The role of pharmacists in cardiovascular disease prevention: Qualitative studies from the United Kingdom and Greece

Abstract

Objective:In the United Kingdom (UK), cardiovascular disease (CVD) is the second main cause of death (27.4%) and the leading cause of death in Greece, accounting for 48% incidences. Pharmacists, the most accessible health-care professionals, can have a key role in all stages of CVD prevention. This study aimed to explore the current and future role of pharmacists in CVD prevention, focusing on two European countries, the United Kingdom and Greece.Methods:Semi-structured interviews were conducted with 40 community pharmacists; 20 in the UK and 20 in Greece. All interviews were audio-recorded, transcribed, and analyzed thematically.Findings:Five main themes were identified: current pharmacists' role, future pharmacists' role, communication, resources and tools, and knowledge. Whereas pharmacists in the UK use a patient-centered approach, Greek pharmacists use a paternalistic approach. Nevertheless, the majority found it difficult to initiate a consultation. Both the UK and Greek pharmacists primarily focus on secondary CVD prevention, while dispensing prescribed medications, which is their main current role. Greek pharmacists recognized a potential role in primary prevention and early screening of CVD through the initiation of CVD prevention services with a weight management program being proposed. Barriers identified for a role in CVD prevention included: high workload in Greece and reimbursement issues and interprofessional relations in the UK.Conclusion:Pharmacists in both countries perceive having a potential role in CVD prevention based on their accessibility and customer relations. The challenges include a closer working relationship with other clinicians, communication/consultation skills training, and developing a sustainable funding model for the service.

The role of Lesotho community pharmacists in preventing and controlling cardiovascular diseases: The perceived facilitators and barriers

“…On the same note, it was evident that the community pharmacist would initiate the lifestyle discussion on many occasions, posing the question of patients’ awareness of community pharmacist’s provision of service beyond medication dispensing. A similar finding was reported by Peletidi, Nabhani-Gebara [ 31 ] who established that Greek pharmacists adopted a paternalistic approach where pharmacists give instructions to the patients [ 31 ]. On the other hand, patients initiate lifestyle conversations in the United Kingdom (UK).…”

Evaluation of pharmacy-led weight management service to minimise the risk of cardiovascular disease

“…This pharmacy-led WM programme was the first attempt by Greek pharmacists to expand their role by delivering public health services. The programme was chosen in accordance with the preferences of the Greek pharmacists [ 23 ]. It was delivered in Patras, owing to its convenient location and the local knowledge of the researcher and was supported by the obesity statistics in that city.…”

“…An important difference between this WM programme and the UK WM services offered is the use of a structured approach, something that is already implemented by the UK service providers [ 41 ]. All pharmacists received the same training, and had a structured way of delivering the programme, including the way in which they collected the results, the visits, as well as the advice given to the participants, which incorporated both verbal and written communication as both were deemed important by interviewed pharmacists in a previous study [ 23 ]. Thus, regardless of where participants received the programme, they had the same booklets containing the appropriate information about weight loss and improving their lifestyle.…”

“…In terms of participants’ recruitment, there were variations between pharmacies. This may reflect the confidence in approaching clients, the communication skills and the ability of pharmacists to motivate clients all of which are difficulties already highlighted by pharmacists [ 23 ]. Therefore, continuous training should be offered to ensure that pharmacists are always in a position to recruit and offer public health interventions.…”

“…Additionally, based on a resent published report stated that pharmacists in the community have clinical roles over the last 50 years [ 22 ]. According to Peletidi et al [ 23 ], Greek pharmacists were found to be eager to expand their role and offer public health services, regarding weight control in particular. There is clear evidence that UK pharmacists and pharmacy staff achieved positive results upon offering CVD prevention public health services including locally commissioned weight management (WM) services to the general public [ 24 ].…”