International Journal of Clinical Pharmacy

, Volume 35, Issue 6, pp 1208–1217 | Cite as

Thai community pharmacist involvement in weight management in primary care to improve patient’s outcomes

  • Wiraphol PhimarnEmail author
  • Pattharapol Pianchana
  • Parichart Limpikanchakovit
  • Kanchanok Suranart
  • Suthanekarn Supapanichsakul
  • Apiwat Narkgoen
  • Kritsanee Saramunee
Research Article


Background The community pharmacist has significant potential to assist in providing health advice aimed at the improvement outcomes pertaining to weight management, however, up to now, evidence regarding its effectiveness has been inconclusive. In Thailand, community pharmacy involvement in weight management is a novel idea and therefore needs an evaluation of its effectiveness. Objective To examine essential outcomes, comparing the pharmacist’s interventions with a routine weight management service provided at a primary care unit (PCU). Setting Maha Sarakham province, Thailand. Methods A randomized controlled trial was designed involving sixty-six obese patients randomly assigned to either the control group or the experimental group. Participants in the control group received group counselling from the PCU staff as usual, while those participants in the experimental group received one-on-one advice from a community pharmacist along with the weight loss handbook for self-study. Both groups were followed up and clinical outcomes were monitored four times at weeks 0, 4, 8, and 16. Eating behaviours and knowledge about overweight and obesity were measured twice, at weeks 0 and 16. Main outcome measure Clinical outcomes included weight, waist circumference, body mass index, measured by standard medical devices. Eating behaviours were measured by the theory of planned behaviour (TPB) questionnaire. Knowledge was measured by a questionnaire focusing on the subjects’ level of understanding regarding overweight and obesity issues. Results Neither group showed improvement in clinical outcomes. The TPB average sum score significantly increased from baseline in the experimental group in terms of intention to perform healthy dieting behaviour, subjective norm, behavioural beliefs, normative beliefs, and control beliefs. (P < 0.05) In the control group, scores increased significantly from the baseline only for behavioural beliefs. (P < 0.05) Moreover, the knowledge score in experimental group increased significantly from 6.42 ± 1.94 to 8.75 ± 0.68 (P < 0.05). Conclusion Thai community pharmacists can help to improve both eating behaviour and knowledge about weight and obesity among obese patients. However, since the effect on clinical outcomes is unclear, a long-term study is still needed.


Community pharmacist Obesity Overweight Primary care unit Thailand Weight management 



The authors wish to thank National Health Security Office (NHSO) Thailand Fund and Faculty of Pharmacy, Mahasarakham University for research facilities and financial support. In addition, appreciation is expressed to participants, staff at the primary care unit and pharmacy students who assisted the investigation. Finally, thanks to Mr. Larry Simons and Professor Edward Moreton for editorial assistance.


National Health Security Office (NHSO) Thailand Fund supported grant through Primary Care Practice Research Unit, Mahasarakham University.

Conflicts of interest



  1. 1.
    World Health Organisation. Obesity and overweight. 2013, 2011 October 13 [cited 2012 April 20]. Available from:
  2. 2.
    Kaufman ND, Chasombat S, Tanomsingh S, Rajataramya B, Potempa K. Public health in Thailand: emerging focus on non-communicable diseases. Int J Health Plann Manage. 2011;26(3):197–212.CrossRefGoogle Scholar
  3. 3.
    Field AE, Coakley EH, Must A, Spadano JL, Laird N, Dietz WH, et al. Impact of overweight on the risk of developing common chronic diseases during a 10-years period. Arch Intern Med. 2001;161(13):1581–6.PubMedCrossRefGoogle Scholar
  4. 4.
    Fontaine KR, Redden DT, Wang C, Westfall AO, Allison DB. Years of life lost due to obesity. JAMA. 2003;289(2):187–93.PubMedCrossRefGoogle Scholar
  5. 5.
    World Health Organisation. Thailand health profile. 2011, 2011 October 13 [cited 2012 April 20]. Available from:
  6. 6.
    Roongpisuthipong C, Boontawee A, Kulapongse S. Behaviour modification in the treatment of obesity. J Med Assoc Thai. 1993;76(11):617–22.PubMedGoogle Scholar
  7. 7.
    Ajzen I. The theory of planned behaviour: reactions and reflections. Psychol Health. 2011;26(9):1113–27.PubMedCrossRefGoogle Scholar
  8. 8.
    Conner M, Norman P, Bell R. The theory of planned behaviour and healthy eating. Health Psychol. 2002;21(2):194–201.PubMedCrossRefGoogle Scholar
  9. 9.
    Kim K, Reicks M, Sjoberg S. Applying the theory of planned behaviour to predict dairy product consumption by older adults. J Nutr Educ Behav. 2003;35(6):294–301.PubMedCrossRefGoogle Scholar
  10. 10.
    Verbeke W, Vackier I. Individual determinants of fish consumption: application of the theory of planned behaviour. Appetite. 2005;44(1):67–82.PubMedCrossRefGoogle Scholar
  11. 11.
    Sesselberg TS, Klein JD, O’Connor KG, Johnson MS. Screening and counseling for childhood obesity: results from a national survey. J Am Board Fam Med. 2010;23(3):334–42.PubMedCrossRefGoogle Scholar
  12. 12.
    Waleekhachonloet O, Limwattananon C, Limwattananon S. Explaining diet control in overweighing and obese women living in rural using theory of planned behaviour: structural equation modelling. Qual Life Res. 2005;14(9):2034.Google Scholar
  13. 13.
    Awad A, Waheedi M. Community Pharmacists role in obesity treatment in Kuwait: a cross-sectional study. BMC Public Health. 2012;12:863.PubMedCrossRefGoogle Scholar
  14. 14.
    Anderson C, Blenkinsopp A, Armstrong M. The contribution of community pharmacy to improving the public’s health: Summary report of literature review 1990–2007. 2008; 1–29.Google Scholar
  15. 15.
    Sookaneknun P, Saramunee K, Rattarom R, Kongsri S, Senanok R, Pinitkit P, et al. Economic analysis of the diabetes and hypertension screening collaboration between community pharmacies and a Thai government primary care unit. Primary Care Diabetes. 2010;4(3):155–64.PubMedCrossRefGoogle Scholar
  16. 16.
    Waleekhachonloet, O. Application of Theory of Planned Behaviour on Weight Control Management in Rural Community. [Ph.D.dissertation]. Khon Kaen: Khon Kaen University; 2007.Google Scholar
  17. 17.
    Food and Drug Administration Thailand. Danger of weight loss medicine [in Thai]. 2009 [cited 2013 March 1]. Available from:
  18. 18.
    Siriruttanapruk S. Integrating occupational health services into public health systems: A model developed with Thailandís primary care units. Bangkok: International Labour Office; 2006.Google Scholar
  19. 19.
    Keawkes A, Sookaneknun P, Seesin T. Satisfaction and opinion of Mahasarakham University population toward the University Pharmacies [in Thai]. J Sci Technol MSU. 2010;29(4):428–38.Google Scholar
  20. 20.
    Samanchat P, Waleekhachonloet O, Towanna B. Effect of the weight control program focusing on the modification of eating behaviour in the overweight or obese University student s [in Thai]. TJPP. 2010;2(1):35–45.Google Scholar
  21. 21.
    The Obesity Task Force of the National Heart L and Blood Institute. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults—the evidence report. National Institutes of Health. Obes Res. 1998; 6 (Suppl 2):51S–209S.Google Scholar
  22. 22.
    Aekplakorn W, Chaiyapong Y, Neal B, Chariyalertsak S, Kunanusont C, Phoolcharoen W, et al. Prevalence and determinants of overweight and obesity in Thai adults: results of the Second National Health Examination Survey. J Med Assoc Thai. 2004;87(6):685–93.PubMedGoogle Scholar
  23. 23.
    Flegal KM, Carroll MD, Ogden CL, Curtin LR. Prevalence and trends in obesity among US adults, 1999–2008. JAMA. 2010;303(3):235–41.PubMedCrossRefGoogle Scholar
  24. 24.
    Wadden TA, Volger S, Sarwer DB, Vetter ML, Tsai AG, Berkowitz RI, et al. A two-year randomized trial of obesity treatment in primary care practice. N Engl J Med. 2011;365(21):1969–79.PubMedCrossRefGoogle Scholar
  25. 25.
    Morrison D, McLoone P, Brosnahan N, McCombie L, Smith A, Gordon J. A community pharmacy weight management programme: an evaluation of effectiveness. BMC Public Health. 2013;13(282):1–8.Google Scholar
  26. 26.
    Hardeman W, Griffin S, Johnston M, Kinmonth AL, Wareham NJ. Interventions to prevent weight gain: a systematic review of psychological models and behaviour change methods. Int J Obes Relat Metab Disord. 2000;24(2):131–43.PubMedCrossRefGoogle Scholar
  27. 27.
    Saramunee K, Chaiyasong S, Krska J. Public health roles for community pharmacy: contrasts and similarities between England and Thailand. IJPS. 2011;7(2):1–11.Google Scholar
  28. 28.
    Weidmann AE, Cunningham S, Gray G, Hansford D, Bermano G, Stewart D. Views of the Scottish general public on community pharmacy weight management services: international implications. IJCP. 2012;34(2):389–97.PubMedGoogle Scholar
  29. 29.
    Aekplakorn W, Mo-Suwan L. Prevalence of obesity in Thailand. Obes Rev. 2009;10(6):589–92.PubMedCrossRefGoogle Scholar
  30. 30.
    World Health Organisation. Obesity: situation and trends. 2013, 2011 October 13 [cited 2013 June 16]. Available from:

Copyright information

© Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie 2013

Authors and Affiliations

  • Wiraphol Phimarn
    • 1
    Email author
  • Pattharapol Pianchana
    • 1
  • Parichart Limpikanchakovit
    • 1
  • Kanchanok Suranart
    • 1
  • Suthanekarn Supapanichsakul
    • 1
  • Apiwat Narkgoen
    • 1
  • Kritsanee Saramunee
    • 2
  1. 1.Clinical Pharmacy Research Unit, Faculty of PharmacyMahasarakham UniversityMahaSarakhamThailand
  2. 2.Social Pharmacy Research Unit, Faculty of PharmacyMahasarakham UniversityMahaSarakhamThailand

Personalised recommendations