

Overall, pharmacists can play an increasing role in health promotion if given the right training and tools.  This can be done cost-effectively.  Payers and governments should increase funding for these services and research on their long-term impact on patients. 

 

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