The contribution of community pharmacy to improving the public's health. Report 1, Evidence from the peer-reviewed literature 1990–2001

Abstract

The modernisation of the NHS has highlighted the
\nGovernment's intent to improve the public’s access to
\nhealth services, information on preventing ill health and
\nsupport for self-care. Community pharmacies are in a
\nstrong position to contribute to this agenda with around
\n12 000 dedicated premises in the UK creating an informal
\nnetwork of ‘drop in’ access points for health care services,
\nmedicines and advice on health and well-being.
\nIt has been estimated that over six million people visit
\npharmacies every day. Many pharmacy staff work in
\npremises that are sited within local communities and
\nshopping precincts where they provide easy access to the
\npublic without the need for an appointment. The
\ninformal nature of contact with a pharmacy creates an
\nexperience for users which is more similar to a ‘consumer’
\nthan as a ‘patient’. Visitors to pharmacies come from all
\nsectors of the population and research has shown that
\nlocal pharmacy services are particularly valued by those
\nwithout easy access to a car or public transport. In
\nrecognition of this potential the recent Health
\nCommittee Inquiry into Public Health5 recommended that
\n‘the Government takes steps for community pharmacists
\nto play a more active role in public health’.
\nAs a result of these characteristics there is an opportunity
\nfor pharmacy staff to give advice and support on health
\nor medicines to a significant proportion of the
\npopulation on a regular or ad hoc basis. Much of this
\nadvice is given with prescriptions and the treatment of
\nminor illnesses, however, some pharmacies also provide
\nother services to improve health, such as help with
\nsmoking cessation, dietary advice, and testing of blood
\npressure and cholesterol. The provision of these latter
\nservices, however, is not universal and there has been no
\nsystematic evaluation of the evidence on their
\ncontribution to public health. To help assess the value of
\nthese services delivered through pharmacy, the Royal
\nPharmaceutical Society of Great Britain (RPSGB)and the
\ncharity PharmacyHealthLink commissioned a review of
\nthe UK and international evidence-base health
\nimprovement in order to determine which activities are
\nmost likely to be effective in a pharmacy setting and how
\nthey might best be provided.
\nThe review demonstrates that certain services are both
\nsufficiently well-researched and well-received by
\npharmacy users at an international level, for example in
\nsmoking cessation, lipid management in the prevention
\nof coronary heart disease, immunisation and emergency
\ncontraception, that recommendations for their
\nwidespread implementation in the UK can be made.
\nOther services also show promise but are less wellresearched
\nand require more evaluation before an
\nassessment of their effectiveness and suitability in a
\npharmacy setting can be determined.
\nThis review can help to shape the contribution of
\ncommunity pharmacists to a modernised health service. It
\nprovides useful evidence to those involved in the
\nplanning and provision of health services to prevent
\nillness and maintain health. Funding bodies and
\ncommissioners may wish to use its findings to develop
\npharmacy services to contribute further to their health
\nimprovement plans and local targets.