Pharmacists can help patients stick to their New Year’s Resolutions… but it’s not easy, writes Ben Basger
With a new year upon us, it is interesting to reflect upon the two main factors responsible for premature disease and mortality.
One is smoking. The other is poor nutrition resulting largely from the sugar, alcohol, salt, and saturated fat content of ready-to-consume food and drink, much of which is manufactured on an industrial scale.
Collectively, these dietary components are the main drivers of the global epidemic of stroke, heart attack, obesity, and type 2 diabetes.
There is little lifestyle choice in avoiding such a nutritional assault unless one is knowledgeable and wealthy enough to buy the right unprocessed foods and organise one’s own cooking.
What about if one has made a resolution? Processed foods rich in added sugar, salt, and saturated fat are convenient, cheap, heavily advertised, and ubiquitous. A hamburger and fries and a non-diet canned drink can, at a modest cost, provide more than half a person’s daily calorific requirement − an important economic choice for people on low incomes.
So where do resolutions fit in? Perhaps a springboard to a healthier lifestyle has been provided by your GP—but there is a problem! GPs have been shown to counsel only about a third of patients who are overweight, and this rate decreases with increasing weight (AFP 2017; 46 (10): 751-755).
In addition to this, doctors overestimate the effect of their counselling. In fact, it has been shown that only about half believe patients would follow their recommendations (Family Practice 2012; 29:553–560, doi:10.1093/fampra/cms004).
What about pharmacist support of New Year’s Resolutions? Does this time of year provide us with an opportunity to ask our patients if they have made any lifestyle resolutions? Is this an opportunity to open a dialogue with them?
This appears to depend upon the type of pharmacist that you are. For example, it has been shown that public trust in GPs was greater than that in pharmacists. Many were reluctant to trust pharmacists to deliver unfamiliar services.
Numerous system-based factors were found to reinforce public trust and confidence in GPs including GP registration and appointment systems, GPs’ expert/gatekeeper role and their practice environments (BMJ Open 2012;2:e000939. doi:10.1136/bmjopen-2012-000939).
Of course, with the right ingredients—proactivity, communication skills, knowledge, empathy − pharmacists (like anybody) can establish a rapport with people. This could be put to good use in promoting people’s New Year’s Resolutions.
Dr Ben Basger PhD MSc BPharm DipHPharm FPS AACPA is a clinical pharmacist and educator at Wolper Jewish Hospital and The University of Sydney, NSW.