Study of the potential role of the community pharmacist in health promotion

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Pharmacist monitoring of patient health in the community

The Government has established essential principles in order to make significant improvements in the health of the people and has placed an emphasis on shifting care to the primary sening. This research has explored the potential role of the community pharmacist in health promotion in the pharmacy, and at general medical practices. The feasibility of monitoring patients' health status in the community was evaluated by intervention to assess and alter cardiovascular risk factors.68, hypertensive patients, monitored at one surgery, had a change in mean systolic blood pressure from 158.28 to 146.55 mmHg, a reduction of 7.4%, and a change in mean diastolic bood pressure from 90.91 to 84.85 mmHg, a reduction of 6.7%.120 patients, from a cohort of 449 at the major practice, with an initial serum total cholesterol of 6.0+mmol/L, experienced a change in mean value from 6.79 to 6.05 mmol/L, equivalent to a reduction of 10.9%. 86% of this patient cohort showed a decrease in cholesterol concentration. Patients, placed in a high risk category according to their coronary rank score, assessed at the first health screening, showed a consistent and significant improvement in coronary score throughout the study period of two years. High risk and intermediate risk patients showed improvements in coronary score of 52% and 14% respectively. Patients in the low risk group maintained their good coronary score. In some cases, a patient's improvement was effected in liaison with the GP, after a change or addition of medication and/or dosage.Pharmacist intervention consisted of advice on diet and lifestyle and adherence to medication regimes. It was concluded that a pharmacist can facilitate a health screening programme in the primary care setting, and provide enhanced continuity of care for the patient.

An argument for using participatory approaches for the design of online health interventions targeted at young women

The Internet is becoming an increasingly important portal to health information and means for promoting health in user populations. As the most frequent users of online health information, young women are an important target population for e-health promotion interventions. Health-related websites have traditionally been generic in design, resulting in poor user engagement and affecting limited impacts on health behaviour change. Mounting evidence suggests that the most effective health promotion communication strategies are collaborative in nature, fully engaging target users throughout the development process. Participatory design approaches to interface development enable researchers to better identify the needs and expectations of users, thus increasing user engagement in, and promoting behaviour change via, online health interventions. This article introduces participatory design methods applicable to online health intervention design and presents an argument for the use of such methods in the development of e-Health applications targeted at young women.

Interactive online health promotion interventions : a “health check”

As an increasingly popular medium by which to access health promotion information, the Internet offers significant potential to promote (often individualized) health-related behavioral change across broad populations. Interactive online health promotion interventions are a key means, therefore, by which to empower individuals to make important well being and treatment decisions. But how ldquohealthyrdquo are interactive online health promotion interventions? This paper discusses a literature review (or ldquohealth checkrdquo) of interactive online health interventions. It highlights the types of interactive interventions currently available and identifies areas in which research attention is needed in order to take full advantage for the Internet for effective health promotion.

Interactive online health promotion interventions:a “health check”

As an increasingly popular medium by which to access health promotion information, the Internet offers significant potential to promote (often individualized) health-related behavioral change across broad populations. Interactive online health promotion interventions are a key means, therefore, by which to empower individuals to make important well being and treatment decisions. But how ldquohealthyrdquo are interactive online health promotion interventions? This paper discusses a literature review (or ldquohealth checkrdquo) of interactive online health interventions. It highlights the types of interactive interventions currently available and identifies areas in which research attention is needed in order to take full advantage for the Internet for effective health promotion.

Undermining patient and public engagement and limiting its impact:the consequences of the Health and Social Care Act 2012 on collective patient and public involvement

Patient and public involvement has been at the heart of UK health policy for more than two decades. This commitment to putting patients at the heart of the British National Health Service (NHS) has become a central principle helping to ensure equity, patient safety and effectiveness in the health system. The recent Health and Social Care Act 2012 is the most significant reform of the NHS since its foundation in 1948. More radically, this legislation undermines the principle of patient and public involvement, public accountability and returns the power for prioritisation of health services to an unaccountable medical elite. This legislation marks a sea-change in the approach to patient and public involvement in the UK and signals a shift in the commitment of the UK government to patient-centred care. © 2013 John Wiley & Sons Ltd.

Using XML and XSLT for flexible elicitation of mental-health risk knowledge

Current tools for assessing risks associated with mental-health problems require assessors to make high-level judgements based on clinical experience. This paper describes how new technologies can enhance qualitative research methods to identify lower-level cues underlying these judgements, which can be collected by people without a specialist mental-health background. Content analysis of interviews with 46 multidisciplinary mental-health experts exposed the cues and their interrelationships, which were represented by a mind map using software that stores maps as XML. All 46 mind maps were integrated into a single XML knowledge structure and analysed by a Lisp program to generate quantitative information about the numbers of experts associated with each part of it. The knowledge was refined by the experts, using software developed in Flash to record their collective views within the XML itself. These views specified how the XML should be transformed by XSLT, a technology for rendering XML, which resulted in a validated hierarchical knowledge structure associating patient cues with risks. Changing knowledge elicitation requirements were accommodated by flexible transformations of XML data using XSLT, which also facilitated generation of multiple data-gathering tools suiting different assessment circumstances and levels of mental-health knowledge. © 2007 Informa UK Ltd All rights reserved.

Functional outcomes in the Cleft Care UK study - Part 3:oral health and audiology

OBJECTIVES: To compare oral health and hearing outcomes from the Clinical Standards Advisory Group (CSAG, 1998) and the Cleft Care UK (CCUK, 2013) studies. SETTING AND SAMPLE POPULATION: Two UK-based cross-sectional studies of 5-year-olds born with non-syndromic unilateral cleft lip and palate undertaken 15 years apart. CSAG children were treated in a dispersed model of care with low-volume operators. CCUK children were treated in a centralized, high volume operator system. MATERIALS AND METHODS: Oral health data were collected using a standardized proforma. Hearing was assessed using pure tone audiometry and middle ear status by otoscopy and tympanometry. ENT and hearing history were collected from medical notes and parental report. RESULTS: Oral health was assessed in 264 of 268 children (98.5%). The mean dmft was 2.3, 48% were caries free, and 44.7% had untreated caries. There was no evidence this had changed since the CSAG survey. Oral hygiene was generally good, 96% were enrolled with a dentist. Audiology was assessed in 227 of 268 children (84.7%). Forty-three per cent of children received at least one set of grommets--a 17.6% reduction compared to CSAG. Abnormal middle ear status was apparent in 50.7% of children. There was no change in hearing levels, but more children with hearing loss were managed with hearing aids. CONCLUSIONS: Outcomes for dental caries and hearing were no better in CCUK than in CSAG, although there was reduced use of grommets and increased use of hearing aids. The service specifications and recommendations should be scrutinized and implemented.