‘At least my computer doesn’t nag me when I reach for the biscuits.’


a man eating a biscuit looking worried

Pharmacists shouldn’t be telling customers to lose weight, or they may risk turning people away to online pharmacies, argues this commentator

A National Institute for Health and Care Excellence (NICE) draft quality standard published this month says UK pharmacists can use patient transactions to start general conversations about wellbeing.

This includes encouraging patients to stop smoking, cut down on drinking and/or lose weight.

It says that when community pharmacy teams dispense medicine, sell over-the-counter products or are asked for advice, “they can use the opportunity to start a more general conversation about health and wellbeing”.

“Community pharmacy teams can offer support with adopting a healthier lifestyle, including stopping smoking, reducing alcohol consumption and managing weight,” reads the standard.

One commentator has written an editorial response arguing that “pharmacists shouldn’t be telling customers to lose weight”.

“I’ve had a number of embarrassing run-ins with pharmacists … But never has a pharmacist commented on my weight. This might be about to change,” writes Joanna Williams in The Spectator.

“Under new guidance from NICE, chemists are being urged to chat to customers about diet, alcohol consumption and smoking. They could then go on to suggest lifestyle changes or recommend a GP’s appointment.

“We can only imagine how these conversations might go. Presumably, requests for the morning after pill will be accompanied by a recommendation not to open the second bottle of wine next time. Indigestion? Stay off the fatty food. Calpol (paracetamol), nit lotion and a tube of athlete’s foot cream? You look like you could do with losing a few pounds. Just want to pick up a prescription? Let’s discuss that pack of cigarettes sticking out of your jacket pocket.

“Having pharmacists tell customers that they could do with shedding a few pounds each time they pop in to stock up on paracetamol is unlikely to encourage weight loss – though it may well raise blood pressure,” says Dr Williams.

While the new NICE guideline refers mostly to community pharmacy, an independent evaluation found over half of GP pharmacists in the UK already give lifestyle advice to patients every day.

Australian pharmacists have been offering lifestyle advice for a while – the PSA’s 2017 Professional Practice Standards lists ‘counselling’ as a criteria for patient-centred care, which includes “provid[ing] primary health care to patients, and offer[ing] information on alternative non-pharmacological options and lifestyle advice to complement the use of non-prescription medicines or therapeutic devices.”

The standards also say that “pharmacists can encourage their patients to identify social support networks, adopt healthy lifestyles and consider the effect of their health choices on their wellbeing” and that “pharmacists have the ability to raise awareness of the risks of poor health through evidence-based pharmacy services and advice.”

Additionally, research findings indicate that implementation of lifestyle advice programs in pharmacies is feasible and may lead to positive health outcomes such as reduced blood pressure and reduced HbA1c.

However Dr Williams isn’t having a bar of it.

“Being lectured about the importance of living according to NICE-approved rules risks turning people away from high street chemists altogether and promoting the use of online pharmacies,” she argues.

“Redundant pharmacists benefit no one but at least my computer doesn’t nag me when I reach for the biscuits – yet.”

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