[Improvements in Lifestyle from a Lifestyle Consecutive Self-Review at a Pharmacy]

Pharmacists' involvement in physical activity promotion in community pharmacy: a systematic review

BACKGROUND

Physical activity (PA) promotion in healthcare systems is one of the priority areas highlighted by the World Health Organization, which recognizes that progress has been slow largely due to a lack of awareness and investment while requiring a system-based approach. Community pharmacies are one of the health structures that are more easily accessible to populations, thus constituting an ideal venue for developing health promotion activities. This research aimed to describe PA-enabling interventions developed in community pharmacies by pharmacists.

METHODS

An electronic search was performed in PubMed, Scopus, Web of Science, Cochrane and reference lists of the different papers until June 2023. Studies were eligible if performed in community pharmacies by pharmacists, focused on interventions aimed at increasing PA levels and if at least one PA-specific outcome was measured at two different time points.

RESULTS

We identified 7076 publications in the initial search, plus 31 records identified through backward citation tracking from relevant studies. After an initial screening, 236 were selected for full-text analysis. Of the 29 selected papers, 10 presented a low risk of bias for the measurement of PA levels. PA outcomes were generally self-reported outcomes where the change in terms of the percentage of individuals considered active or who increased PA because of the intervention.

CONCLUSION

Several interventions to improve PA through community pharmacies were found although with a high level of heterogeneity and with only few with a low risk of bias. More targeted research that aims to capture PA levels and support the training of healthcare professionals is needed.

Exploring Changes in Attitudes, Behaviors, and Self-Measured Health Data Through Lifestyle Modification Support by Community Pharmacists: Suito-Ogaki Selfcare (SOS) Trial

Purpose

Contributing to public health by supporting people's health is the social mission of community pharmacists. This multicenter, prospective case series study aimed to evaluate changes in people's behavior and health states through community pharmacists' self-care support for healthy lifestyles.

Methods

The participants were recruited from voluntary adults aged ≥20 years who agreed to participate in the study, at community pharmacies in Gifu, Japan, between June and September 2021. Participants self-managed their lifestyles for six months while recording their health data, including blood pressure (BP), daily using devices (home BP monitor, body composition monitor, and activity meter) and a diet-recording app. They received lifestyle modification support at pharmacies at least once per month. Participants' subjective health status, attitudes, and behavioral changes were evaluated using self-report questionnaires. Due to the exploratory nature of this study, data were primarily analyzed descriptively.

Results

Fifty-four participants aged 20 to 77 (mean age: 49.6 years; female participant proportion: 55.6%) participated in this study. Their mean weekly BP shifted almost horizontally from baseline to week 24 (systolic BP: 118.8 to 121.5 mmHg; diastolic BP: 76.1 to 77.5 mmHg). At six months, 38.9% and 35.2% of the participants reported better overall health and mental health, respectively, than at baseline. Over 85% of the participants became more proactive in improving their lifestyles regarding salt intake, diet, weight loss, and exercise, although drinking and smoking habits were more challenging to change. All the participants reported that they intended to continue to improve their lifestyle.

Conclusion

The participants' responses suggested that community pharmacists' support helped increase participants' health awareness and promote their health-enhancing behaviors. However, its impact on health parameters should be further examined in future studies. More vigorous, tailored self-care support may be worth considering in developing a more effective, community-fitted health/well-being support system in Japan.

Comparative trial of the effects of continuous locomotion training provided at pharmacies: a pilot study

Background

While the world’s population is growing older, healthy life expectancy is not increasing. The Japanese Orthopedic Association proposed the concept of ‘locomotive syndrome,’ manifested as a decline in mobility functions, and introduced a short test battery for assessing the risk of this syndrome. The test battery includes the ‘stand-up test,’ ‘two-step test,’ and ‘25-question Geriatric Locomotive Function Scale’ (25-question GLFS). The purpose of locomotion training is to improve and sustain standing and gait functions. However, the place where locomotion training can be provided and followed up has not been decided upon. Therefore, a study was conducted to explore the effect of locomotive syndrome improvement by continuous locomotion training provided at community pharmacies. The objective of this study was to evaluate the effect of pharmacists’ instructions and follow-up on the compliance and effectiveness of locomotion training.

Methods

The inclusion criteria were 1) age ≥ 65 years and 2) decline in mobility functions. Guidance on how to perform locomotion training was provided by a pharmacist at the pharmacy. The participants performed locomotion training at home. They were tested and instructed at the pharmacy once a month for 3 months. The main outcome measures were test battery results and the percentage of number of days participants who were able to do the training at home.

Results

Eleven participants were analysed. The minimum implementation percentage was 78%. Improvements were observed in 25-question GLFS, muscle strength, and standing time on one leg. Three participants no longer showed a noticeable decline in mobility function.

Conclusion

Continuous locomotion training provided at pharmacies could contribute to locomotive syndrome prevention.

Trial registration

This study was registered with the University hospital Medical Information Network Clinical Trials Registry (UMIN-CTR; identification No. UMIN000027963. Registered 28 June 2017).

Patients' Attitudes, Awareness, and Opinions About Community Pharmacies in Japan: Next Steps for the Health Support Pharmacy System

Purpose

Despite the formal establishment of the Health Support Pharmacy system, few community pharmacies have transitioned to this new designation in Japan. Moreover, patients’ perspectives on the usefulness of health-support pharmacies and community pharmacies have not yet been investigated. In this work, we investigated patients’ attitudes, opinions, and awareness as users of member pharmacies of the Japan Federation of Democratic Medical Institutions (Min-Iren), with respect to two essential functions provided by community pharmacies—primary care and health support—to identify modern challenges facing community pharmacies.

Methods

Regular visitors to participating Min-Iren community pharmacies were asked to complete an anonymous questionnaire. Responses were compared between users of health-support pharmacies and other pharmacy types, as well as between members and non-members of “collaborating organizations” (CO). CO is organizational partners of Min-Iren whose activities support affiliated facilities. Logistic regression analysis was performed to explore the predictive value of different factors on pharmacies’ primary-care and health-support functionality.

Results

A total of 181 Min-Iren community pharmacies (51.7%: 181/350) participated in this study, and most patients answered the questionnaire (97.7%, n=2623). Relatively few patients recognized the term “Health Support Pharmacy” (12.2%). CO members tended to have a superior understanding of a wide variety of services provided by CPs as compared to non-members. Statistically significant predictors of primary-care and health-support functionality included male gender, having a primary-care pharmacist, age ≥60 years, recognition of the term “Health Support Pharmacy” and CO membership.

Conclusion

CO members, a class of patients with a superior awareness of health promotion, demonstrated a good understanding of the variety of services provided by community pharmacies and tended to positively rate their pharmacy. Moving forward, efforts to raise awareness about the importance of health-promotional activities among community pharmacy users should further reinforce the primary-care and health-support functions of community pharmacies.