Formalising the current state of play in weight management: the knowledge, experiences and practices of women, pharmacists and pharmacy assistants
thesisposted on 22.02.2017 by Fakih, Souhiela
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Background The development of weight management interventions specifically targeting women has recently been emphasised. Pharmacists have been highlighted as key healthcare professionals in the treatment of overweight and obesity. Currently, there is little information about weight management services provided to women pharmacy consumers by pharmacists and pharmacy assistants. Aims The overall aim of this research, conducted in four phases, was to investigate the state of weight management services currently provided to women through community pharmacies by identifying the attitudes, recommendations, practices and knowledge of women, pharmacists and pharmacy assistants. Methods The research project was divided into four phases: Phase 1 utilised researcher-administered questionnaires to elicit women pharmacy consumers’ experiences with weight loss products and programs in community pharmacies in Victoria, Australia and Nottingham, England; Phase 2 explored community pharmacy weight management services throughout Australia; Phase 3 investigated pharmacists’ and pharmacy assistants’ weight management recommendations to women pharmacy consumers using case vignettes and simulated patient methodology (mystery shoppers); and Phase 4 involved conducting four focus groups with women, pharmacists and pharmacy assistants using the nominal group technique to determine the requirements, content and design of future educational resources for community pharmacy use. Key findings Results from Phase 1 highlighted that the majority of women in Victoria who had attempted to lose weight in the past (81.9%; 230/281) feel comfortable receiving advice from pharmacists, with 42% (117/281) wanting a pharmacist in their ideal weight management program and 42% (118/281) wanting their program to be delivered in a pharmacy. Overall, women in Victoria and Nottingham had similar views of what they wanted in their ideal weight management program. This study highlighted the potential for weight management educational resources developed for women pharmacy consumers in Australia or England to be used interchangeably. In Phase 2, a total of 537 pharmacist and 403 pharmacy assistant responses, from 880 different pharmacies, were received. Weight loss products were stocked by 94.5% (n=832/880) of associated pharmacies and 48.2% (n=424/880) offered a weight management program. This study highlighted current deficiencies in weight management advice offered by pharmacists and pharmacy assistants. Results from Phase 3 highlighted that, overall, pharmacists had a better understanding of the consumer’s needs in each case vignette compared to pharmacy assistants. Just fewer than 60% (64/108) of pharmacists were able to correctly identify gestational weight gain for healthy weight women and how this changed when women were overweight or obese. Pharmacy assistants were significantly more likely (P < 0.05) to recommend herbal supplements in each of the case vignettes compared to pharmacists. Mystery shopper visits further highlighted the need for pharmacy weight management educational resources to be developed. Pharmacists and pharmacy assistants demonstrated very poor history-taking in both scenarios. Recommendations made, and advice given, were not in line with the 2013 NHMRC Clinical Practice Guidelines for the Management of Overweight and Obesity in Adults, Adolescents and Children in Australia. In Phase 4, pharmacists and pharmacy assistants were seen as having a role in the treatment of overweight and obesity due to their accessibility, trust and the availability of products in pharmacy. Participants unanimously agreed that training in weight management needed to be ongoing, easily accessible, online and in hard copy formats (for those who do not have access to the internet), and most importantly, needs to originate from reputable sources. Conclusion This research has provided a greater understanding of the current weight management practices of women pharmacy consumers and recommendations made by pharmacists and pharmacy assistants. The need for the development of pharmacy-specific educational resources was identified and reinforced in all four phases of the research project. These findings collectively will guide the development and content of women-specific weight management educational resources for community pharmacy use.