| · EPS
· Public health
· Supervision
· Assisted dying
· Paracetamol
· FDCs
· Branded prescribing
· Methadone mixture
· Incontinence products
· CPD
· The Society (2)
Letters to the Editor
|
Public health
Pharmacists have the chance to make a difference
From Dr B. P. Curwain, MRPharmS
I loved Chris Brewer’s Broad
spectrum piece on why coronary prevention
is a gamble (PJ, 11 March, p290). For a while now I have been explaining
to GPs that, when a patient asks if a statin will stop them having a heart
attack, the correct answer is: “Yes, if you are the lucky one out
of the last 35 patients I have prescribed this drug for, otherwise no.”
Contrast this with the effects of lifestyle interventions. As Bandolier1 pointed out, if we can deal with smoking, weight, diet and lack of exercise
we can massively reduce heart disease and strokes, and probably cancer,
bone disorders, arthritis, depression and erectile dysfunction.
It is commonly thought that lifestyle interventions do not work. They do,
if you do them, and they are more effective than medicines. It is not easy,
but in the New Forest area, our smoking cessation service is currently
recording a 90 per cent success rate after four weeks. Some of these patients
will relapse but, nevertheless, this is impressive.
Similarly, there are successful interventions for those wishing to lose
weight (most of us) and take more exercise. Dietary advice and prescriptions
for exercise do not have to be a punishment for the overweight.
Pharmacists are being encouraged to develop their public health role. There
are significant opportunities for both community and primary care trust-based
pharmacists here. In fact, both groups should be working together. As well
as coming up with suitable services, we must be prepared to evaluate them
and, thus, add to the evidence base. Of course, medicines and advice about
medicines will continue to be the core business of pharmacy but, with the
NHS short of funds and looking for services which genuinely add value,
things which demonstrably improve health will receive support.
Practice-based commissioning has significant incentives to develop services
aimed at enhancing health and reducing the need for hospital and other
health care. Traditionally, public health workers have been great at measuring
the health of the population but have been less successful in improving
it. With a workforce inside the NHS, plus the large network of publicly
accessible premises, pharmacists have the chance to move this agenda on
significantly. We need to work in partnership with other bodies and individuals.
It does not have to be the pharmacist who personally delivers all these
services, but it could form a significant plank in the development of community-based
health care services.
Brian Curwain
Council election candidate
Royal Pharmaceutical Society
Reference
1. Healthy lifestyle for the few. Bandolier 2005;136:4. |
The
Pharmaceutical Journal