Weight management counselling among community pharmacists: a scoping review
27 Nov 2018-International Journal of Pharmacy Practice (John Wiley & Sons, Ltd)-Vol. 26, Iss: 6, pp 475-484
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.
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04 Aug 2019
TL;DR: This paper will review community-based pharmacy practice innovations and the role of the community- based pharmacist practitioner in the United States.
Abstract: Community-based pharmacy practice is evolving from a focus on product preparation and dispensing to becoming a health care destination within the four walls of the traditional community-based pharmacy. Furthermore, community-based pharmacy practice is expanding beyond the four walls of the traditional community-based pharmacy to provide care to patients where they need it. Pharmacists involved in this transition are community-based pharmacist practitioners who are primarily involved in leading and advancing team-based patient care services in communities to improve the patient health. This paper will review community-based pharmacy practice innovations and the role of the community-based pharmacist practitioner in the United States.
95 citations
TL;DR: The knowledge of pharmacists was better for the use of weight loss products as opposed to their side effects and interactions, and could be used to inform the development of future evidence-based community pharmacists led weight management service provision nationally and internationally.
Abstract: Ideally situated within the community, pharmacists can be involved in a broad range of health promotion campaigns including prevention of obesity. Limited evidence is available regarding their involvement in weight management in Lebanon, a country with escalating prevalence rate of obesity. To examine the role of community pharmacists in weight management in Lebanon, specifically studying their beliefs, current practices, services, and knowledge. Using a stratified random sampling approach, a cross sectional national survey of community pharmacists was conducted (n = 341, response rate 89%). At the pharmacy, and through a face-to-face interview, pharmacists completed a multi-component questionnaire that addressed, in addition to socio-demographic and work characteristics, their beliefs, practices, knowledge in relation to weight management. Frequencies and proportions were used to describe the data. Simple and multiple linear regression analyses were used to examine the determinants of knowledge in the study population. Over 80% of study participants agreed that they have an important role to play in weight management. However, 50% of pharmacists did not agree that weight loss products are well regulated and 81.1% thought that companies marketing weight loss products are making false promises. The majority of pharmacists always/often sold weight loss products (84.7%) and counseled their patients for diet (86.3%) and physical activity (91.7%). Despite taking weight and height measurements, 50% of pharmacists rarely/never calculated BMI. Among the pharmacists who reported side effects of weight loss products (46.5%), the majority (91.3%) did so to the pharmaceutical company. The knowledge of pharmacists was better for the use of weight loss products as opposed to their side effects and interactions. Significant predictors of knowledge were holding a Masters/ PhD degree in Pharmacy, graduating from a university inside Lebanon, obtaining weight management training within the academic degree, and receiving inquiries about weight management in the pharmacy more than once daily. The results of the study provided important insights on the beliefs, practices and knowledge of community pharmacists in weight management in Lebanon. These findings could be used to inform the development of future evidence-based community pharmacists led weight management service provision nationally and internationally.
14 citations
Cites background from "Weight management counselling among..."
...A recent scoping review of studies addressing the role of pharmacists in weight management counseling concluded that weight and obesity management interventions delivered by community pharmacies resulted in some weight loss, which, despite being modest, can be clinically significant as it improves surrogate markers of cardiovascular disease [16]....
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TL;DR: In this article , the authors applied the capability, opportunity, motivation, behaviour (COM-B) model to factors associated with WMS implementation among community pharmacists to develop and recommend better intervention strategies.
Abstract: Previous qualitative studies exploring the experiences of community pharmacists (CP) in implementing weight management services (WMS) often lack a theoretical underpinning. This study applied the capability, opportunity, motivation, behaviour (COM-B) model to factors associated with WMS implementation among CPs to develop and recommend better intervention strategies.A qualitative study design was used by conducting in-depth, semi-structured interviews with CPs. All the interviews were audio-recorded and duly transcribed. The thematic analysis approach was used to analyse the data, and the themes generated were mapped onto COM-B model components.The themes that emerged were (1) motivation of pharmacists and (2) knowledge and skills, which were identified as both barriers and facilitators, and (3) the barriers to implementation in aspects of social norms and resources. Factors were subsequently categorised into the subcomponents of the model: physical capability (e.g., training), psychological capability (e.g., lack of knowledge), physical opportunity (e.g., product range), social opportunity (e.g., stigma), automatic motivation (e.g., remuneration) and reflective motivation (e.g., CPs extended roles).In conclusion, programs or training For Cps should develop their psychological capability to change their behaviour by being more proactive in promoting and providing weight management services, with a vital educational component. This behavioural change will improve the promotion of this service and will help many customers who were unaware of this service. Learning opportunities will leave CPs to feel more empowered and overcome barriers to implementing and maintaining WMS in primary care. The study findings provided essential insights into the factors that affect this provided service in Malaysia. The results will help to encourage the embedding of nutrition counselling in academic curricula.
4 citations
01 Nov 2021
TL;DR: The objective of this practice and research network opinion paper was to identify literature for pharmacist‐led services with obesity management, summarize clinical evidence for this disease state, and describe the role of a clinical pharmacist among patients who are overweight or have obesity.
Abstract: The objective of this practice and research network opinion paper was to identify literature for pharmacist‐led services with obesity management, summarize clinical evidence for this disease state, and describe the role of a clinical pharmacist among patients who are overweight or have obesity. Clinical pharmacists play a critical role in the safe and effective management of obesity in both the inpatient and outpatient settings. In an outpatient setting, the role of the clinical pharmacist includes a comprehensive patient interview to design an individualized therapeutic plan involving nonpharmacological interventions with or without pharmacological interventions or surgical options. A clinical pharmacist conducts a risk‐benefit analysis for pharmacological interventions. Furthermore, the potential of medications to contribute to weight gain or prevent weight loss can be reviewed by a clinical pharmacist when managing comorbid conditions. In an inpatient setting, a clinical pharmacist conducts medication reconciliation, determines appropriate supplements for nutritional deficiencies, and provides medication management for people with obesity who may or may not be undergoing bariatric surgery. In addition, a clinical pharmacist can provide thorough patient education with monitoring for transitions from hospital to the outpatient setting and subsequent follow‐up visits.
4 citations
Cites background from "Weight management counselling among..."
...Rosenthal et al.(27) Scoping review of articles from January 2010 to March 2017 Community pharmacy delivered weight-loss and obesity management services 2141 (from 9 studies) Avg....
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...Rosenthal et al.27 Scoping review of articles from January 2010 to March 2017 Community pharmacy delivered weight-loss and obesity management services 2141 (from 9 studies) Avg. weight loss of 3.38 kg among the studies....
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06 Sep 2017
TL;DR: In the interviewed group of young, obese women, it was seen that physical activity reduced along with increasing age, and the cause of obesity was inappropriate diet and lifestyle.
Abstract: Introduction: Obesity is a consequence of abnormal lifestyle and poor nutrition. The aim of this paper was to show the relation between the way of nutrition and physical activity, and the increased body weight among young women. Material and methods: The survey was conducted between June and October 2014 among 176 women from all parts of Poland, at the age between 16 and 25 years. The survey was conducted on the basis of a survey questionnaire consisting of questions that covered the dietary preferences, the frequency of eating particular dietary products, and physical activity. Women were divided into two age groups, and the results that were drawn from both groups were compared. Results: Every third interviewee did not eat breakfast every day, every fifth ate her last meal too late. Women were characterised by low physical activity. The majority of them spent their free time passively, and only a small percentage of interviewees performed certain physical exercises. A large group of respondents ate highly calorific desserts. On the other hand, desserts based on fruit were eaten only by one third of the researched group. The scant amount of fruit and vegetables that should be eaten was also proven. Seventy percent of the interviewees did make certain ineffective dieting attempts. Conclusions: In the interviewed group of young, obese women we noted a range of abnormalities connected with the way of nutrition and the quality of eating products. It was seen that physical activity reduced along with increasing age. Every second respondent, in spite of their young age, complained about chronic ailments that may appear as a result of obesity. That is why it was concluded that the cause of obesity was inappropriate diet and lifestyle.
2 citations
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TL;DR: In this paper, the authors compared a lifestyle intervention with metformin to prevent or delay the development of Type 2 diabetes in nondiabetic individuals. And they found that the lifestyle intervention was significantly more effective than the medication.
Abstract: Background Type 2 diabetes affects approximately 8 percent of adults in the United States. Some risk factors — elevated plasma glucose concentrations in the fasting state and after an oral glucose load, overweight, and a sedentary lifestyle — are potentially reversible. We hypothesized that modifying these factors with a lifestyle-intervention program or the administration of metformin would prevent or delay the development of diabetes. Methods We randomly assigned 3234 nondiabetic persons with elevated fasting and post-load plasma glucose concentrations to placebo, metformin (850 mg twice daily), or a lifestyle modification program with the goals of at least a 7 percent weight loss and at least 150 minutes of physical activity per week. The mean age of the participants was 51 years, and the mean body-mass index (the weight in kilograms divided by the square of the height in meters) was 34.0; 68 percent were women, and 45 percent were members of minority groups. Results The average follow-up was 2.8 years. The incidence of diabetes was 11.0, 7.8, and 4.8 cases per 100 person-years in the placebo, metformin, and lifestyle groups, respectively. The lifestyle intervention reduced the incidence by 58 percent (95 percent confidence interval, 48 to 66 percent) and metformin by 31 percent (95 percent confidence interval, 17 to 43 percent), as compared with placebo; the lifestyle intervention was significantly more effective than metformin. To prevent one case of diabetes during a period of three years, 6.9 persons would have to participate in the lifestyle-intervention program, and 13.9 would have to receive metformin. Conclusions Lifestyle changes and treatment with metformin both reduced the incidence of diabetes in persons at high risk. The lifestyle intervention was more effective than metformin.
17,333 citations
TL;DR: Specific recommendations to clarify and enhance this methodology are outlined for each stage of the Arksey and O'Malley framework, to support the advancement, application and relevance of scoping studies in health research.
Abstract: Scoping studies are an increasingly popular approach to reviewing health research evidence. In 2005, Arksey and O'Malley published the first methodological framework for conducting scoping studies. While this framework provides an excellent foundation for scoping study methodology, further clarifying and enhancing this framework will help support the consistency with which authors undertake and report scoping studies and may encourage researchers and clinicians to engage in this process. We build upon our experiences conducting three scoping studies using the Arksey and O'Malley methodology to propose recommendations that clarify and enhance each stage of the framework. Recommendations include: clarifying and linking the purpose and research question (stage one); balancing feasibility with breadth and comprehensiveness of the scoping process (stage two); using an iterative team approach to selecting studies (stage three) and extracting data (stage four); incorporating a numerical summary and qualitative thematic analysis, reporting results, and considering the implications of study findings to policy, practice, or research (stage five); and incorporating consultation with stakeholders as a required knowledge translation component of scoping study methodology (stage six). Lastly, we propose additional considerations for scoping study methodology in order to support the advancement, application and relevance of scoping studies in health research. Specific recommendations to clarify and enhance this methodology are outlined for each stage of the Arksey and O'Malley framework. Continued debate and development about scoping study methodology will help to maximize the usefulness and rigor of scoping study findings within healthcare research and practice.
7,536 citations
"Weight management counselling among..." refers background in this paper
...Sixth, and finally, is to provide a summary of the findings, along with relevant implications and directions for future research.([26,29]) Steps two through...
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Mariachiara Di Cesare1, Mariachiara Di Cesare2, James Bentham2, Gretchen A Stevens3 +738 more•Institutions (60)
TL;DR: The posterior probability of meeting the target of halting by 2025 the rise in obesity at its 2010 levels, if post-2000 trends continue, is calculated.
3,766 citations
"Weight management counselling among..." refers background in this paper
...Moreover, obesity is no longer just a concern for Western nations, as countries like India and China are also facing increasing rates of obesity.([6]) According to the WHO, most of the world’s population now live in countries where overweight and obesity kills more people than underweight....
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TL;DR: This analysis presents updated estimates of the costs of obesity for the United States across payers (Medicare, Medicaid, and private insurers), in separate categories for inpatient, non-inpatient, and prescription drug spending.
Abstract: In 1998 the medical costs of obesity were estimated to be as high as $78.5 billion, with roughly half financed by Medicare and Medicaid. This analysis presents updated estimates of the costs of obesity for the United States across payers (Medicare, Medicaid, and private insurers), in separate categories for inpatient, non-inpatient, and prescription drug spending. We found that the increased prevalence of obesity is responsible for almost $40 billion of increased medical spending through 2006, including $7 billion in Medicare prescription drug costs. We estimate that the medical costs of obesity could have risen to $147 billion per year by 2008.
2,816 citations
"Weight management counselling among..." refers background in this paper
...By 2008, half of these costs were being incurred by federal government spending through Medicaid and Medicare.([14]) On an individual level, it was estimated in 2008, that individuals with obesity had annual health care costs approximately $1400 higher than individuals of normal weight....
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...[13] By 2008, half of these costs were being incurred by federal government spending through Medicaid and Medicare....
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TL;DR: There is a substantial (if incomplete) evidence base to guide choice of knowledge translation activities targeting healthcare professionals and consumers and there are a profusion of innovative approaches that warrant further evaluation.
Abstract: One of the most consistent findings from clinical and health services research is the failure to translate research into practice and policy. As a result of these evidence-practice and policy gaps, patients fail to benefit optimally from advances in healthcare and are exposed to unnecessary risks of iatrogenic harms, and healthcare systems are exposed to unnecessary expenditure resulting in significant opportunity costs. Over the last decade, there has been increasing international policy and research attention on how to reduce the evidence-practice and policy gap. In this paper, we summarise the current concepts and evidence to guide knowledge translation activities, defined as T2 research (the translation of new clinical knowledge into improved health). We structure the article around five key questions: what should be transferred; to whom should research knowledge be transferred; by whom should research knowledge be transferred; how should research knowledge be transferred; and, with what effect should research knowledge be transferred? We suggest that the basic unit of knowledge translation should usually be up-to-date systematic reviews or other syntheses of research findings. Knowledge translators need to identify the key messages for different target audiences and to fashion these in language and knowledge translation products that are easily assimilated by different audiences. The relative importance of knowledge translation to different target audiences will vary by the type of research and appropriate endpoints of knowledge translation may vary across different stakeholder groups. There are a large number of planned knowledge translation models, derived from different disciplinary, contextual (i.e., setting), and target audience viewpoints. Most of these suggest that planned knowledge translation for healthcare professionals and consumers is more likely to be successful if the choice of knowledge translation strategy is informed by an assessment of the likely barriers and facilitators. Although our evidence on the likely effectiveness of different strategies to overcome specific barriers remains incomplete, there is a range of informative systematic reviews of interventions aimed at healthcare professionals and consumers (i.e., patients, family members, and informal carers) and of factors important to research use by policy makers. There is a substantial (if incomplete) evidence base to guide choice of knowledge translation activities targeting healthcare professionals and consumers. The evidence base on the effects of different knowledge translation approaches targeting healthcare policy makers and senior managers is much weaker but there are a profusion of innovative approaches that warrant further evaluation.
1,796 citations
"Weight management counselling among..." refers background in this paper
...As such, researchers should also turn to reviews like this one and others to identify the KT theory or framework that best applies to their setting and begin to test them.([49,50]) Without a theory informing the development of an intervention, it is difficult to know which specific variables contributed to its success or failure, making its application in new settings difficult....
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