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Help shape future policies and practice

Community pharmacists are being urged by the National Institute for Health and Care Research to help ensure its research applies to all members and groups in society and “better reflects the location of the burden of disease”.

With a budget of £1.3bn, the NIHR funds “health, public health and social care research that leads to improved outcomes for patients and the public, and makes the health and social care system more efficient, effective and safe”.

“Reducing inequity and inequality is core to the NIHR agenda,” says Dr Jemma Kwint, senior research fellow at the Institute. “We want to move research away from the traditional centres, where the population may be healthier, to better reflect the location of the burden of disease. Involving the public can be difficult but every time we fund a project, the applicant needs to demonstrate that research is placed in areas of highest need.” And this is where community pharmacy comes in.

“Community pharmacists are an important audience and stakeholder group. The NIHR works really hard to ensure that the research applies to all members and groups in society. Pharmacists are exceptionally well placed to understand the needs and issues in their local area,” says Dr Kwint. “However, few studies actually involve community pharmacists.”

Insights from the community sector

Certainly, community pharmacists can offer invaluable insights. Dr Kwint recently collaborated with a community pharmacist to summarise examples of NIHR research that could help pharmacies further support local communities.

Importantly, the studies chosen reported “actionable findings for the pharmacy team and commissioners” to increase the breadth of services in areas such as polypharmacy, sexual health, dermatology and health needs among marginalised groups. The studies included:

Managing polypharmacy: One programme suggested ways in which community pharmacy teams could help people manage polypharmacy. “An important finding was that older people and their families may not tell anyone when they find managing medication a burden,” says Dr Kwint. 

The study suggested that pharmacists could consider the polypharmacy burden in the same way that they think about possible side-effects with a new or different medicine. The study also highlighted the need for a simple strategy, such as a couple of questions, to indicate who needs more help, advice or support.

Another NIHR-funded study showed that pharmacists are not always aware of the difficulties facing people managing medicines towards the end of life. Suggestions that help people at this difficult time included:

  • Providing clear instructions on the box
  • Giving out laminated prompt cards allowing patients and carers to record daily doses. These can be wiped clean each week
  • Directly asking how patients take their medications and if there are any problems.

Helping marginalised groups

Community pharmacists and their teams can help the homeless, people who abuse street drugs and other marginalised groups to access services. 

For example, many pharmacies offer needle and syringe exchange schemes for people who inject drugs but pressure on local budgets often means that injection packs do not include sterile water. As a result, homeless people sometimes use puddle water, alcoholic and soft drinks, saliva and even toilet cistern water to prepare injections, which increases the risk of potentially fatal infections. Pharmacies could distribute water for injection much more widely, it is suggested. 

Time to get involved?

With so much pressure on pharmacists, is there the time and are there the resources to allow them to become more involved in research? Dr Kwint argues that research benefits both patients and pharmacy teams. “Research means that we learn more about a condition and its management,” she says. “Patients may be able to access more services and research attracts additional funding. We believe there is plenty of space for pharmacists to be more involved in research.” 

Indeed, several initiatives aim to increase community pharmacists’ engagement in research programmes. The Royal Pharmaceutical Society and the NIHR, supported by the Association of Pharmacy Technicians UK, have launched an e-learning module for pharmacists and pharmacy technicians to develop their skills and knowledge in the research field.3 

The NIHR also introduced the Your Path in Research initiative that outlines how health professionals, including community pharmacists, can make research part of their career.4 

“There is a lot of support for community pharmacists to become more involved in research,” Dr Kwint concludes. “Research helps patients, the public and pharmacists themselves. By being involved in research, community pharmacists can help shape the future policies and practices in tomorrow’s NHS.”

Research highlights skin misconceptions

Misconceptions about acne and eczema can hinder effective management of these skin diseases, NIHR reviews have found. 

Acne patients often blame themselves, incorrectly thinking that their diet or skin care routine is responsible. Eczema sufferers, meanwhile, may be reluctant to use topical corticosteroids because they worry about skin damage and other long-term adverse events. 

“People often do not realise that acne and eczema require long-term treatment, which can lead to frustration and disappointment,” says Dr Jemma Kwint. “Pharmacists are well placed to address these misunderstandings.” 

They could, for instance, help people understand how long acne and eczema treatments take to start working, how to manage side-effects and appropriate long-term use. Pharmacists can also reassure patients that topical corticosteroids are, when used correctly, safe and effective, and signpost people to reliable sources of information.

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