Community Pharmacists role in obesity treatment in Kuwait: a cross-sectional study

BMC Public Health

Mohammad Waheedi¹  Abdelmoneim Awad¹ 

[1] Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Kuwait, Kuwait

关键词: Kuwait;    Obesity counseling;    Obesity;    Community pharmacists;   

Others  :  1162993
DOI  :  10.1186/1471-2458-12-863

 received in 2012-05-24, accepted in 2012-10-08,  发布年份 2012

【 摘 要 】

Background

Obesity is a growing health concern in Kuwait. Obesity has been identified as a key risk factor for many chronic diseases including hypertension, dyslipidemia and type 2 diabetes mellitus. It has been shown that community pharmacists' involvement is associated with successful weight management in developed countries. This study was conducted to investigate the role of community pharmacists in obesity counseling, and to identify the barriers to counseling in Kuwait.

Methods

A descriptive cross-sectional study involved 220 community pharmacies that were selected via stratified and systematic random sampling. A pretested self-administered questionnaire collected information on frequency and comfort level with obesity counseling, and the perceived effectiveness of four aspects of obesity management (diet and exercise, prescribed antiobesity medications, diet foods, and nonprescription products and dietary supplements). Information on perceived confidence in achieving positive outcomes as a result of counseling and barriers to counseling was also collected. Descriptive and Spearman’ r analysis were conducted using SPSS version 17. Responses with Likert scale rating 1(low score) to 5 (high score) and binary choices (yes/no) were presented as mean (SD) and (95% CI), respectively.

Results

The response rate was 93.6%. The overall mean (SD) responses indicated that pharmacists counseled obese patients sometimes to most of the time, 3.67 (1.19) and were neutral to comfortable with counseling about aspects of obesity management, 3.77 (1.19). Respondents perceived obesity management aspects to be somewhat effective, 3.80 (1.05). Of the four aspects of obesity management, diet and exercise, and diet foods were the highest ranked in terms of frequency of counseling, comfort level and perceived effectiveness. Pharmacists were neutral to confident in achieving positive outcomes as a result of obesity counseling, 3.44 (1.09). Overall mean responses of counseling obese patients by pharmacists were positively correlated with their perceived comfort with counseling and perceived effectiveness of obesity management aspects. The most anticipated barriers to obesity counseling were lack of patient awareness about pharmacists' expertise in counseling 76.2% (95% CI: 69.7-81.7) and pharmacists’ opinions that obese patients lack willpower and are non-adherent to weight reduction interventions 71.8% (95% CI: 65.1-77.8).

Conclusions

Strengths, weaknesses and barriers related to obesity counseling by pharmacists in Kuwait were identified, and suggestions were provided to strengthen that role.

【 授权许可】

   
2012 Awad and Waheedi; licensee BioMed Central Ltd.

【 参考文献 】

• [1]World Health Organization: Obesity and overweight. 2011. Fact sheet N 311. http://www.who.int/mediacentre/factsheets/fs311/en/ webcite. Accessed: 2/04/12
• [2]Malnick SD, Knobler H: The medical complications of obesity. Q J Med 2006, 99:565-579.
• [3]Olusi SO, Al-Awadi AM, Abraham M: Baseline population survey data on the prevalence of risk factors for coronary artery disease among Kuwaitis aged 15 years and older. Ann Saudi Med 2003, 23:162-166.
• [4]Sorkhou I, Al-Qallaf K, Al-Shamali N, Hajia A, Al-Qallaf B: Childhood obesity in Kuwait–prevalence and trends. Fam Med 2003, 35:463-464.
• [5]El-Bayoumy I, Shady I, Lotfy H: Prevalence of obesity among adolescents (10 to 14 years) in Kuwait. Asia Pac J Publ Health 2009, 21:153-159.
• [6]Food Agricultural Organization: Kuwait: Nutrition Country Profiles. http://www.fao.org/ag/agn/nutrition/kwt_en.stm webcite. Accessed: 2/04/12
• [7]Lyznicki JM, Young DC, Riggs JA, Davis RM: Obesity: assessment and management in primary care. Am Fam Physician 2011, 63:2185-2196.
• [8]Murphree D: Patient attitudes toward physician treatment of obesity. J Fam Pract 1994, 38:45-48.
• [9]O’Donnell MP: Definition of health promotion: part III: expanding the definition [abstract]. Am J Health Promot 1989, 3:5.
• [10]American Society of Health-System Pharmacists: ASHP Statement on the Role of Health-System Pharmacists in Public Health. Am J Health Syst Pharm 2008, 65:462-467.
• [11]National Public Health Service for Wales: Weight management interventions by community pharmacists: a rapid review of the evidence. 2009. http://www2.nphs.wales.nhs.uk:8080/pharmaceuticalphtdocs.nsf/Main%20Frameset?OpenFrameSet&Frame=Right&Src=%2Fpharmaceuticalphtdocs.nsf%2F1f8687d8da97650980256fa30051b0be%2Fd694bf1fb94bddbc8025756e004068f1%3FOpenDocument%26AutoFramed webcite. Accessed 22/07/12
• [12]World Health Organization: Health Promotion Glossary. 1998. http://www.who.int/hpr/NPH/docs/hp_glossary_en.pdf webcite]. Accessed: 10/04/12
• [13]Jackson JK, Snell B, Sweidan M, Duncan GJ, Spinks JM: Public health - recognising the role of Australian pharmacists. J Pharm Pract Res 2004, 34:290-292.
• [14]Chandra A, Malcolm N, Fetters M: Practicing health promotion through pharmacy counseling activities. Health Promot Pract 2003, 4:64-71.
• [15]Babb VJ, Babb J: Pharmacist involvement in Healthy People 2010. J Am Pharm Assoc 2003, 43:56-60.
• [16]Campbell RK: Unraveling the mysteries of syndrome X. As the number of Americans with insulin resistance grows, pharmacists can help patients prevent the onset of type 2 diabetes and cardiovascular disease. J Am Pharm Assoc 2003, 43(5 suppl 1):S32-S33.
• [17]Dombrowski SR, Ferro LA: Pharmacist counseling on nutrition and physical activity-Part 2 of 2: Helping patients make changes. J Am Pharm Assoc 1999, 39:613-627.
• [18]Gordon J, Watson M, Avenell A: Lightening the load? A systematic review of community pharmacy-based weight management interventions. Obes Rev 2011, 2:897-911.
• [19]Department of Health, London: Pharmacy in England. Building on strengths – delivering the future. 2008. http://www.official-documents.gov.uk/document/cm73/7341/7341.pdf webcite. Accessed: 22/07/12
• [20]ASHP Commission on Therapeutics: ASHP therapeutic position statement on the safe use of pharmacotherapy for obesity management in adults. Am J Health Syst Pharm 2001, 58:1645-1655.
• [21]National Institute for Health and Clinical Excellence: Obesity: guidance on the prevention, identification, assessment and management of overweight and obesity in adults and children. 2006. http://www.nice.org.uk/Guidance/CG43 webcite. Accessed: 22/07/12
• [22]De Young M: Research on the effects of pharmacist-patient communication in institutions and ambulatory care sites, 1969–1994. Am J Health Syst Pharm 1996, 53:1277-1291.
• [23]Malone M, Alger-Mayer SA: Pharmacist intervention enhances adherence to orlistat therapy. Ann Pharmacother 2003, 37:1598-1602.
• [24]Ahrens RA, Hower M, Best AM: Effects of weight reduction interventions by community pharmacists. J Am Pharm Assoc 2003, 43:583-589.
• [25]Lloyd KB, Thrower MR, Walters NB, Krueger KP, Stamm PL, Evans RL: Implementation of a weight management pharmaceutical care service. Ann Pharmacother 2007, 41:185-192.
• [26]Botomino A, Bruppacher R, Krähenbühl S, Hersberger KE: Change of body weight and lifestyle or persons at risk for diabetes after screening and counselling in pharmacies. Pharm World Sci 2008, 30:222-226.
• [27]Lenth RV: Java Applets for Power and Sample Size. http://www.stat.uiowa.edu/~rlenth/Power webcite
• [28]World Health Organization: How to investigate drug use in health facilities: Selected drug use indicators. WHO/DAP/ 93.1. World Health Organization, Geneva; 1993:1-87.
• [29]Dastani HB, Brown CM, O'Donnell DC: Combating the obesity epidemic: community pharmacists' counseling on obesity management. Ann Pharmacother 2004, 38:1800-1804.
• [30]O'Donnell DC, Brown CM, Dastani HB: Barriers to counseling patients with obesity: a study of Texas community pharmacists. J Am Pharm Assoc 2006, 46:465-471.
• [31]Awad A, Abahussain E: Health promotion and education activities of community pharmacists in Kuwait. Pharm World Sci 2010, 32:146-153.
• [32]Maguire T: The battle against obesity: European experts and pharmacists call for an increased role for pharmacy. 2008. http://www.gsk.com/media/pressreleases/2008/2008_pressrelease_10050.htm webcite. Accessed: 22/07/2012
• [33]Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM, Diabetes Prevention Program Research Group: Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002, 346:393-403.
• [34]Heshka S, Anderson JW, Atkinson RL, Greenway FL, Hill JO, Phinney SD, Kolotkin RL, Miller-Kovach K, Pi-Sunyer FX: Weight loss with self-help compared with a structured commercial program. JAMA 2003, 289:1792-1798.
• [35]McKenney JM, Bradberry JC, Talbert RL, Cahill E, Brown WV: National survey of pharmacists about coronary heart disease, hypercholesterolemia, nonprescription statin therapy, and pharmacists' services. J Am Pharm Assoc 2004, 44:562-568.
• [36]Chan TY: Potential risks associated with the use of herbal anti-obesity products. Drug Saf 2009, 32:453-456.
• [37]Al-Jeheidli A, Moquddan F, Al-Rumh M, Salmin N: General practitioners’ attitudes and practices toward managing obesity. KMJ 2007, 39:138-143.
• [38]Matowe L, Al-Kandery A, Bihzad S: Pharmacy in Kuwait. Am J Health Syst Pharm 2003, 60:1591-1592.
• [39]McDonough RP: Obstacles to pharmaceutical care. In A Practical Guide to Pharmaceutical Care. 2nd edition. Edited by Rovers JP. American Pharmaceutical Association, Washington; 2003:267-278.
• [40]Bell JS, Väänänen M, Ovaskainen H, Närhi U, Airaksinen MS: Providing Patient Care in Community Pharmacies: Practice and Research in Finland. Ann Pharmacother 2007, 41:1039-1046.
• [41]Globe DR, Johnson K, Conant L, Frausto S: Implementing a Community-based Health Promotion Program into the Pharmacy Curriculum: The USC FUENTE Initiative. Am J Pharm Educ 2004, 68:Article32.
• [42]McKenney JM: An evaluation of cholesterol screening in community pharmacies. Am Pharm 1993, 33:34-40.
• [43]Crawford N: The pharmacists officentre: providing quality care. Am Pharm 1992, 32:36-38.
• [44]Nykamp D, Barnett CW: Use of stationary automated blood pressure devices in pharmacies. Am Pharm 1992, 32:33-36.
• [45]Rutter PM: Pharmacist work patterns: Are they affected by staffing levels and prescription numbers. Int J Pharm Pract 2000, 10:R 49.
• [46]Kotescki JE, Elanjian SI, Torabi MR: Health promotion beliefs and practices among pharmacists. J Am Pharm Assoc 2000, 40:773-779.
• [47]Anderson C: Health promotion by community pharmacists: Perceptions, realities and constraints. J Soc Admin Pharm 1998, 15:10-22.