Do pharmacists have a role in the prevention and management of non communicable diseases? By Olla Wasfi
With the increasing burden of NCDs worldwide including Africa, there needs to be a holistic approach in order to combat this epidemic. There are multiple factors that lead to the increase in number of NCDs around the world, including decreased physical activity, unhealthy diet, smoking, etc. Therefore, there are multiple areas to target which need the effort of the whole community. Increasing awareness will help with the control and prevention of NCDs (WHO, 2019). This requires the training and commitment of the different healthcare providers including pharmacists.
I work closely with pharmacists and appreciate their broad knowledge. Pharmacists have multiple roles in different settings including clinical, academia, and community practice. Community pharmacists are the most accessible healthcare workers and can provide multiple services to their customers/patients. The International Pharmaceutical Federation (FIP) reviewed the role of pharmacists in the management and control of NCDs (FIP, 2019). The FIB report “Beating non-communicable diseases in the community: The contribution of pharmacists” presented initiatives from a number of countries that focuses on how pharmacists can play a significant role in fighting NCDs (FIP, 2019). From Africa, the following countries were selected: Nigeria, and South Africa (FIP, 2019). FIB’s Working Group generated their report on NCDs based on a survey of FIP member organisations which showed that pharmacists can have a pertinent role in the prevention of NCDs through increasing health awareness, medication recommendation, and counselling (FIP, 2019; Patterson, 2008).
A study that was done in Ethiopia on the practice and barriers in the provision of health promotion services among community pharmacists concluded that pharmacists took part in health promotions activities, however, more training is needed especially in cancer health promotion (Gelayee, Mekonnen, & Atnafe, 2017).
A cross-sectional study in Nigeria showed that pharmacists have a positive attitude towards public health services but sometimes lack the appropriate training (Offu, Anetoh, Okonta, & Ekwunife, 2015). In addition, the researchers noted that pharmacists mentioned some barriers such as the unavailability of adequate funding, space and time (Offu et al, 2015). Such challenges impede their ability to provide public health services such as health awareness on NCDs (Offu et al, 2015).
The integration of pharmacists’ role within the circle of primary care services will ensure that the word spreads to a larger sector of the community. The South African approach is an interesting one; Bheekie and Bradley (2016), focused on the potential role of pharmacists in the South African re-engineered primary healthcare system. They have highlighted that pharmacists and pharmacy technicians can be well prepared starting from their pharmacy education to have a full understanding of how they can play a significant role in providing health promotion and help in the management of NCDs (Bheekie and Bradley, 2016). Pharmacists are the most accessible healthcare providers in the community which will encourage patients to seek information from them. Multiple services have been incorporated into the scope of pharmacy practice as mentioned earlier including but not limited to immunization clinics, public health campaigns, diabetes management clinics and patient counselling (Dang, Dudley, Truong, Boyle, & Layson-Wolf, 2012; Nuffer, McCollum, Ellis, & Turner, 2012; Perez et al., 2009) . Bheekie and Bradley (2016) emphasized that pharmacists are integral members of the healthcare team.
In conclusion, focusing on educating and training pharmacists on public health services will increase the health care force capacity in Africa. This will in turn, allow the provision of services such as the management and control of NCDs especially in countries which lack enough numbers of healthcare centers and/or providers. Pharmacists are highly interested in public health services but need further training and recognition in order to be able to integrate those services within their current scope of work.
Bheekie & H. Bradley (2016) Re-engineering of South Africa’s primary health care system: where is the pharmacist?, South African Family Practice, 58:6, 242-248, DOI: 10.1080/20786190.2016.1186365. Retrieved from https://www.tandfonline.com/doi/pdf/10.1080/20786190.2016.1186365
Dang, C. J., Dudley, J. E., Truong, H. A., Boyle, C. J., & Layson-Wolf, C. (2012). Planning and implementation of a student-led immunization clinic. American journal of pharmaceutical education, 76(5), 78. doi:10.5688/ajpe76578 Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3386029/
Gelayee, D.A., Mekonnen, B.G., & Atnafe, S.A (2017). Practice and Barriers towards Provision of Health Promotion Services among Community Pharmacists in Gondar, Northwest Ethiopia. BioMed research international, 2017, 7873951. doi:10.1155/2017/7873951 Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5555023/
International Pharmaceutical Federation (FIP). (2019). Beating non-communicable diseases in the community: The contribution of pharmacists . Retrieved from https://www.fip.org/files/content/publications/2019/beating-ncds-in-the-community-the-contribution-of-pharmacists.pdf
Nuffer, W., McCollum, M., Ellis, S. L., & Turner, C. J. (2012). Further development of pharmacy student-facilitated diabetes management clinics. American journal of pharmaceutical education, 76(3), 50. doi:10.5688/ajpe76350 Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3327248/
Offu, O., Anetoh, M., Okonta, M., & Ekwunife, O. (2015). Engaging Nigerian community pharmacists in public health programs: assessment of their knowledge, attitude and practice in Enugu metropolis. Journal of pharmaceutical policy and practice, 8, 27. doi:10.1186/s40545-015-0048-0 Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4638028/#Sec2title
Patterson B. Y. (2008). An advanced pharmacy practice experience in public health. American journal of pharmaceutical education, 72(5), 125. doi:10.5688/aj7205125 Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2630152/
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WHO (2019). Prevention of Non communicable diseases. Retrieved from https://www.who.int/ncds/prevention/introduction/en/