When it comes to talking about his own health, the normally macho male becomes a healthcare hermit, says pharmacy consultant Glen Savage of Pharmacoach.
“Further to IQ and EQ, if we created a new arbitrary healthcare intelligence, say HQ, men would score much lower than women on this scale. Why? Because in the matter of personal healthcare, men are the weaker sex. Women will self-examine and report anything unusual. They will proactively have regular checks, such as mammograms. If men detect something, they will often ignore it and hope it just magically goes away.”
This offers pharmacy a golden opportunity, he says. “With care and focus, pharmacy professionals could draw men out of their shells to address their health, fitness and wellbeing.”
Nick Kaye, superintendent pharmacist at S. Kaye & Son Ltd, agrees. “Men tend to be bad at engaging with healthcare, as it scares us. This, however, does put pharmacy in a unique place to intervene in men’s health.”
Since men do not engage as effectively with health services as women, particularly those of working age, they are less likely to:
• Visit a GP
• Attend a NHS health check
• Opt for bowel cancer screening
• Take a chlamydia test, or...
• Visit a pharmacy.
There is a clear link between men’s lower use of primary care and their higher rate of accessing hospital services. “Research from the Men’s Health Forum suggests that men have lower health literacy than women and are less likely to research or engage with health services, ignoring symptoms until it is often too late,” says Deborah Evans, managing director of Pharmacy Complete and previously the national lead for the healthy living pharmacy (HLP) initiative.
The research, for example, suggests that 67 per cent of men are overweight or obese, yet only 10-20 per cent of those on NHS weight loss programmes are men. The NHS health check programme, which focuses on circulatory conditions, is also underutilised by men, with the result that men account for 71 per cent of CVD-related deaths in the under-65s.
“Actively promoting the NHS health check programme through pharmacy, specifically targeting men’s health, is a good starting point and, of course, would be financially rewarding for the pharmacies themselves,” says Glen Savage.
The type of communication used will have a big impact on a man’s willingness to engage with health matters, says Trevor Gore, director of Maestro Consulting. “Men tend to be risk averse rather than reward seeking, so pharmacy teams should reframe how they promote their services to men. For example, rather than saying ‘if you do this you’ll live forever’, a message such as ‘if you don’t do this, you may not play football again’ may have more sway.”
Pharmacies need to be prepared to try something different, such as taking their services out of the pharmacy and see what happens as a result, says Nick Kaye, who has seen pharmacists doing blood pressure checks at local rugby and swimming clubs.
Gary Choo, a pharmacy consultant, agrees. “Why not go to a football match or place of work, such as an industrial estate or garage, to carry out health checks?” he asks.
“Men can be highly competitive, so a pharmacy could conduct regular weight management assessments in these locations. Men may well then put in more effort to see who loses the most.”
“We actually go to the pub and carry out blood pressure checks,” says Ade Williams of Bedminster Pharmacy in Bristol. “Rather than focusing our effort on people coming into the pharmacy, we take pharmacy out into the community. We also go to gyms and have links with local podiatrists, chiropractors and physios to encourage them to refer patients to us.
Men are no longer catching up with women in the life expectancy stakes. The latest ONS data shows that the gap between the life expectancy of men and women in the UK is no longer closing. Baby girls are now expected to live to an average age of 82.9 years, 3.7 years more than their male counterparts at 79.2 years. In 2006-8 the gap was 4.2 years.
“Each year we run a men’s health campaign called “The Bemmy Challenge”. Any man who gets his weight, waist and BP measured receives a brief alcohol intervention and a free gift. We highlight and run the campaign through local barbers and tattoo parlours, which refer people to us.
“The Lord Mayor of Bristol promoted the campaign after his health check with us by sharing his story of how he had to lose weight as he was pre-diabetic and needed to cut out eating cakes at functions!”
Many pharmacies have become involved in the healthy living pharmacy initiative, especially since this was included as part of the Quality Payments Scheme in England. To be awarded HLP status, pharmacy teams must demonstrate and apply a healthy living ethos throughout their daily practice by providing advice
on a range of lifestyle-related health issues.
“Being a healthy living pharmacy has helped us to become aware of our local health profile, which helps us to frame and deliver our services. For example, we know that a high proportion of men in our local community smoke, so we run a successful smoking cessation programme,” says Ade Williams.
Getting your team involved is a really important part of the HLP model, says Deborah Evans. “The reality is that community pharmacy will lose business to online providers unless it adds value at every opportunity. When running a pharmacy business, providing a memorable customer experience is essential.
“Ensure every team member is adding value and making the pharmacy indispensable to the local community. Look at what is happening around you. What can you do to protect your business and the sector?”
The HLP programme offers not only good business benefits but can help make inroads in engaging men with healthcare, says Glen Savage. “Pharmacies need to be going beyond just customer service and delivering a customer experience. Pharmacies should seriously look at the HLP programme and consider what it can do for their customers and their business.”
Recent research from TENA Men has revealed that one in two men in the UK (58 per cent) do not talk openly about their health, with up to 90 per cent choosing to ignore a health concern in a bid to avoid discussing their worries, says training and brand manager Donna Wilson.
When asked, 25 per cent said it was the fear of treatment that held them back from discussing common men’s health concerns, such as urine leakage and prostate problems.
TENA highlights three steps that should help reassure any men who may feel uncomfortable about raising such a sensitive issue:
• Point out that urine leakage is experienced by one in four men over the age of 40 years. Explain that, should they wish to discuss their experience of bladder weakness, a quiet area or consultation room is available to discuss this in private
• Tell them there are products on the market for urine leakage, such as TENA Men, that have been specifically designed for the male anatomy
• Advise them about the self-help steps they can take, such as avoiding stimulants like alcohol and caffeine and eating healthily to avoid constipation that puts pressure on the bladder.
TENA recently upgraded its offering for men with TENA Men Premium Fit Level 4 Pants and TENA Men Active Fit Pants. The latter are our most boxer-like design to date, says Wilson, while the new masculine finish of TENA Men Premium Fit Level 4 Pants is designed to help men feel less afraid of using our products.
“They look more underwear-like than ever before, while maintaining the level of protection needed to prevent unwanted leakage,” she says. The pants are available in both a medium and large fit.
It can be a challenge to get men to talk about delicate subjects or indeed any personal matters. “Men can be harder to engage with on health topics as they may not visit the pharmacy as often as women, and are less inclined to open up and discuss any problems or concerns,” says Clare Clark of Alphega Pharmacy.
“Many men find talking about conditions such as hair loss or weight management embarrassing – so counter staff need to be aware of the sensitive nature of these conditions and make use of the consultation room or private area when appropriate.”
There is a very prominent sign in our pharmacy saying that there is a private consultation room available, says Ade Williams. Other practical ideas include signs around the pharmacy pointing out that patients can speak to a female or male member of staff.
Some things that have worked well include simple shelf-edge labels highlighting men’s health issues near to products such as male toiletries and medication for pain relief and fungal nail infections, says Nick Kaye.
“We also use leaflets and a lot of material from the Men’s Health Forum,” adds Ade Williams. “We have posters around the pharmacy on issues such as weight and alcohol – they were easy to download from the website and contain a good balance of humour and information.”
Technology should also be harnessed to target men. Messages on pharmacy websites, including what services are offered, are important, says Glen Savage. “Simple tools like a BMI calculator and information on signs and symptoms of male-related conditions can help to draw men into the pharmacy.”
We take pharmacy out into the community
“There are many common conditions affecting men’s health that pharmacy teams can easily help with,” says Clare Clark of Alphega Pharmacy. Men can be harder to engage with on health topics, as they are infrequent visitors to the pharmacy and less inclined to open up and discuss any problems or concerns, she says. “The key to handling these conversations well is good staff knowledge of the subject area.”
Cigarettes and alcohol (and weight)
Having information readily available on diet and healthy eating, exercise, weight management, smoking and alcohol consumption can all help improve wellbeing in men. There are now many free apps and wearable tech available that can be recommended to your male customers to track their calorie intake and calories burned from exercise. These apps also calculate whether there is a calorie deficit or excess and help keep customers on track with their goals.
Male pattern baldness
Male pattern baldness affects about half of men by the age of 50 years. It usually starts in the late 20s or early 30s, with most men experiencing hair loss to some extent by their late 30s. Male pattern baldness is hereditary and is thought to be caused by oversensitive hair follicles and has been linked to male hormone levels. There are two main treatments available but only one (minoxidil) is available over the counter. The level of success of these treatments varies from person to person and they require a degree of commitment as they only work for as long as they are used.
Sports injuries are common, especially in men new to an unfamiliar sport. Where appropriate, they should look for sensible, quick and easy help, such as a hot or cold pack, depending on the type of injury and when the injury occurred. PRICE (Protect, Rest, Ice, Compression and Elevation) and avoiding HARM (Heat, Alcohol, Running and Massage) in the first 48 hours after injury is good practical advice for sports injuries. Over-the-counter analgesics, such as anti-inflammatories, help to relieve pain as well as reduce any inflammation.
Fungal conditions, such as toenail infections or athlete’s foot, can easily be treated with OTC products, although persistence is needed as some can take a number of months to clear. Good foot hygiene can prevent the most common problems. This includes:
• Washing feet regularly to remove any dirt and prevent infection
• Drying the feet well, especially between the toes, otherwise this can lead to athlete’s foot
• Removing hard skin regularly using a foot scrub, pumice stone or foot file
• Cutting toenails correctly – straight across, level with the top of the toe
• Changing socks daily
• Wearing flip-flops in communal changing areas and around swimming pools to avoid catching verrucas.
Advice on self-examination and how to spot the warning signs for testicular and other cancers is important, along with the distribution of information leaflets. It is vital to have signposting material readily available to assist in conversations with male customers who have questions or concerns about cancer and their health generally.