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Cochrane: Community pharmacy health promotion benefits patients

Health promotion interventions in community pharmacies “probably” improve patient health outcomes while being cost-effective, a Cochrane review has determined.

The medical research charity’s review of 57 randomised trials with over 16,000 participants asked whether community pharmacy interventions could improve health outcomes and enhance pharmacy teams’ skills.

The authors comment on community pharmacy’s “rapid expansion” to a more services-based role, explaining: “In low‐ and middle‐income countries, but also increasingly in high‐income countries, pharmacies are often seen as the first place to call for advice on symptoms and for early diagnosis of illness."

Effects seen over range of conditions

Around half of the interventions involved skills training for pharmacy teams, while the other half focused on interventions between pharmacy workers and patients.
 
The clinical areas most frequently studied were diabetes, hypertension, asthma and modification of cardiovascular risk. The authors note that the “duration of follow-up interventions was often unclear”.
 
Based on the data, health promotion interventions in community pharmacy “probably” improve teams’ behaviour and “probably have a slight beneficial effect on health-related behaviour, intermediate clinical outcomes and quality of life for pharmacy users,” they write.
 
These effects are seen “across a range of clinical conditions and health-related behaviours,” they say although they note that the “magnitude of the effects varies between conditions”.
 
For example, health promotion interventions “probably improved” blood pressure in hypertension and blood glucose levels in diabetes, but “probably made little or no difference” for asthma control or cardiovascular risk ['purely medication‐related' interventions were not considered in the review], the authors write.

Cost-effective

On cost, they say they “found that health promotion interventions are likely to be cost-effective based on moderate certainty evidence”.

The authors conclude that community pharmacy “is potentially a helpful setting in which to offer behavioural and health promotion interventions”.

They also describe a need for “greater use of thorough, systematic approaches in the description of these interventions” and for new studies examining the effect of community pharmacy interventions.




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