Developing and testing evidence-based weight management in Australian pharmacies: A Healthier Life Program
29 Apr 2015-International Journal of Clinical Pharmacy (Springer Netherlands)-Vol. 37, Iss: 5, pp 822-833
TL;DR: This study demonstrated that an evidence-based patient-centred weight management program can be implemented in Australian pharmacies and participants achieved targeted weight loss.
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.
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TL;DR: The authors focus on "healthy weight" with the emphasis on the pathophysiologic effects of weight gain on the cardiovascular system; mechanistic/triggering factors; and the role of preventive actions through personal, education/environment, and societal/authoritative factors, as well as factors to provide guidance for caregivers of health promotion.
279 citations
TL;DR: In this article, the authors focus on the pathophysiologic effects of weight gain on the cardiovascular system; mechanistic/triggering factors; and the role of preventive actions through personal, education/environment, and societal/authoritative factors, as well as factors to provide guidance for caregivers of health promotion.
37 citations
TL;DR: Community pharmacists in Malaysia expressed significantly stronger agreement that medication adherence is beneficial for weight loss compared to those CPs between 41–50 years and CPs who were pharmacy owners provided significantly more frequent BMI measurement and patient information materials as part of their weight management practices.
Abstract: In Malaysia, sharp increment in the prevalence of obesity over the last four decades has been documented. Community pharmacists (CPs) are strategically placed to tackle obesity by providing weight managements services (WMS) to general public. This study assessed the attitudes, practices and perceived barriers of Malaysian CPs to the provision of WMS. A cross-sectional, descriptive survey was conducted, and responses related to attitudes, practices and perceived barriers of CPs were collected using five-point Likert scale. A total of 550 pharmacists who worked across six states of Malaysia (Selangor, Federal Territory of Kuala Lumpur, Pulau Pinang, Johor, Sabah, and Melaka) participated in this study. Most of the CPs strongly agreed that over eating (n = 312, 56.7%) and sedentary lifestyles (n = 297, 54.0%) contribute to obesity and overweight. Most of them also strongly agreed that exercise training is an effective weight reduction strategy (n = 285, 51.9%), but they were generally not in favor of surgery (n = 231, 42% disagreed/strongly disagreed). CPs generally perceived barriers related to a lack of staff to provide WMS (n = 308, 56.0% agreed/strongly agreed) and ethical and legal issues associated with sales of products/drugs for obesity management (n = 285, 51.9% agreed/strongly agreed). Sociodemographic and practice characteristics such as age group, type of pharmacy, highest education qualification, and employment status of CPs influenced the attitudes, practices and perceived barriers associated with WMS. In terms of age, CPs who were aged less then 30 years expressed significantly stronger agreement that medication adherence is beneficial for weight loss compared to those CPs between 41-50 years. Additionally, CPs who were pharmacy owners provided significantly more frequent BMI measurement and patient information materials as part of their weight management practices compared to CPs who worked as a part timer/locum. This study could be taken as a baseline study on Malaysian CPs' perceptions on WMS.
11 citations
Cites background from "Developing and testing evidence-bas..."
...The AHLP was well received by the participants, with 32% of them achieving >5% weight loss from baseline, suggesting the potential of such evidence-based patient-centered community pharmacy based weight management program (Um et al., 2015)....
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TL;DR: A scoping review of studies of community pharmacy‐delivered weight and obesity management services from January 2010 to March 2017 finds no significant difference in the quality of these services between the two periods.
Abstract: OBJECTIVES To complete a scoping review of studies of community pharmacy-delivered weight and obesity management services from January 2010 to March 2017. METHODS A scoping review was conducted to obtain an overview of research related to the study objective. The PubMed, EBSCO and CINAHL databases were searched from January 2010 to March 2017 for articles examining obesity/weight management in community pharmacies. Included studies had to contain an obesity/weight management programme delivered primarily by community pharmacies. All non-interventional studies were excluded. KEY FINDINGS Nine articles were eligible for data extraction. Across the nine included studies, 2141 patients were enrolled. The overwhelming majority of patients enrolled in the studies were female, approximately 50 years of age, had a mean weight of 92.8 kg and mean BMI of 33.8 kg/m2 at baseline. Patients in these various programmes lost a mean of 3.8 kg, however, two studies demonstrated that long-term (>6 months) weight loss maintenance was not achieved. The average dropout rate for each study ranged from 8.3% to 79%. CONCLUSIONS Obesity has a significant impact on the health and wellness of adults globally. Recent research has shown that community pharmacies have the potential to positively impact patient weight loss. However, additional research is needed into the specific interventions that bring the most value to patients and can be sustained and spread across community pharmacy practice.
10 citations
Cites background from "Developing and testing evidence-bas..."
...Four studies utilized between 12 and 34 pharmacies.([32,33,36,37]) One study did not specify how many pharmacies were involved in their study....
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...Three studies had patients self-refer to the study through promotional materials displayed around the pharmacy or attached to recent prescriptions.([31,32,36])...
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...3% to 79% (see Table 2).([30,32,33,36]) Four studies included some formal training of pharmacists in the administration of the weight management programme to patients....
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...Two studies were conducted in the United States,([30,31]) three in England, two in Australia,([35,36]) one in Scotland([37]) and one in Thailand....
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...Two studies were conducted in the United States,[30,31] three in England,[32–34] two in Australia,[35,36] one in Scotland[37] and one in Thailand....
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01 Jan 2018
TL;DR: Though different programs may induce weight loss, the most efficacious incorporate exercise and diet, programs combining muscular endurance and resistance being the most recommended.
Abstract: espanolEl objetivo de esta revision fue conocer el estado actual del tratamiento de la obesidad en adultos mediante estudios de intervencion que apliquen la Actividad Fisica (AF) como uno de los pilares fundamentales. La busqueda se realizo en las bases de datos Pubmed, ISI Web of Science y Scopus descartando en la busqueda aquellos resultados referentes a ninos, mujeres embarazadas y personas mayores. De los 850 resultados iniciales, se seleccionaron 27 articulos referentes a programas de actividad fisica que combinaban de diferente forma el ejercicio fisico y la dieta para el tratamiento de la obesidad. En conclusion, aunque diferentes programas lograban reducir la obesidad, los mas eficaces fueron los que combinaron dieta y ejercicio fisico, siendo mas recomendables aquellos en los que se realizaba una combinacion de entrenamiento aerobico y de fuerza resistencia muscular. Otros aspectos como sesiones para el cambio del comportamiento y el apoyo de las nuevas tecnologias pueden ayudar a la eficacia de la intervencion. EnglishThe aim of this review was to highlight the current state of obesity treatment programs that include physical activity. The search was performed in Pubmed, ISI Web of Science and Scopus databases, with programs applied in children, pregnant women, and older people being excluded from the final sample. Of the 850 initial results, we selected 27 articles regarding programs implementing exercise and diet for the treatment of obesity. In conclusion, though different programs may induce weight loss, the most efficacious incorporate exercise and diet, programs combining muscular endurance and resistance being the most recommended. Other aspects like behavioral change sessions and new technologies support may imply greater weight loss.
8 citations
Cites background from "Developing and testing evidence-bas..."
...…intensidad moderada y vigorosa lograron en su mayoría mejoras en la reducción del peso y en la adquisición de hábitos alimenticios y de AF (Annesi & Mareno, 2015; Armenta et al., 2015; Jakicic et al., 2015; Jakicic et al., 2015; Ma et al., 2015; Mitchell, Andrews & Schenker, 2015; Um et al., 2015)....
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TL;DR: Evidence of the effectiveness of self-management interventions is presented and a possible mechanism, self-efficacy, through which these interventions work are posited.
Abstract: Self-management has become a popular term for behavioral interventions as well as for healthful behaviors. This is especially true for the management of chronic conditions. This article offers a short history of self-management. It presents three self-management tasks—medical management, role management, and emotional management—and six self-management skills—problem solving, decision making, resource utilization, the formation of a patient-provider partnership, action planning, and self-tailoring. In addition, the article presents evidence of the effectiveness of self-management interventions and posits a possible mechanism, self-efficacy, through which these interventions work. In conclusion the article discusses problems and solutions for integrating self-management education into the mainstream health care systems.
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TL;DR: Qualitative inquiry can improve the description and explanation of complex, real-world phenomena pertinent to health services research as they use these methods themselves or collaborate with qualitative researchers from a wide range of disciplines.
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