Public Health in Community Pharmacy
Fiona Macfarlane BSc MPH
Health Promotion Officer
NHS Forth Valley
Background
•
•
•
•
1.
2.
Scottish Executive – Dental Action Plan
(2005)1
NHS Forth Valley – Dental Health Strategy
(2005)2
1 Year Pilot - Oral Health Initiative in
Community Pharmacy (2007- 2008)
Pilot Service Evaluation and Client
Experiences
The Scottish Executive. An Action Plan for Improving Oral Health and Modernising the NHS Dental Services in Scotland.
Edinburgh: The Scottish Executive; 2005
NHS Forth Valley. Multi-agency and Dental Health Strategy for NHS Forth Valley. Stirling: NHS Forth Valley; 2005
The experiences and perceptions of Community
Pharmacists in NHS Forth Valley involved in
delivering an innovative oral health intervention
with clients accessing substance misuse
services.
Objectives
• To explore the community pharmacists’
perceptions of their public health role in
contributing to health improvement amongst
substance misuse clients
• To identify factors that influence community
pharmacists participation in public health
interventions
• To explore the experiences of community
pharmacists who delivered oral health
interventions to substance misuse clients
Objectives
• To investigate the perceptions and attitudes
towards oral health improvement with
substance misuse clients
• To determine if community pharmacists
believe they can engage effectively with
substance misuse clients to affect health
behaviour and behaviour change related to
oral health improvement
• To investigate if community pharmacists are
appropriately placed to deliver oral health
improvement with substance misuse
Method / Data Collection
• Qualitative Methodology
– Non random sampling
– Semi- structured interview schedule
– Face to face interviews
• Analysis and Interpretation
– Data transcription
– Thematic analysis and coding
• Ethical Approval
– University of Glasgow Faculty of Medicine Ethics
Experiences and Perceptions
• Good Idea, Beneficial, Raised Awareness
“A lot of them with regards to the oral health,
you know, have mentioned about their
teeth and they’ve had problems with, you
know dental work and stuff so obviously
the oral hygiene initiative is a good idea”
Pharmacist 12
“I think…it may be of benefit [to] one of two
cases out of the 6 in our particular case…”
Pharmacist 13
“I think it just reminds them. I think they are
all becoming a lot more aware of their oral
health”
Pharmacist 16
Intervention / Service Delivery
• Easy to deliver and well organised
“It is quite an easy way that it’s been set out.
Its quite easy to give the information…
simple and straight forward and not time
consuming that’s the kind of things we
need”
Pharmacist 4
“It’s been, I think, very well organised… it’s
been very straightforward and very easy to
do… I think it’s been made very easy for me
to do…”
Pharmacist 13
Engagement / Attitude
• Three quarters of pharmacists involved other
staff in the delivery of the intervention
• Staff engagement was viewed positively by
the pharmacists
• Mixed perceptions of client engagement
• It’s just a freebie?
Effectiveness
• Over half reported that the model was
‘effective’ or ‘very effective’
“They are guaranteed to come in for their
methadone … utilising the pharmacists is
the most effective way of doing it”
Pharmacist 7
Impact on Client Attitudes and
Behaviours
• Some perceived impact on client attitudes
and behaviours
“I think its had a good impact, I think it just
remind them … they are more aware of their
health and oral health especially… I think it’s
had a positive impact definitely”
Pharmacist 16
“… It did have an impact, I wouldn’t say it was
enormous, probably I would say significant”
Pharmacist 1
“Hopefully we’ve maybe changed some of
their attitudes… sort of dispelled their
theories on oral health and methadone… I
think we must have made an impact”
Pharmacist 10
“… they’ve been coming here for while so
they’re like ‘oh yes, I don’t wet the toothbrush’
and you know it seems that they’re
remembering what you’ve told them”
Pharmacist 12
Appropriateness
• All of the pharmacists believed they were
appropriately placed to engage and deliver
the oral health intervention
• Recurring themes
– Regular / frequent contact
– Existing relationship
– Accessibility of the pharmacy
“ We’re best placed really, if we are seeing
them everyday. That’s really the only
healthcare professional they’re going to be
seeing on a regular basis”
Pharmacist 4
“I think that this is more than appropriate …
we’re a bit of continuity for them and we do
see them most regularly…”
Pharmacist 16
Summary
• Good idea, beneficial, raised awareness and
influenced the behaviours and attitudes of some
clients
• Simple and straightforward to deliver, well organised
and not time consuming
• Largely positive experiences of the intervention
• Community pharmacists feel appropriately placed to
deliver the intervention
• Could be adopted to address other health issues with
this client group
Contact Details
Fiona Macfarlane
Health Promotion Officer
NHS Forth Valley
Tel. 01786 442940
Email. Fiona.macfarlane2@nhs.net