Community pharmacists' contribution to public health: assessing the global evidence base

Abstract

In the UK, community pharmacies are more accessible to the general population than general practices. Therefore, government white papers and briefing documents from pharmacy professional bodies have advocated the expansion of the role of community pharmacists, particularly in relation to the provision of services that contribute to disease prevention and health improvement. It is unknown whether the same evidence exists globally for the expansion of these roles.This article attempts to appraise and summarise the global evidence for the public health roles that community pharmacists play. Barriers, as well as strategies that can enhance these roles, are also discussed.Electronic databases were searched to retrieve relevant literature published since 1 January 2000. The selected literature included 2 meta-analyses, 7 literature reviews, 23 interventional studies and 41 descriptive studies. These were assessed according to health topics (i.e. smoking cessation, weight management, health promotion, disease screening and preventive activities, vaccination and immunisation, alcohol dependence advice and drug misuse, emergency hormonal contraception, and sexual health services).The effectiveness of community pharmacy-based public health interventions was shown in smoking cessation, health promotion, disease screening and preventive activities, provision of emergency hormonal contraceptive, and vaccination services. Although there was mixed evidence with respect to weight management and alcohol dependence advice interventions, the available data suggest feasibility and acceptability of these services due to the perceived ease of access and convenience. Key points:2  The effectiveness of community pharmacy-based public health interventions was shown in smoking cessation, health promotion, disease screening and preventive activities, provision of emergency hormonal contraceptive, and vaccination services. Overall, the evidence demonstrates that pharmacists are capable of providing both population-based and individual level public health services. However, strategies that can help facilitate and enhance community pharmacists' public health roles are needed. Further studies on cost-effectiveness of community pharmacists' public health intervention are also needed. IntroductionThe World Health Organization (WHO) defines health as "A state of complete physical, mental and social wellbeing, and not merely the absence of infirmity"[1]. The main determinants of health include non-modifiable factors (e.g. age, sex and hereditary factors) and modifiable factors (e.g. individual lifestyle, social and community influences, living and working conditions, and general socio-economic, cultural and environmental conditions)[2]. Since these determinants were identified, there has been increased awareness of health as a global issue[3]. The UK Faculty of Public Health (FPH) defines public health as "The science and art of promoting and protecting health and wellbeing, preventing ill health and prolonging life through the organised effor...

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