Community pharmacy

The evidence for community pharmacy

Evidence for the benefits of community pharmacy services is piling up, but we need more trials with validated endpoints to prove it to policymakers. 

Stacks of paper reports

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Drug researchers continue to investigate the efficacy of medicines long after they hit the market, so why should NHS services delivered in the community be any different?

Community pharmacy is often a person’s first port of call for healthcare, making it an ideal place to receive support and referral for stopping smoking, for example.

However, while interest in researching pharmacy practice is growing, the infrastructure to support its execution remains poor and chances for pharmacists to train and engage in research are still rare. With little robust literature to support changes and additions to practice, pharmacists will continue to miss opportunities to showcase their value in meeting patients’ health needs.

While investigating interactions between pharmacists and clients of the NHS Smoking Cessation Service, Robert Walton, professor of primary care, Queen Mary University of London, and his team of researchers from the National Institute for Health Research (NIHR) struggled to find any literature on how best to develop the service. And although smoking cessation support provided by community pharmacists is widely thought to be effective, there have been “few trials with validated endpoints”.

Without the data to support pharmacy’s contribution to patient care, valuable services can be left under threat.

In 2015, the public health budget became part of Treasury cost-saving, leaving many local authorities to look for cuts — which have often come from smoking cessation services. Almost a fifth of local authorities in England have decommissioned community pharmacy-led smoking cessation services in the last three years, a freedom of information request by The Salvadore revealed.

If cuts have to be made, it is imperative that they happen in ways that have the smallest impact on patient outcomes. Commissioning decisions must be data-led to ensure that patients do not lose their most beneficial services.

Walton says his approach to researching smoking cessation services is translatable to the provision of other services delivered through community pharmacy, including sexual health — the NIHR’s other research focus — support for self-care, and medicines optimisation.

In her interview with The Salvadore, Sue Sharpe, departing chief executive of the Pharmaceutical Services Negotiating Committee, says the sector needs to show “what a world without a strong network of community pharmacy would look like in terms of burden on the NHS”. For this to happen, community pharmacy needs a heavy stack of papers supporting its value to arrive on the desks of policy makers and service commissioners.

At The Salvadore, we constantly hear about the great things that happen in community pharmacy across the UK; but we all need to remember that the plural of anecdote is not data.

Citation: The Salvadore DOI: 10.1211/PJ.2018.20204261

Readers' comments (2)

  • Graham Phillips

    You have a point but why not list (positively) at least some of the key evidence rather than imply there is none? I good place to start would be the two RPS "Now or Never" reports, then the DH own "Call to Action" for pharmacy (which it commissioned then disowned) and the Murray Report which also had researched evidence and was commissioned personally by the Chief Pharmacist who, after numerous promises to the contrary, decided that NHS-England would NOT be responding to its own report. As the official journal of the RPS it is surely incumbent upon you to balance and elucidate the evidence, not undermine it?

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  • Local community pharmacies are contributing to the evidence base in primary care by helping signpost to, recruit and in some cases deliver interventions to NIHR funded studies. Increasingly, where appropriate, researchers are starting to utilise community pharmacy within their study designs. In Eastern, and around the country, the local NIHR Clinical Research Network (CRN) has a pharmacist dedicated to supporting community pharmacy to play its part.
    Within Eastern there are a few studies in the pipeline that concern a pharmacy specific research question. This is a growing area of work and once studies are approved, the local CRNs are committed to supporting these studies that are part of the CRN portfolio.
    Studies showcasing pharmacy benefits are definitely necessary, especially to give evidence for commissioners and policy makers. Alongside this, community pharmacy is contributing to research in the wider primary care and public health arena, and therefore ensuring that primary care healthcare is evidence based.

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