Health promotion is something that all pharmacists must do, and its basic philosophy is something that all pharmacists should have, according to Dr CLAIRE ANDERSON (school of pharmacy, University of Nottingham).
Speaking at an FIP forum on September 7, Dr Anderson recognised that health promotion was more than providing information to encourage healthy lifestyles — it was about empowering people to have control of their health. Pharmacists should work for health gain in their communities, encouraging an increase in the number of years that people spent free of illness. Clearly, pharmacists were experts in medicines, and a large proportion of their health promoting role was related to the sale and supply of medicines. Indeed, health promotion was an implicit part of pharmaceutical care.
Health promotion was high on the agenda in the UK, both for the Government and for the pharmacy profession. Moreover, pharmacy practice was changing, giving pharmacists more time and freedom to give advice. Operating in a commercial environment was not necessarily the disadvantage that it was sometimes considered to be, and was actually a factor which could be exploited by pharmacists to sell health. There was a growing "market” for health and well being, particularly in the higher social classes, and, available seven days a week in some settings, community pharmacists were in a good position to make the most of this. Patient medication records could be used to target specific patient groups, and clinics for people with angina, diabetes, the menopause and so on, could be set up. Pharmacist collaboration with general practitioners could ensure adequate uptake of vaccination and screening. Moreover, to be truly health promoting meant active lobbying for change at local, national and global level, she said.
However, health promotion posed several challenges for pharmacy. Remuneration was one, but consumer perceptions were also important. Although pharmacists were accessible, health promotion often involved being accessible for longer periods of time than pharmacists were used to and also required consultation areas to ensure privacy. Moreover, research had shown that prescription customers were more likely to accept advice than non-prescription customers. This certainly posed a challenge, as did the ability and willingness of pharmacists to move to a "concordance model of care.”
Describing a health promotion project involving pharmacists providing nutritional advice, Dr MONTSERRAT RIVERO (head, national board of nutrition, General Council of Official Pharmacist Colleges, Spain) said that pharmacists’ accessibility was just one of the factors that justified their direct intervention in health campaigns.
During recent years, two nutrition campaigns had been developed in Spain. Run during 1998, the first had targeted housewives. Of the 20,000 or so community pharmacists in Spain, 2,954 had participated, reaching more than 59,000 individuals and 236,000 families. Aided by posters, games and leaflets, pharmacists had been trained to emphasise simple dietary messages, such as "eat more fruit and vegetables and bread”.
The second programme was due to run between October and December this year. It had been targeted at schoolchildren aged 10-11 years and it involved 3,858 pharmacists,. Official recognition had been obtained from the Spanish Ministry of Health, and the Ministry of Education and Culture was helping to introduce the campaign to schools. Pharmacists would visit schools to teach and encourage correct dietary habits, and the expectation was that 115,740 children and 462,960 families would be reached. Part of the programme evaluation (to be completed by June, 2000) would involve the target population filling in questionnaires to identify whether dietary habits had changed.