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Motlohi NF, Wiafe E, Mensah KB, Padayachee N, Petrus R, Bangalee V. A systematic review of the role of community pharmacists in the prevention and control of cardiovascular diseases: the perceptions of patients. Syst Rev 2023; 12:160. [PMID: 37705090 PMCID: PMC10500864 DOI: 10.1186/s13643-023-02338-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 08/28/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Cardiovascular diseases are a leading cause of mortality globally. The modifiable risk factors can be measured and identified early at primary healthcare facilities. Community pharmacists present an opportunity for improved management of cardiovascular diseases and health outcomes. The systematic review aims to identify the roles of community pharmacists in preventing and controlling cardiovascular diseases and patients' perceptions towards such functions. METHODS A systematic review of the literature was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The team searched MEDLINE, CINAHL via EBSCOhost, and Web of Science from January 2001 to December 2021 with a focus on studies reporting the role of community pharmacists in preventing and controlling cardiovascular diseases, and patients' perceptions of such roles. Search terms included were ''interventions,'' ''community pharmacists,'' ''patients,'' ''cardiovascular diseases,'' ''risk factors,'' and "perceptions". The quality of studies was appraised using the Joanne Briggs Institute checklist. RESULTS A total of 45 studies met the inclusion criteria: 35 (78%) and 10 (22%) reported community pharmacists' preventive and control roles, respectively. Generally, drug therapy monitoring, medicine and lifestyle counselling, and health education were most common roles, with pharmacist-initiated prescribing and social support least common. A total of 11 (24%) studies reported patients' perceptions of community pharmacists' contribution in preventing (73%, n = 8) and controlling (27%, n = 3) cardiovascular diseases. Patients were satisfied with community pharmacists' services in 10 of 11 studies. CONCLUSIONS The findings highlight community pharmacists' capability of providing primary healthcare services in preventing and controlling cardiovascular diseases and provide evidence for their inclusion in primary healthcare frameworks. Future research should assess the effectiveness of these roles and provide a comprehensive evaluation of clinical, humanistic, and economic outcomes. SYSTEMATIC REVIEW REGISTRATION Open Science Framework (OSF) registration https://doi.org/10.17605/OSF.IO/WGFXT .
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Affiliation(s)
| | - Ebenezer Wiafe
- Discipline of Pharmaceutical Sciences, University of KwaZulu-Natal, Durban, South Africa
- Ho Teaching Hospital, Ho, Ghana
| | - Kofi Boamah Mensah
- Discipline of Pharmaceutical Sciences, University of KwaZulu-Natal, Durban, South Africa
- Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Neelaveni Padayachee
- Department of Pharmacy and Pharmacology, University of Witwatersrand, Johannesburg, South Africa
| | - Ruwayda Petrus
- Discipline of Psychology, University of KwaZulu-Natal, Durban, South Africa
| | - Varsha Bangalee
- Discipline of Pharmaceutical Sciences, University of KwaZulu-Natal, Durban, South Africa
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Athiyah U, Setiawan CD, Nugraheni G, Zairina E, Utami W, Hermansyah A. Assessment of pharmacists' knowledge, attitude and practice in chain community pharmacies towards their current function and performance in Indonesia. Pharm Pract (Granada) 2019; 17:1518. [PMID: 31592292 PMCID: PMC6763301 DOI: 10.18549/pharmpract.2019.3.1518] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Accepted: 08/11/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The introduction of universal healthcare coverage in 2014 has affected the practice of community pharmacies in Indonesia. Studies regarding the practice of pharmacist in the chain community pharmacy setting in Indonesia are very limited. The chain community pharmacies in Indonesia are operated and controlled by the same management. The chain community pharmacies usually show better services compared to independent community pharmacies in Indonesia. OBJECTIVE The study aimed to assess the knowledge, attitude and practice (KAP) of pharmacist working in chain community pharmacy towards their current function and performance in delivering pharmacy services. METHODS A cross-sectional study using questionnaires was conducted between January and March 2017 in KF, one of the largest chain community pharmacies in Indonesia. The total sampling method was used in the recruitment process. The data were analyzed using descriptive statistics, independent t-Test and one-way ANOVA. The KAP scores were assessed and categorized as "poor", "moderate" and "good" based on the standardized scoring system. RESULTS A total of 949 KF's pharmacists (100% response rate) were participated in the study. The majority of pharmacists showed a good score in terms of knowledge and attitude, which is in contrast to practice as majority only obtained a moderate score. Working experience, age and the availability of standard operating procedures (SOP) for both dispensing and self-medication services were found to be statistically significant (p<0.005) aspects to KAP of pharmacists in delivering pharmacy services. CONCLUSIONS This study identified several important aspects that could affect the KAP of pharmacists working in chain community pharmacies in Indonesia. Specific policies should be conceived to improve the competencies of pharmacist and to ensure the compliance with the SOP and standardization system within pharmacy sector.
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Affiliation(s)
- Umi Athiyah
- Faculty of Pharmacy, Airlangga University. Surabaya (Indonesia).
| | - Catur D Setiawan
- Faculty of Pharmacy, Airlangga University. Surabaya (Indonesia).
| | | | - Elida Zairina
- Faculty of Pharmacy, Airlangga University Surabaya (Indonesia).
| | - Wahyu Utami
- Faculty of Pharmacy, Airlangga University. Surabaya (Indonesia).
| | - Andi Hermansyah
- Faculty of Pharmacy, Airlangga University. Surabaya (Indonesia).
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Corlett SA, Krska J. Evaluation of NHS Health Checks provided by community pharmacies. J Public Health (Oxf) 2018; 38:e516-e523. [PMID: 28158743 DOI: 10.1093/pubmed/fdv153] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S A Corlett
- Medway School of Pharmacy, Universities of Kent and Greenwich at Medway, Chatham ME4 4TB, UK
| | - J Krska
- Medway School of Pharmacy, Universities of Kent and Greenwich at Medway, Chatham ME4 4TB, UK
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Woringer M, Nielsen JJ, Zibarras L, Evason J, Kassianos AP, Harris M, Majeed A, Soljak M. Development of a questionnaire to evaluate patients' awareness of cardiovascular disease risk in England's National Health Service Health Check preventive cardiovascular programme. BMJ Open 2017; 7:e014413. [PMID: 28947435 PMCID: PMC5623403 DOI: 10.1136/bmjopen-2016-014413] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The National Health Service (NHS) Health Check is a cardiovascular disease (CVD) risk assessment and management programme in England aiming to increase CVD risk awareness among people at increased risk of CVD. There is no tool to assess the effectiveness of the programme in communicating CVD risk to patients. AIMS The aim of this paper was to develop a questionnaire examining patients' CVD risk awareness for use in health service research evaluations of the NHS Health Check programme. METHODS We developed an 85-item questionnaire to determine patients' views of their risk of CVD. The questionnaire was based on a review of the relevant literature. After review by an expert panel and focus group discussion, 22 items were dropped and 2 new items were added. The resulting 65-item questionnaire with satisfactory content validity (content validity indices≥0.80) and face validity was tested on 110 NHS Health Check attendees in primary care in a cross-sectional study between 21 May 2014 and 28 July 2014. RESULTS Following analyses of data, we reduced the questionnaire from 65 to 26 items. The 26-item questionnaire constitutes four scales: Knowledge of CVD Risk and Prevention, Perceived Risk of Heart Attack/Stroke, Perceived Benefits and Intention to Change Behaviour and Healthy Eating Intentions. Perceived Risk (Cronbach's α=0.85) and Perceived Benefits and Intention to Change Behaviour (Cronbach's α=0.82) have satisfactory reliability (Cronbach's α≥0.70). Healthy Eating Intentions (Cronbach's α=0.56) is below minimum threshold for reliability but acceptable for a three-item scale. CONCLUSIONS The resulting questionnaire, with satisfactory reliability and validity, may be used in assessing patients' awareness of CVD risk among NHS Health Check attendees.
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Affiliation(s)
- Maria Woringer
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | | | - Lara Zibarras
- Department of Psychology, City University London, London, UK
| | | | - Angelos P Kassianos
- Department of Applied Health Research, University College London, London, UK
| | - Matthew Harris
- Institute of Global Health Innovation, Imperial College London, London, UK
| | - Azeem Majeed
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Michael Soljak
- Department of Primary Care and Public Health, Imperial College London, London, UK
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Woringer M, Cecil E, Watt H, Chang K, Hamid F, Khunti K, Dubois E, Evason J, Majeed A, Soljak M. Evaluation of community provision of a preventive cardiovascular programme - the National Health Service Health Check in reaching the under-served groups by primary care in England: cross sectional observational study. BMC Health Serv Res 2017; 17:405. [PMID: 28615019 PMCID: PMC5471843 DOI: 10.1186/s12913-017-2346-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 05/31/2017] [Indexed: 11/14/2022] Open
Abstract
Background Cardiovascular disease (CVD) is the leading cause of premature mortality and a major contributor of health inequalities in England. Compared to more affluent and white counterparts, deprived people and ethnic minorities tend to die younger due to preventable CVD associated with lifestyle. In addition, deprived, ethnic minorities and younger people are less likely to be served by CVD prevention services. This study assessed the effectiveness of community-based outreach providers in delivering England’s National Health Services (NHS) Health Check programme, a CVD preventive programme to under-served groups. Methods Between January 2008 and October 2013, community outreach providers delivered a preventive CVD programme to 50,573 individuals, in their local communities, in a single consultation without prescheduled appointments. Community outreach providers operated on evenings and weekends as well as during regular business hours in venues accessible to the general public. After exclusion criteria, we analysed and compared socio-demographic data of 43,177 Health Check attendees with the general population across 38 local authorities (LAs). We assessed variation between local authorities in terms of age, sex, deprivation and ethnicity structures using two sample t-tests and within local authority variation in terms of ethnicity and deprivation using Chi squared tests and two sample t-tests respectively. Results Using Index of Multiple Deprivation, the mean deprivation score of the population reached by community outreach providers was 6.01 higher (p < 0.05) than the general population. Screened populations in 29 of 38 LAs were significantly more deprived (p < 0.05). No statistically significant difference among ethnic minority groups was observed between LAs. Nonetheless some LAs – namely Leicester, Thurrock, Sutton, South Tyneside, Portsmouth and Gateshead were very successful in recruiting ethnic minority groups. The mean proportion of men screened was 11.39% lower (p < 0.001) and mean proportion of 40–49 and 50–59 year olds was 9.98% and 3.58% higher (p < 0.0001 and p < 0.01 respectively) than the general population across 38 LAs. Conclusions Community-based outreach providers effectively reach under-served groups by delivering preventive CVD services to younger, more deprived populations, and a representative proportion of ethnic minority groups. If the programme is successful in motivating the under-served groups to improve lifestyle, it may reduce health inequalities therein.
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Affiliation(s)
- Maria Woringer
- Department of Primary Care and Public Health, Imperial College London, Charing Cross Campus, The Reynolds Building, St Dunstan's Road, London, W6 8RP, UK.
| | - Elizabeth Cecil
- Department of Primary Care and Public Health, Imperial College London, Charing Cross Campus, The Reynolds Building, St Dunstan's Road, London, W6 8RP, UK
| | - Hillary Watt
- Department of Primary Care and Public Health, Imperial College London, Charing Cross Campus, The Reynolds Building, St Dunstan's Road, London, W6 8RP, UK
| | - Kiara Chang
- Department of Primary Care and Public Health, Imperial College London, Charing Cross Campus, The Reynolds Building, St Dunstan's Road, London, W6 8RP, UK
| | - Fozia Hamid
- Department of Primary Care and Public Health, Imperial College London, Charing Cross Campus, The Reynolds Building, St Dunstan's Road, London, W6 8RP, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, Leicester Diabetes Centre, University of Leicester, Leicester, LE5 4PW, UK
| | - Elizabeth Dubois
- Department of Primary Care and Public Health, Imperial College London, Charing Cross Campus, The Reynolds Building, St Dunstan's Road, London, W6 8RP, UK
| | - Julie Evason
- Health Diagnostics Ltd., Suite C, The Quadrant,, Sealand Road,, Chester, CH1 4QR, UK
| | - Azeem Majeed
- Department of Primary Care and Public Health, Imperial College London, Charing Cross Campus, The Reynolds Building, St Dunstan's Road, London, W6 8RP, UK
| | - Michael Soljak
- Department of Primary Care and Public Health, Imperial College London, Charing Cross Campus, The Reynolds Building, St Dunstan's Road, London, W6 8RP, UK
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Jahangard-Rafsanjani Z, Hakimzadeh N, Sarayani A, Najafi S, Heidari K, Javadi MR, Hadjibabaie M, Gholami K. A community pharmacy-based cardiovascular risk screening service implemented in Iran. Pharm Pract (Granada) 2017; 15:919. [PMID: 28690693 PMCID: PMC5499348 DOI: 10.18549/pharmpract.2017.02.919] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 04/11/2017] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Cardiovascular disease is a major health concern around the world. OBJECTIVE To assess the outcomes and feasibility of a pharmacy-based cardiovascular screening in an urban referral community pharmacy in Iran. METHODS A cross sectional study was conducted in a referral community pharmacy. Subjects aged between 30-75 years without previous diagnose of cardiovascular disease or diabetes were screened. Measurement of all major cardiovascular risk factors, exercise habits, medical conditions, medications, and family history were investigated. Framingham risk score was calculated and high risk individuals were given a clinical summary sheet signed by a clinical pharmacist and were encouraged to follow up with their physician. Subjects were contacted one month after the recruitment period and their adherence to the follow up recommendation was recorded. RESULTS Data from 287 participants were analyzed and 146 were referred due to at least one abnormal laboratory test. The results showed 26 patients with cardiovascular disease risk greater than 20%, 32 high systolic blood pressure, 22 high diastolic blood pressures, 50 high total cholesterol levels, 108 low HDL-C levels, and 22 abnormal blood glucose levels. Approximately half of the individuals who received a follow up recommendation had made an appointment with their physician. Overall, 15.9% of the individuals received medications and 15.9% received appropriate advice for risk factor modification. Moreover, 7.5% were under evaluation by a physician. CONCLUSION A screening program in a community pharmacy has the potential to identify patients with elevated cardiovascular risk factor. A plan for increased patient adherence to follow up recommendations is required.
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Affiliation(s)
- Zahra Jahangard-Rafsanjani
- Assistant Professor of Clinical Pharmacy. Department of Pharmacotherapy, Faculty of Pharmacy, Tehran University of Medical Sciences. Tehran (Iran).
| | - Negar Hakimzadeh
- PharmD. Faculty of Pharmacy, Tehran University of Medical Sciences. Tehran (Iran).
| | - Amir Sarayani
- PharmD. Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran (Iran).
| | - Sheyda Najafi
- PharmD. Department of Pharmaceutical Care, Faculty of Pharmacy, Tehran University of Medical Sciences, Imam Khomeini Hospital Complex. Tehran (Iran).
| | - Kazem Heidari
- PhD (Epidemiol). School of Public Health, Tehran University of Medical Sciences. Tehran (Iran).
| | - Mohammad R Javadi
- Professor of Clinical Pharmacy. Department of Pharmacotherapy, Faculty of Pharmacy, Tehran University of Medical Sciences. Tehran (Iran).
| | - Molouk Hadjibabaie
- Professor of Clinical Pharmacy. Research center for rational use of drugs and faculty of pharmacy, Tehran university of Medical sciences, Tehran (Iran).
| | - Kheirollah Gholami
- Professor of Clinical Pharmacy. Reseasrch Center for Rational Use of Drugs, Tehran, University of Medical Sciences. Tehran (Iran).
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Roberts DJ, de Souza VC. A venue-based analysis of the reach of a targeted outreach service to deliver opportunistic community NHS Health Checks to 'hard-to-reach' groups. Public Health 2016; 137:176-81. [PMID: 27062066 DOI: 10.1016/j.puhe.2016.03.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 02/25/2016] [Accepted: 03/02/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Opportunistic outreach services have been commissioned to overcome potential barriers to uptake, by offering health checks in accessible community venues. This study aimed to evaluate the ability of an outreach health check service to reach key target groups: men, people of South Asian ethnicity and people from deprived areas. The comparator was the health check service provided by GP practices. One aim was to investigate whether the addition of an outreach service would result in a higher percentage of health checks being done for people from the target groups compared to a GP-based service alone. The second aim was to assess which types of venues used for outreach health checks were most effective in reaching these groups. STUDY DESIGN Evaluation of Public Health Programme with retrospective control group comparison. METHODS The percentages of completed health checks in men, people of South Asian ethnicity, and participants registered at general practices with lowest quintile area-level deprivation status were compared between all opportunistic community checks conducted by the Outreach Service over a ten month period and checks conducted in general practice in a partially-overlapping time period of the same financial year. For the venue-based comparison of Outreach Service checks, the number of checks per visit and percentage of checks in each target group were calculated for each venue. RESULTS Of 3849 Outreach Service checks, 38% were in men (compared to 50% of checks conducted in Primary Care), and 11% were in people of South Asian ethnicity (compared to 3% in Primary Care). 3558 Outreach check participants were registered with a general practice in the County (92%), and of these, 32% of checks were in people registered with a general practice in the lowest deprivation quintile (compared to 13% of checks in Primary Care). There were 519 visits by the outreach service to 23 different types of venue. Certain venues recorded large numbers of checks e.g. supermarkets and libraries, but they were not always the most efficient places to recruit people for checks. Mosques and bus stations were the venues with the broadest reach to all target groups. Other venues, despite having lower turnover or recruitment rates, were still good settings to reach specific target groups. CONCLUSION The NHS Health Check can successfully be targeted at people from deprived areas and people of South Asian ethnicity using a targeted opportunistic community outreach approach. Our findings show that the reach to different groups varies substantially by venue, and therefore best results may be achieved by combining venues and strategies specific to the target group.
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Affiliation(s)
- D J Roberts
- Public Health Team, Buckinghamshire County Council, County Hall, Walton Street, Aylesbury, HP20 1UA, United Kingdom.
| | - V C de Souza
- Public Health Team, Buckinghamshire County Council, County Hall, Walton Street, Aylesbury, HP20 1UA, United Kingdom; Solutions for Public Health, 1 Wooton Edge Barns, Holly Bank, Wooton-by-Woodstock, Oxfordshire, OX20 1AE, United Kingdom.
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Lowres N, Krass I, Neubeck L, Redfern J, McLachlan AJ, Bennett AA, Freedman SB. Atrial fibrillation screening in pharmacies using an iPhone ECG: a qualitative review of implementation. Int J Clin Pharm 2015. [DOI: 10.1007/s11096-015-0169-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Saramunee K, Krska J, Mackridge A, Richards J, Suttajit S, Phillips-Howard P. General public's views on pharmacy public health services: current situation and opportunities in the future. Public Health 2015; 129:705-15. [DOI: 10.1016/j.puhe.2015.04.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Revised: 03/09/2015] [Accepted: 04/09/2015] [Indexed: 11/26/2022]
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Mackridge A, Krska J, Stokes E, Heim D. Towards improving service delivery in screening and intervention services in community pharmacies: a case study of an alcohol IBA service. J Public Health (Oxf) 2015; 38:92-8. [DOI: 10.1093/pubmed/fdv010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Burgess C, Wright AJ, Forster AS, Dodhia H, Miller J, Fuller F, Cajeat E, Gulliford MC. Influences on individuals' decisions to take up the offer of a health check: a qualitative study. Health Expect 2014; 18:2437-48. [PMID: 24889817 DOI: 10.1111/hex.12212] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2014] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Health checks are promoted to evaluate individuals' risk of developing disease and to initiate health promotion and disease prevention interventions. The NHS Health Check is a cardiovascular risk assessment programme introduced in the UK aimed at preventing cardiovascular disease (CVD). Uptake of health checks is lower than anticipated. This study aimed to explore influences on people's decisions to take up the offer of a health check. METHODS Semi-structured interviews were conducted with people registered at four general practices in South London. The interview schedule was informed by the Theoretical Domains Framework. Data were analysed qualitatively using the Framework method using NVivo for data management. RESULTS Twenty-seven participants invited for a health check were included in the study. Seventeen received the health check while 10 either did not attend or failed to complete the check. Five themes emerging from the data included a lack of awareness of the health check programme, beliefs about susceptibility to CVD, beliefs about civic responsibility, issues concerning access to appointments, and beliefs about the consequences of having a check. CONCLUSIONS Health check programmes need to raise public awareness to ensure that people are informed about the objectives and nature of the programme in order to reach an informed decision about taking up the invitation. Emphasizing the benefits of prevention and early detection might encourage attendance in those who are reluctant to burden the public health-care systems. Extending outreach initiatives and increasing 'out of hours' provision at local community sites could facilitate access.
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Affiliation(s)
- Caroline Burgess
- Department of Primary Care and Public Health Sciences, King's College London, London, UK
| | - Alison J Wright
- Department of Primary Care and Public Health Sciences, King's College London, London, UK
| | - Alice S Forster
- Department of Primary Care and Public Health Sciences, King's College London, London, UK
| | - Hiten Dodhia
- Lambeth & Southwark Public Health, Southwark Council, London, UK
| | - Jane Miller
- Lewisham Clinical Commissioning Group, London, UK
| | | | - Eric Cajeat
- Lambeth & Southwark Public Health, Southwark Council, London, UK
| | - Martin C Gulliford
- Department of Primary Care and Public Health Sciences, King's College London, London, UK
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Willis A, Rivers P, Gray LJ, Davies M, Khunti K. The effectiveness of screening for diabetes and cardiovascular disease risk factors in a community pharmacy setting. PLoS One 2014; 9:e91157. [PMID: 24690919 PMCID: PMC3972156 DOI: 10.1371/journal.pone.0091157] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 02/11/2014] [Indexed: 11/21/2022] Open
Abstract
Risk factors for cardiovascular disease including diabetes have seen a large rise in prevalence in recent years. This has prompted interest in prevention through the identifying individuals at risk of both diabetes and cardiovascular disease and has seen increased investment in screening interventions taking place in primary care. Community pharmacies have become increasingly involved in the provision of such interventions and this systematic review and meta-analysis aims to gather and analyse the existing literature assessing community pharmacy based screening for risk factors for diabetes and those with a high cardiovascular disease risk. Methods We conducted systematic searches of electronic databases using MeSH and free text terms from 1950 to March 2012. For our analysis two outcomes were assessed. They were the percentage of those screened who were referred for further assessment by primary care and the uptake of this referral. Results Sixteen studies fulfilled our inclusion criteria comprising 108,414 participants screened. There was significant heterogeneity for all included outcomes. Consequently we have not presented summary statistics and present forest plots with I2 and p values to describe heterogeneity. We found that all included studies suffered from high rates of attrition between pharmacy screening and follow up. We have also identified a strong trend towards higher rates for referral in more recent studies. Conclusions Our results show that pharmacies are feasible sites for screening for diabetes and those at risk of cardiovascular disease. A significant number of previously unknown cases of cardiovascular disease risk factors such as hypertension, hypercholesterolemia and diabetes are identified, however a significant number of referred participants at high risk do not attend their practitioner for follow up. Research priorities should include methods of increasing uptake to follow up testing and early intervention, to maximise the efficacy of screening interventions based in community pharmacies.
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Affiliation(s)
- Andrew Willis
- Diabetes Research Unit, University of Leicester, Leicester, United Kingdom
- * E-mail:
| | - Peter Rivers
- DeMontford University, Leicester, United Kingdom
| | - Laura J. Gray
- Diabetes Research Unit, University of Leicester, Leicester, United Kingdom
| | - Melanie Davies
- Diabetes Research Unit, University of Leicester, Leicester, United Kingdom
| | - Kamlesh Khunti
- Diabetes Research Unit, University of Leicester, Leicester, United Kingdom
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