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The truth between the lines – Community pharmacists in improving the health of the public – The need for evidence based practice
 

The truth between the lines – Community pharmacists in improving the health of the public – The need for evidence based practice

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PharmaCon2007 Congress, Dubrovnik, Croatia "New Technologies and Trends in Pharmacy, Pharmaceutical Industry and Education" http://www.pharmacon2007.com ...

PharmaCon2007 Congress, Dubrovnik, Croatia "New Technologies and Trends in Pharmacy, Pharmaceutical Industry and Education" http://www.pharmacon2007.com
Abstract is available at http://www.pharmaconnectme.com

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The truth between the lines – Community pharmacists in improving the health of the public – The need for evidence based practice The truth between the lines – Community pharmacists in improving the health of the public – The need for evidence based practice Presentation Transcript

  • The truth between the lines – Community pharmacists improving the health of the public – The need for evidence base practice. Claire Anderson PhD, BPharm, FRPharmS, MCPP Professor of Social Pharmacy Division for Social Research in Medicines and Health
    • Rising public expectations
    • Ageing population
    • New technologies
    • Changing workforce
    • System performance and quality
    • Will lead to:
    • More time reviewing evidence
    • Longer consultations with greater information
    • exchange
    • Development of training in communicating
    • with patients and information technology for
    • all health professionals
    • Virtual health services
    • Policy futures for UK health - 2000 report, Nuffield Trust and University of Cambridge
    Key shifts in society
  • Role of Pharmacist
    • Ensuring best use of Medicines
    • Improving patient safety
    • Patients as partners
    • Part of the healthcare team
    • Public health
    • Evidence based practice
    • UK A vision for pharmacy in the 21 st Century
    • US ASHP 2015 Initiative
    • NZ Focus on the Future – 10 year vision
  • Determinants of Health Agriculture and food production Education Work environment Employment status Water and sanitation Health care services Housing
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  • Public health
    • “ The science and art of preventing disease, prolonging life and promoting health through organised efforts of society”
    • (Acheson Inquiry into Inequalities in Health, 1998)
  • Pharmacy and health promotion
    • The promotion of health and the prevention of disease are now seen as a priority for the health services. The pharmacists role too needs to develop to reflect this shift in emphasis away from simply treating those who are ill
    • (Blenkinsopp Panton and Anderson, 2000)
            • “ To date pharmacists have been a major untapped resource for health improvement. The track record of community pharmacists in areas such as stopping smoking, sexual health advice and substance misuse is evidence of how integral they are to tackling public health issues. But we would like pharmacists to do even more.”
            • Health Minister
            • Rosie Winterton MP
    The evidence The policy
  • Public Health and Pharmacy
    • Promoting health and well-being
      • e.g. nutrition, physical activity
    • Preventing illness
      • e.g. smoking cessation, immunisation, travel health
    • Identifying ill health
      • e.g. screening and case finding
    • The maintenance of health for those with chronic or potentially long-term conditions
      • e.g. diabetes, asthma, hypertension
    • 94% of the population visits a pharmacy at least
    • once a year
    • Each adult visits a pharmacy on average 12 times
    • a year
    • 1.8 million visits to pharmacies every day for
    • prescriptions, buying medicines and health advice
    • 260,000 visits each day are specifically for health
    • advice
    • Frequent users of pharmacy:
        • Older people
        • Families with young children
        • Unemployed people
        • Homeless
        • Drug users
        • Those living in inner cities or rural areas
    • The Evidence
    • Pharmacists attach a high degree of
    • importance to public health
    • activities
    • Pharmacists are more comfortable with
    • activities that are related to medicines and
    • need support to extend their portfolio of
    • health-related work
    • Pharmacists’ advice is more likely to be
    • reactive rather than proactive
    • The Evidence
    • Pharmacists are more comfortable with
    • activities that are related to medicines and
    • need support to extend their portfolio of
    • health-related work
    • Pharmacists’ advice is more likely to be
    • reactive rather than proactive
    • The Evidence
    • Pharmacists’ concerns about being
    • ‘ intrusive’ in offering potentially
    • unwelcome health advice predisposes to
    • a reactive stance
    • Dispensing duties are widely reported as
    • a key barrier to pharmacists’ greater
    • involvement in health development
    • activities
    • Majority report having followed the health
    • advice given by pharmacists with positive
    • views on the pharmacist’s input
    • Most pharmacy users perceive there is
    • sufficient privacy in the pharmacy to
    • discuss even sensitive subjects
    • Awareness of pharmacy based leaflets on
    • health topics among pharmacy users is
    • higher among those who are taking
    • prescribed medicines
    The evidence- patients
  • The Evidence
    • Smoking cessation
    • Sexual health
    • Lipid management
    • BP screening
    • Immunisation
    • Services for drug users
    • Develop holistic and proactive approach
    • Be aware of the wider determinants of ill
    • health, in particular socio-economic
    • factors and the need to reduce health
    • inequalities
    • Communicate appropriate and consistent
    • health information
    • Work other health professionals on
    • integrated care pathways for people with
    • long-term conditions
    Choosing Health Through Pharmacy
    • www.pharmacymeetspublichealth.org
  • Pharmacists
    • Brief healthy lifestyle advice to
    • People who have diabetes
    • People at risk of coronary heart disease especially those with high blood pressure
    • Smokers
    • Overweight
  • Priority areas for giving lifestyle advice in community pharmacy
    • Physical Activity
    • Weight management
    • Diet and nutrition
    • Alcohol
    • Smoking
  • Priority areas for giving lifestyle advice in community pharmacy
    • Physical Activity
    • Weight management
    • Diet and nutrition
    • Alcohol
    • Smoking
  • Brief advice
    • Opportunistic, proactive advice
    • Linked to supply of a medicine, product or service
    • Takes up to 3 minutes
    • Brief Advice
    • Listen - to person’s needs or concerns
    • Observe - for signs of health related problems, e.g. nicotine stained fingers, alcohol odour, being overweight
    • Ask – raise health issues in a friendly, non threatening manner using indirect questions to start with
    • Assess - the person’s response do they appear wiling to engage in further discussion?
    • Advise – give advice or information
    • Record - record the outcome
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  • Smoking- raising the issue
    • 1. Symptoms
    • person is complaining of
      • Being unhappy with their health
      • Respiratory problems.
    • 2. Proactively seeking lifestyle advice or
    • asking about pharmacy services
    • 3. Responding to requests for medicines etc.
      • Cough medicines
      • Nicotine replacement therapy
  • Indirect questions
    • Have seen our promotion/advertisement for a healthy lifestyle consultation
    • Do you catch colds and flu easily?
    • Do you find coughs and colds stay around for a long time? Dou you get out of breath easily?
  • Direct questions
    • Have you ever tried to stop smoking? How did you get on?
    • Do any of your family/friends smoke?
    • Has your doctor/family/friend suggested you stop smoking?
    • We are offering people a chance to attend our stop smoking clinic would you be interested?
  • Tips for stopping smoking
    • Do it together with a friend or relative
    • Use Nicotine Replacement Therapy
    • Avoid situations where you might be tempted to smoke again
    • Note how much money you save
    • Keep telling your self you can do it!
  • Emergency Hormonal Contraception
    • Public willing to receive advice in pharmacies
    • Over 50% of all emergency contraception in UK is now via pharmacy
  • Ten key roles for pharmacy in public health
    • 1. Assessing the health and social needs of the local community, through involvement in surveillance and the gathering of intelligence public health
    • 2. As public health leaders in their local communities acting as advocates on behalf of others on health issues, contributing to sustainable communities and neighbourhoods
    • 3. Recognising all the key influences on health , such as income and education, as well as lifestyle issues such as smoking and diet
    • 4. Being accessible to all, communicating accurate, contemporary health information clearly and promoting health literacy
  • Health literacy
    • Enabling people to gain access to, understand and use information in ways which promote and maintain good health
      • Transforming information into knowledge
      • Transforming information into behaviour change
      • Supporting behaviour change
  • Ten key roles for pharmacy in public health
    • 5. Signposting to other services, including IT to help people make healthy choices
    • 6. Delivering a wide range of health improvement services, particularly those that help to reduce health inequalities both in the pharmacy and in other settings such a primary care premises, schools and workplaces
    • 7. Work in active partnership with a range of other statutory and voluntary services, both within the pharmacy and elsewhere in the community
  • Ten key roles for pharmacy in public health
    • 8. Supporting people with long-term conditions , by helping people to use their medicines effectively , promoting healthier lifestyles, supporting self care. Monitoring and assessing patient’s conditions and participating in multidisciplinary care teams
    • 9 . Protecting health through promoting the safe, effective,
    • informed and responsible use of medicines
    • 10 Contributing to public health capacity at all levels, ensuring the whole pharmacy team is trained and evaluating its services
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    • “ We are not tinkers who merely patch and mend what is broken... We must be watchmen, guardians of the life and the health of our generation, so that stronger and more able generations may come after “
    • Dr Elizabeth Blackwell (1821-1910)
    • The First Woman Doctor
  • Community pharmacy in UK: role of pharmacists in public health Prof Claire Anderson PhD, BPharm, FRPharmS, MCPP Division for Social Research in Medicines and Health