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Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead pharmacist, Health and Wellbeing Directorate, Public Health England
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smoking1March 9 2016

Community pharmacy smoking cessation interventions including behavioural support and/or nicotine replace therapy (NRT), are effective and cost-effective, particularly when compared with usual care.

However, there is insufficient data at this stage to say whether other public health intervention services provided through community pharmacy are effective, a BMJ Open study has found.

Researchers looked at the evidence base for community pharmacy-delivered interventions for alcohol reduction, smoking cessation and weight management. A systematic review and meta-analyses looked at 19 studies from a number of countries with data up to May 2014. Of the available studies for consideration, two dealt with alcohol reduction, 12 with smoking cessation and five with weight management.

Among the smoking cessation studies, was a UK pharmacy study which had compared a behavioural intervention group based on the Pharmacist Action on Smoking (PAS) model with a control group that received nicotine gum, and another control group who expressed a wish to stop smoking.

“At six months, there was a statistically significant difference in cessation rates between intervention and control groups. Six-month carbon monoxide CO-verified abstinence was 46% in the intervention group, 6% in the nicotine gum control group, and 0% in the control group that expressed a wish to stop smoking.”

Another UK study was a randomised controlled trial comparing a PAS model intervention to ad hoc smoking cessation advice, and where over 80% in each group also had NRT. The “PAS intervention significantly increased validated smoking cessation compared with control at 12 months (14.3% vs 2.7%).”

In terms of weight loss, the researchers found that “pharmacy-based interventions produced similar weight loss compared with active interventions in other primary care settings; however, weight loss was not sustained longer term in a range of primary care and commercial settings compared with control.

“Pharmacy-based weight management interventions have similar provider costs to those delivered in other primary care settings, which are greater than those delivered by commercial organisations.”

The researchers also noted: “Very few studies explored if and how sociodemographic or socioeconomic variables moderated intervention effects. Insufficient information was available to examine relationships between effectiveness and behaviour change strategies, implementation factors, or organisation and delivery of interventions.”

PSNC commented: “The review concluded that community pharmacy is an appropriate and feasible setting to deliver a range of public health interventions and that given the potential reach, effectiveness and associated costs of these interventions, community pharmacy should be considered by commissioners to help deliver public health services.”

Links:

TJ Brown et al. ‘Community pharmacy-delivered interventions for public health priorities: a systematic review of interventions for alcohol reduction, smoking cessation and weight management, including meta-analysis for smoking cessation’. BMJ Open 2016;6:e009828. Published online February 29 2016

PSNC statement

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