| Men suffer considerable inequality in their use of health services
and their health outcomes. They attend a third fewer appointments with
GPs
and are less likely to receive hospital treatment. They are more likely
to suffer from mental illness and almost twice as likely to be diagnosed
with, and die as a result of, cancers that affect both sexes.
However, the Government believes that pharmacists can help to tackle
such inequalities. “Choosing health through pharmacy” suggested
pharmacists could reduce health inequalities for men by providing information
and advice.
The Men’s Health Forum, which organises Men’s Health Week,
also believes that pharmacy should play a larger role in providing services
targeted at men.
“There is significant under-use of pharmacies by men,” Peter
Baker, chief executive of the Men’s Health Forum, says. “Pharmacies
have many characteristics that in other settings appeal to men, such
as their confidentiality, the fact that you don’t need to make
an appointment, and their long opening hours, particularly when compared
to GP surgeries.”
Nigel Duncan, press officer for Men’s Health Forum, adds: “Community
pharmacy is often a much more appropriate place for men to access health
services than going to their GP, in terms of convenience and because
of pharmacists’ expertise with medicines and their use.”
Mr Duncan would also like to see more pharmacies offering specific health
checks that could attract men into pharmacies, such as cholesterol, blood
pressure and chlamydia tests (see Panel). He believes that many men are
more likely to use such tests when they are easily available rather than
when they are accessible through an appointment at a GP surgery.
In addition to providing diagnostic tests for men to use at home, pharmacies
could offer more general on-site health check-ups, he adds. “These
sorts of check-ups are popular with many men and tend to detect a significant
number of cases of hypertension, diabetes and weight problems.” They
also enable men to raise other health concerns, and could be provided
by pharmacists off-site at community venues used by men, such as working
men’s clubs, sports clubs, pubs or barbers’ shops, he adds.
Chlamydia screening
Even though similar proportions of men and
women have chlamydia, only 12.5 per cent of those tested in 2004–05
by the NHS chlamydia screening programme were men. This failure
to test a
sufficient number of men is contributing to a cycle of reinfection
for women, the Men’s Health Forum argues.
At the same time,
around 21 per cent of those accessing Boots’s free-of-charge
chlamydia screening and treatment service for 16–24-year-olds
have been men, and an even higher proportion of men have been
buying Boots’s private chlamydia testing kits for £25.
Julie
Hanmer, programme manager for pharmacy services at Boots The
Chemists,
believes that the popularity of the private service among men
is because it has no upper age limit and the kits can be purchased
anonymously. “The availability of this type of test through
the pharmacy route does appear to increase accessibility for
men,” she
said. |
Projects
A number of projects targeting pharmacy-based health checks at men
have already shown considerable success. Last year eight community pharmacies
in Knowsley ran a three-month pilot scheme offering health checks in
community pharmacies to men aged 50–65 years.
A previous scheme in which health checks were offered in pubs, working
men’s clubs and work places had shown that such checks could engage
men who did not regularly access primary care services. These checks
were not, however, part of a sustainable programme regularly available
in the community and Knowsley Primary Care Trust believed that local
pharmacists could provide a similar assessment and signposting service
in a sustainable way.
Mark Pilling, community pharmacy development manager at Knowsley PCT,
helped organise the pilot, which was paid for by a Neighbourhood Renewal
Fund. “The pilot was operated on a mix of appointments and drop-ins,
depending on how busy the pharmacy was at the time,” Mr Pilling
says.
“During the three-month pilot 159 health checks were carried out and, as
a result of the health checks, 96 per cent of participants made lifestyle changes
and 99 per cent said they were very or quite likely to attend a follow-up health
check and recommend health checks in pharmacies to other men,” he adds.
NHS Fife has also run a men’s health assessment programme based in pharmacies.
Using funding from the Scottish Executive Health Department, NHS Fife Pharmacy
Services Primary Care Division saw the opportunity to deliver a service from
community pharmacies, making use of their consultation rooms.
Pharmacy technicians performed the assessments, which were undertaken in line
with standard operating procedures. “The project was a top-to-toe assessment
scheme,” Carole Muir, pharmacy support staff development officer at NHS
Fife explains. “If men who had risk factors were identified, the technician
would recommend the man consult other services. For instance, it would be recommended
that men with elevated blood pressure make an appointment with their GPs and
men who smoked could be referred to pharmacies offering smoking cessation services.”
South Gloucestershire Primary Care Trust is using men’s health as the
focus of one of its six health promotion campaigns for this year. The PCT has
sent out leaflets and information packs to community pharmacies that have requested
them.
It has also paid for pharmacies to be sent free-of-charge copies of the “Man
manual”, a guide to men’s health produced by Haynes, the publisher
of car maintenance books which now also publishes health guides in the same
style as its workshop manuals. Local pharmacists are planning to use the leaflets
and packs as prompts for raising health issues with men who show an interest
in the materials.
As well as these local projects, a men’s health service kit has been
developed by AAH. The service comprises a half-hour check-up, including calculation
of body mass index, measurement of blood pressure, blood cholesterol and glucose,
and a short lifestyle questionnaire. The pharmacist then reviews risk factors
with the patient, provides appropriate health promotion advice and information
and refers him to other health care professionals if appropriate. For £80,
AAH provides pharmacists with a training manual in hard copy or on CD, patient
information leaflets and appointment cards, and promotional posters targeted
at men.
Looking ahead
The Government is also now beginning to put its weight (in the shape
of funding worth £30,000) behind efforts to implement the men’s
health aspects of its strategy for public health through pharmacy (p662).
It has launched a project to promote pharmacy services to men in their
workplaces and to train pharmacists to target services at men.
In addition, Graham Phillips, a community pharmacist from Hertfordshire,
has worked with the Men’s Health Forum to develop a “mini” Haynes
manual on community pharmacy services for men. “The mini-manual
is a booklet of advice on how men can make better use of community pharmacies,” he
says. “It is intended to be given out free of charge to men who
might not normally visit community pharmacies, or might not know about
some of the services available from pharmacies.” |
The
Pharmaceutical Journal