Obesity Management
with
associated risk factors programme
Presentation
To
Health & Well-being Partnership board
Meera Sharma BPharm (Hons), MRPharmS, PGDip
Professional Services Manager
Objectives
• Background
• Pharmacy & pharmacist
selection
• Service process
• Training & Communication
Skills
• Progress to-date
• Future Vision
Obesity & Coventry Teaching PCT
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Coventry’s population 300,848
50% adult population overweight
23% clinically obese = 51,622
60% eat less 5 portions of fresh fruit & vegetables
Only 22% travel to work by foot bicycle public transport
Coventry’s vision for public health
• Improve people’s dietary habits and increase physical
activity
• To provide weight management services to reduce mortality
and morbidity
• Improving the health of the local population
Aim of Service
To provide a weight management service for patients with a BMI (3038kg/m2) with at least ONE diagnosed or established risk factor. Risk
factors include:
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Hypertension
Type -11 Diabetes
Hyperlipidaemia
Increased waist circumference – Male 102cm (40 ins) Female 88cms (35ins)
Why Community Pharmacy?
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Ready accessibility for advice & support
Ideally located for improving public health
Part of primary healthcare team & inter-professional working
Community pharmacy contract provides foundation for quality, costeffective patient services
Pharmacy and Pharmacist Selection
Criteria included:
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Pro-active pharmacist and support staff enthusiastic about opportunity
presented by programme,
Pharmacy has consultation area that has been verified during monitoring
visits to meet contract specification
Consultation area has sink available for use
Pharmacy has achieved a satisfactory contract monitoring report 2006-7
Pharmacist is HEI accredited for providing MUR service
Pharmacist is providing MUR service (> 10 MURs completed, claimed and
documented)
Pharmacy has demonstrated through past performance that it will actively
engage and support local intimates and services
Suitable pharmacy location (to ensure good geographical distribution)
Selection was carried out jointly by Coventry Teaching PCT & LPC
Acknowledgements
To all who were involved in the development of this programme
Dr Terry Maguire
Equipment training for measuring the following parameters:
HbA1c
Blood Pressure
BMI
Weight
Height
Total
Cholesterol
Pharmacist and support staff training
• 1- day training programme provided by Dr Terry Maguire,
which covered:
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Behavioural change
Facilitating healthy choices by patients
Techniques to change dietary, lifestyle and exercise habits
Sustainable, realistic and gradual modification
• Motivational interviewing technique skills:
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Patient ‘wins’ & ‘challenges’
Patient’s typical day in terms of diet, lifestyle and exercise
Provision of tailored, bespoke information
Working towards target systematically
Facilitating decision making, without jumping in with answers
Successful engagement with patient
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Express empathy with patient
Develop structured, personalised plans
Avoid confrontations/challenges with the patient
Roll with patient resistance to change
Work within boundaries that the patient is comfortable
with
• Active listening
Planning with the patient
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Create a tailored plan
Be realistic
2lbs per week
Old habits die hard!!!
Small Changes Big Benefits
Aim for a 500 calorie reduction in calorie intake per day to achieve
a 1-2lb weight loss per week
Resources available
Local resources
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Expert Patient Programme
Exercise Specialist
Dietician
Coventry Teaching PCT personnel
Expert resources
• GPs & nurses
• UniChem Professional Services Team – project facilitation
• Equipment suppliers and pharmaceutical Industry support
• Academic experts e.g. Dr Terry Maguire,
• Department of Health guidance
National resources
• Websites e.g. Diabetes UK, British Heart Foundation etc.
• National publications e.g. NICE guidance, Skills for Health National Workforce
Competency Frameworks
Progress to-date
• 29 patients enrolled onto service since launch on 10th January 2007
• 1 peer-review meeting held, which was productive and allowed all
pharmacists to feedback on successes/challenges
Future vision
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To gather programme data and outcomes for academic research
and evaluation of service for publication
• To develop a Weight Management Programme for Children and
Adolescents
• Pharmacy to be seen as first port of call for patients and GPs to
see pharmacy as a valuable patient referral pathway
• To provide a sustainable and cost effective programme through
out Coventry PCT for the people of Coventry
Implications for Health & Well Being Partnership
• Estimated obesity rate for West Berkshire is 21.5%,
which is higher than the regional average
• The above Coventry Teaching PCT model can be
adapted for roll-out within West Berkshire
• Similar selection, training and recruitment process
• Can adapt patient inclusion & exclusion criteria
according to local needs
• Engagement with local healthcare professionals can be
built into the model for seamless patient care
Supporting the patient
Pharmacist
GP
PCT
Dietician
Partner organisations
Expert Patient
Group
Exercise Expert
Together Everyone Achieves More
Thank you
Questions?