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International Journal of Clinical Pharmacy

, Volume 37, Issue 5, pp 822–833 | Cite as

Developing and testing evidence-based weight management in Australian pharmacies: A Healthier Life Program

  • Irene S. UmEmail author
  • Ines Krass
  • Carol Armour
  • Timothy Gill
  • Betty B. Chaar
Research Article

Abstract

Background Pharmacies represent a valuable opportunity to deliver weight management services, rather than just the routine supply of weight-loss products. In order to provide optimal services and translation of evidence-based weight management in community pharmacy, a best practice model program was designed and pilot tested to facilitate implementation of such services in pharmacies in Australia. Objective To develop and pilot a pharmacist-delivered, evidence-based, non-product-centred weight management service for community pharmacy in Australia. Setting Sydney, New South Wales, Australia. Method A pharmacy-based weight management service called the A Healthier Life Program (AHLP), for overweight and obese individuals, was developed based on current Australian weight management guidelines and recommendations made by key stakeholders. The pharmacist undertook training to acquire specific competencies to deliver the program. The AHLP involved six individual face-to-face sessions with the pharmacist over 3 months. The intervention targeted three areas: diet, physical activity and behavioural change. Main outcome measures Weight, BMI, waist circumference, blood pressure, dietary intake, and physical activity levels at 3 months were compared with values at baseline. Qualitative feedback on participants’ satisfaction and willingness to pay were also analysed. Results Eight pharmacies provided the AHLP between February and December 2013. Thirty-four participants were enrolled in the AHLP; mean age 50.7 years (SD 15.7) and mean BMI 34.3 kg/m2 (SD 5.3). Of the 22 (65 %) participants who completed the program, six had achieved the target weight loss of ≥5 %. The mean change in weight was −3.5 kg (95 % CI −4.8, −2.2) and waist circumference −2.0 cm (95 % CI −2.8, −1.3) for program completers at 3 months. Furthermore, participants reported overall positive experiences of the program, and identified accessibility of the pharmacy and high comfort level with the pharmacist, as the major advantages. Conclusion The AHLP was well received and participants achieved targeted weight loss. This study demonstrated that an evidence-based patient-centred weight management program can be implemented in Australian pharmacies.

Keywords

Australia Community pharmacy Competency-based training Obesity Overweight Pharmacist Pharmacy services Weight management 

Notes

Acknowledgments

The authors would like to thank all the participants and community pharmacies that were involved in the study. We would also like to acknowledge the contributions by a research assistant, Ms Kim Bellamy, for assisting in recruitment, and conducting and transcribing the interviews. We would also like to thank Ms Annim Mohammad for conducting the interviews.

Funding

The Authors declare that no external funding has been obtained for the study.

Conflicts of interest

The Authors declare that they have no conflict of interests.

References

  1. 1.
    OECD. Obesity Update [Internet]. 2014. http://www.oecd.org/els/health-systems/Obesity-Update-2014.pdf Accessed 11 March 2015.
  2. 2.
    Obesity Working Group. Australia: The Healthiest Country by 2020. Technical Report No 1. Obesity in Australia: a need for urgent action. Barton, ACT: Commonwealth of Australia. 2008. ISBN: 1741869285. http://www.health.gov.au/internet/preventativehealth/publishing.nsf/Content/E233F8695823F16CCA2574DD00818E64/$File/obesity-jul09.pdf Accessed 11 March 2014.
  3. 3.
    Saramunee K, Krska J, Mackridge A, Richards J, Suttajit S, Phillips-Howard P. How to enhance public health service utilization in community pharmacy?: general public and health providers’ perspectives. Res Soc Adm Pharm. 2014;10(2):272–84.CrossRefGoogle Scholar
  4. 4.
    Blenkinsopp A, Anderson C, Armstrong M. Community pharmacy’s contribution to improving the public’s health: the case of weight management. Int J Pharm Pract. 2008;16(3):123–5.CrossRefGoogle Scholar
  5. 5.
    Eades CE, Ferguson JS, O’Carroll RE. Public health in community pharmacy: a systematic review of pharmacist and consumer views. BMC Public Health. 2011;11:582. doi: 10.1186/1471-2458-11-582.PubMedCentralCrossRefPubMedGoogle Scholar
  6. 6.
    O’Neal KS, Crosby KM. What is the role of the pharmacist in obesity management? Curr Obes Rep. 2014;3(3):298–306.CrossRefGoogle Scholar
  7. 7.
    Gordon J, Watson M, Avenell A. Lightening the load? A systematic review of community pharmacy-based weight management interventions. Obes Rev. 2011;12(11):897–911.CrossRefPubMedGoogle Scholar
  8. 8.
    American Public Health Association. The Role of the Pharmacist in Public Health [Internet]. 2006. http://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2014/07/07/13/05/the-role-of-the-pharmacist-in-public-health Accessed 11 March 2015.
  9. 9.
    Bush J, Langley C, Mills S, Hindle L. A comparison of the provision of the My Choice Weight Management Programme via general practitioner practices and community pharmacies in the United Kingdom. Clin Obes. 2014;4(2):91–100.CrossRefPubMedGoogle Scholar
  10. 10.
    Um IS, Armour C, Krass I, Gill T, Chaar BB. Managing obesity in pharmacy: the Australian experience. Pharm World Sci. 2010;32(6):711–20.CrossRefPubMedGoogle Scholar
  11. 11.
    Fakih S, Marriott JL, Hussainy SY. A national mailed survey exploring weight management services across Australian community pharmacies. Aust J Prim Health. 2014; Epub 5 March 2014. doi: 10.1071/PY13118.
  12. 12.
    Rieck A, Clifford R, Everett A. Rieck A, Clifford R, Everett A. Community Pharmacy Weight Management Project: stages one and two. Final report. Canberra, ACT: Pharmacy Guild of Australia. 2006. http://www.guild.org.au/docs/default-source/public-documents/services-and-programs/research-and-development/Third-Agreement-R-and-D/2005-522/final-report-.pdf?sfvrsn=0 Accessed 11 March 2015.
  13. 13.
    National Health and Medical Research Council. Clinical Practice Guidelines for the Management of Overweight and Obesity in Adults, Adolescents and Children in Australia. Canberra, ACT: Commonwealth of Australia; 2013. ISBN: 1864965908. http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/n57_obesity_guidelines_130531.pdf Accessed 11 March 2015.
  14. 14.
    Um IS, Armour C, Krass I, Gill T, Chaar BB. Weight management in community pharmacy: what do the experts think? Int J Clin Pharm. 2013;35(3):447–54.CrossRefPubMedGoogle Scholar
  15. 15.
    National Health and Medical Research Council. Australian Dietary Guidelines. Canberra, ACT: Commonwealth of Australia; 2013. ISBN: 1864965754. http://www.eatforhealth.gov.au/sites/default/files/files/the_guidelines/n55_australian_dietary_guidelines.pdf Accessed 11 March 2015.
  16. 16.
    Department of Health. Australia’s Physical Activity and Sedentary Behaviour Guidelines [Internet]. 2014. http://www.health.gov.au/internet/main/publishing.nsf/content/health-pubhlth-strateg-phys-act-guidelines Accessed 11 March 2015.
  17. 17.
    Prochaska JO, Diclemente CC. Stages and processes of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol. 1983;51(3):390–5.CrossRefPubMedGoogle Scholar
  18. 18.
    Miller WR, Rollnick S. Motivational interviewing: preparing people for change. 2nd ed. New York: Guilford Press; 2002. ISBN 1572305630.Google Scholar
  19. 19.
    Lorig KR, Holman HR. Self-management education: history, definition, outcomes, and mechanisms. Ann Behav Med. 2003;26(1):1–7.CrossRefPubMedGoogle Scholar
  20. 20.
    Newlands RS, Watson MC, Lee AJ. The provision of current and future Healthy Weight Management (HWM) services from community pharmacies: a survey of community pharmacists’ attitudes, practice and future possibilities. Int J Pharm Pract. 2011;19(2):106–14.CrossRefPubMedGoogle Scholar
  21. 21.
    Pharmaceutical Society of Australia. National Competency Standards Framework for Pharmacists in Australia 2010. Deakin, ACT: 2010. ISBN: 9780646545387. http://www.psa.org.au/download/standards/competency-standards-complete.pdf Accessed 11 March 2015.
  22. 22.
    Kellow N. Evaluation of a rural community pharmacy-based Waist Management Project: bringing the program to the people. Aust J Prim Health. 2011;17(1):16–22.CrossRefPubMedGoogle Scholar
  23. 23.
    Kinect Australia for the Lifescripts consortium. Lifescripts Practice Manual: supporting lifestyle risk factor management in general practice. Canberra: Commonwealth of Australia; 2005. ISBN 0642827028.Google Scholar
  24. 24.
    Pope C, Mays N. Qualitative research: reaching the parts other methods cannot reach: an introduction to qualitative methods in health and health services research. BMJ. 1995;311(6996):42–5.PubMedCentralCrossRefPubMedGoogle Scholar
  25. 25.
    Bradley EH, Curry LA, Devers KJ. Qualitative data analysis for health services research: developing taxonomy, themes, and theory. Health Serv Res. 2007;42(4):1758–72.PubMedCentralCrossRefPubMedGoogle Scholar
  26. 26.
    Jolly K, Lewis A, Beach J, Denley J, Adab P, Deeks JJ, Daley A, Aveyard P. Comparison of range of commercial or primary care led weight reduction programmes with minimal intervention control for weight loss in obesity: lighten up randomised controlled trial. BMJ. 2011;343:d6500.PubMedCentralCrossRefPubMedGoogle Scholar
  27. 27.
    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.PubMedCentralCrossRefPubMedGoogle Scholar
  28. 28.
    Boardman HF, Avery AJ. Effectiveness of a community pharmacy weight management programme. Int J Clin Pharm. 2014;36(4):800–6.CrossRefPubMedGoogle Scholar
  29. 29.
    Neter JE, Stam BE, Kok FJ, Grobbee DE, Geleijnse JM. Influence of weight reduction on blood pressure: a meta-analysis of randomized controlled trials. Hypertension. 2003;42(5):878–84.CrossRefPubMedGoogle Scholar
  30. 30.
    Lindström J, Louheranta A, Mannelin M, Rastas M, Salminen V, Eriksson J, Uusitupa M, Tuomilehto J. Finnish Diabetes Prevention Study Group. The Finnish Diabetes Prevention Study (DPS): lifestyle intervention and 3-year results on diet and physical activity. Diabetes Care. 2003;26(12):3230–6.CrossRefPubMedGoogle Scholar
  31. 31.
    Villareal DT, Chode S, Parimi N, Sinacore DR, Hilton T, Armamento-Villareal R, Napoli N, Qualls C, Shah K. Weight loss, exercise, or both and physical function in obese older adults. N Engl J Med. 2011;364(13):1218–29.PubMedCentralCrossRefPubMedGoogle Scholar
  32. 32.
    Um IS, Armour C, Krass I, Gill T, Chaar BB. Consumer perspectives about weight management services in a community pharmacy setting in NSW, Australia. Health Expect. 2014;17(4):579–92.CrossRefPubMedGoogle Scholar
  33. 33.
    Coons MJ, DeMott A, Buscemi J, Duncan JM, Pellegrini CA, Steglitz J, Pictor A, Spring B. Technology interventions to curb obesity: a systematic review of the current literature. Curr Cardiovasc Risk Rep. 2012;6(2):120–34.PubMedCentralCrossRefPubMedGoogle Scholar
  34. 34.
    Inelmen EM, Toffanello ED, Enzi G, Gasparini G, Miotto F, Sergi G, Busetto L. Predictors of drop-out in overweight and obese outpatients. Int J Obes (Lond). 2005;29(1):122–8.CrossRefGoogle Scholar
  35. 35.
    Sutton K, Logue E, Jarjoura D, Baughman K, Smucker W, Capers C. Assessing dietary and exercise stage of change to optimize weight loss interventions. Obes Res. 2003;11(5):641–52.CrossRefPubMedGoogle Scholar
  36. 36.
    O’Neal KS, Crosby KM. Patients’ perceptions of a pharmacy-managed weight management clinic in a community setting. Res Soc Adm Pharm. 2013;9(1):129–36.CrossRefGoogle Scholar
  37. 37.
    Salkeld G, Ryan M, Short L. The veil of experience: do consumers prefer what they know best? Health Econ. 2000;9(3):267–70.CrossRefPubMedGoogle Scholar
  38. 38.
    Taylor S, Hourihan F, Krass I, Armour C. Measuring consumer preference for models of diabetes care delivered by pharmacists. Pharm Pract (Granada). 2009;7(4):195–204.Google Scholar
  39. 39.
    Krass I, Costa D, Dhippayom T. Development and validation of the Attitudes to Pharmacist Services for Diabetes Scale (APSDS). Res Soc Adm Pharm. 2015;11(1):74–84.CrossRefGoogle Scholar
  40. 40.
    O’Donnell DC, Brown CM, Dastani HB. Barriers to counseling patients with obesity: a study of Texas community pharmacists. J Am Pharm Assoc. 2006;46(4):465–71.CrossRefGoogle Scholar
  41. 41.
    Mallinckrodt CH. Preventing and treating missing data in longitudinal clinical trials: a practical guide. New York: Cambridge University Press; 2013. ISBN 9781139381666.CrossRefGoogle Scholar

Copyright information

© Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie 2015

Authors and Affiliations

  • Irene S. Um
    • 1
    Email author
  • Ines Krass
    • 1
  • Carol Armour
    • 2
  • Timothy Gill
    • 3
  • Betty B. Chaar
    • 1
  1. 1.Faculty of PharmacyPharmacy and Bank Building A15, The University of SydneySydneyAustralia
  2. 2.Woolcock Institute of Medical ResearchGlebeAustralia
  3. 3.Boden Institute of Obesity, Nutrition, Exercise & Eating DisordersThe Hub, Charles Perkins Centre D17, The University of SydneySydneyAustralia

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