Help England's community pharmacies do more for health, researchers urge
Date: Aug-22-2014 A new study published in BMJ Open urges the government to do more to help
community pharmacies in England tackle major public health concerns such as smoking and
obesity.
The study, by a team from Durham University, is the first to show that most people in England,
particularly in more deprived areas, live within walking distance of a community pharmacy.
The findings suggest that access to pharmacy services does not follow the "inverse care law"
often quoted in respect of medical care - whereby the best medical care is most available to
those who least need it. Instead, it follows its own "positive pharmacy care law," note the
authors.
Lead author Dr. Adam Todd, of Durham's School of Medicine, Pharmacy and Health, says the role
of the local pharmacist has changed considerably in the last few years. Community pharmacies are
increasingly more concerned with promoting healthier living and helping people change their
health-related behavior.
Community pharmacies well placed to deliver public health services
The new study calls on the government to help local pharmacies provide more services to tackle public health concerns.
He adds that their study shows England's local pharmacists are well placed "in the community
to deliver public health services. This is particularly important for the poorest areas where
more people die from conditions such as smoking, alcohol misuse and obesity compared to people
from more affluent areas."
He and his team urge the government to help community pharmacies bolster their role and
provide more services to tackle major public health concerns.
For the study, the team analyzed pharmacy location and local population data for all community
pharmacies in England. Each pharmacy's postcode was assigned to a population lookup table, and
matched to a deprivation index as well as to the type of area, such as urban, town and fringe,
hamlet or isolated dwelling, as a measure of the number of households in the vicinity.
The main outcome measure was whether or not the households in an area - as defined by
postcodes - had access to a community pharmacy within a 20-minute walk. A person walks about 1.6
km in 20 minutes, so the team placed 1.6 km "buffers" around each pharmacy to represent a 20-
minute walk and then clipped the population postcodes to the pharmacy buffers.
They admit that one of the study's limitations is they had to represent the 20-minute walking
distance as a straight line, which is not necessarily the case in real life.
89% of households in England within 20-minute walk of their community pharmacy
They found that overall, 89% of England's households are situated within a 20-minute walk of
their community pharmacy. In areas of high deprivation, the percentage is even higher, reaching
nearly 100% for some postcodes.
Dr. David Branford, chair of the English Pharmacy Board, suggests pharmacists are well placed
to understand and deliver solutions for individual patients, and:
"The less formal approach and sheer convenience provided by a high street presence means they
are a beacon of wellbeing and advice to many who would simply never engage with other healthcare
settings. This study confirms their accessibility and the huge potential they have for delivery
of quality healthcare to those who need it most."
As an example of what they mean, the Durham team points to Dixon and Hall, a group of four
community pharmacies located in North East England.
As well as the customary clinical services such as flu jabs, treatments for minor ailments and
emergency contraception, all four branches offer a range of health promotion services, including
help with giving up smoking, plus health checks and advice on body mass index, cholesterol,
alcohol and diet.
Dixon and Hall's managing director and pharmacist Louise Lydon says:
"Community pharmacies are an accessible option for patients, with a health professional
available to discuss any issues without needing to book an appointment, which is a real
opportunity for community pharmacies."
'Every contact is a health opportunity'
She says they follow an ethos of "every contact is a health opportunity," and openly
ask patients about their smoking habits, as well as conduct brief alcohol interventions and carry out
health checks on an ad hoc basis:
"This is an excellent way to engage with patients as we find appointment systems are often too
formal and have high non-attendance for health promotion type interventions," she explains.
Meanwhile, another study published recently as part of the Pennsylvania Project in the US,
found community pharmacist
intervention boosts drug adherence and reduces health care costs.
Written by Catharine Paddock PhD
View all articles written by Catharine, or follow her on:
Courtesy: Medical News Today
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