Pharmacist Intervention in Promoting Men's Health (Literature Review)

University Degree Medicine and Dentistry

Student Name: YULLIS HEWIS

RN: 07152898

Word Count: 3229

Due Date 30 November 2007

Programme: MSc Advancing Pharmacy Practice

Assignment: Literature Review

Title: PHARMACIST INTERVENTIONS IN

PROMOTING MEN’S HEALTH

PHARMACIST INTERVENTIONS IN PROMOTING MEN’S HEALTH

BACKGROUND

Back to 10 years ago, in public health agenda, mostly the health of men are out of the discussion. However, the men’s health now attracting more attention from many parties recently. Talking about men’s health is not merely focused on the reproductive health that needs to be addressed. However, in most common health issues are approached as general health problems between men and women.

According to statistical data from United Nations, World Population Prospects, year 2006, the expectancy at age 60 of men is lower by 1-7% with the average of 5 years, compare to women in all countries in the world. This data indicates sex differences in survival into older ages. Among the 25 largest countries, the gap in average life expectancy between women and men is largest in the Russian Federation (13.2 years), Ukraine (10.3 years) and France (7.5 years). The gap is the smallest in Iran (1.2 years), and India (0.5 years). This evidence shows that men’s health are poorer than women’s health, by means there are important needs to improve men’s health to live better quality of life and have better life expectancy. In addition, according to the WHO, women are generally more health conscious (United Nation, World Population Prospects, 2005).

In the US, National Centre for Health Statistics 2006 data shows that the health risk factor of men are higher compare to women as men currently have higher rate of overweight and hypertension because of smoking, poor diet and less exercise. Men are also less likely to visit healthcare clinics and hospital than women. This results the mortality leading causes by chronic illness, acute heart diseases, cancer and injury are higher in men. (National Center for Health Statistics, U.S., 2005)

The similar statistical data also produced in Australia, majority of men died of cardiovascular diseases, ischemic heart diseases are twice higher than the prevalence in women. Taking part as the causes are contributed by high cholesterol level, obesity or overweight, smoking habit, unhealthy alcohol consumption, type 2 diabetes with its complication of cardiovascular risk and renal failure (Australian Institute of Health and Welfare. Australia’s Health,2004).

In the UK, according to Office of National Statistics Quarterly no.26, 2005 life expectancy of men is about five years lower that average female life expectancy. The gap is greater in lower social classes. This data indicates that male’s health in the UK is much poorer than it need be. This evidence is supported by In the UK, Derek Wanless in his review stated that life expectancy during 1900-2002 at birth or at age 65 are always higher in female than male. Top causes of years of life lost up to age 75 in England are chronic heart disease 18%, cancer 17%, injury/poisoning 9%, suicide or undetermined death 6%, stroke 6% and respiratory disease 6% (Wanless, 2005),

Nowadays, reducing health disparities between men and women should be a critical role in public health. It is well documented that under-served health needs among men result in avoidable mortality and morbidity, increase medical costs for health systems, and ultimately pose significant public policy challenges in nearly all nations. Strong evidence also indicates that disparities in health outcomes among men occur along the social fault lines of our various nation-states (Krieger, Chen, Water, Waterman, Rehkopf and Subramanian, 2005).

In England Department of Health had supported and funded Gender Equity Project. This study has been done involving 5 PCTs and Essex Primary Care Research Network, and a report has been issued in Oct 2006. The findings of this study suggested that there may be a lack of both commitment and capacity to tackle gender inequalities in any wholehearted way. There is also shortage of expertise in working specifically with men (Gender Equity Audit Report, 2005)

FACTS OF RECENT MEN’S HEALTH CONSCIOUS

In the UK, according to Office for National Statistics, General Household Survey 2003, men are much less likely to visit their GP then woman. Under the age of 45, men visit GP only half as often as woman. It is only in the elderly that the gap narrows significantly, and even then the women measurably see their GP more frequently. The health problems faced by men are compounded by their reluctance to embrace preventive strategies, their inability to communicate their concerns and health problems to health professionals (Banks, 2001).

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Men aged 15-64 years are unlikely to visit GPs compare to women and also very unlikely to be influenced by their spouses or partners. The health problems may occur by their reluctance to have preventive action. In addition, this behaviour will result in lateness for seeking help and will increase risk of further complicated illness. The proactive approach of early detection by GPs may not work. However, promoting the importance of early detection and help-seeking behaviour through practice newsletters may help. Metaphors such as looking after their bodies in the same way that they look after their motor cars may ...

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MEN’S HEALTH ISSUE, DEFINED BY AGE

There are many men’s health issue definition. In the UK, the Male’s Health Forum (MHF), an organisation who works to improve male’s health and well being in England and Wales, proposing a new definition. They uses the term “male’s health issue” to make it clear that the definition should be understood to refer to boys as well as men: “A male health issue is one arrising from physiological, social, cultural or environmental factors that have a specific impact on boys or men and/or where particular interventions are required for boys or men in order to achieve improvements in health and well-being at either the individual or the population level” (Male’s Health Forum, 2004).

As for woman, men also experience the change of condition and physiology function along with the aging process. Neglecting the nutrition, good eating habits and lifestyle in younger age, will cause the disturbance of health & sexual condition in the older age.

A cohort study of men aged 40-59 and 50-69 in seven countries concluded that a BMI of less than 18.5 kg/m2 was clearly associated with increased mortality. A BMI of more than 30 kg/m2 was more prevalent when men were older and was associated with increased mortality in ex- or never smokers. Underweight among men in all smoking categories and sever overweight in ex- or never smokers remain important predictors of increased mortality in middle-aged men when they get older (Visscher, 2000).

Age 20s is the peak of one’s health. In this periode, the body is in fit condition, without many problems, this makes most of men neglect to mind their nutrition, eating habit, not enough sleep, and lack of exercising. Usually at this stage men have very low health conscious to control their lifestyle. Mostly there is no problem in sexual health.

Age 30s is the maintainance stage. If men don’t control their eating habits, it is likely to get overweight. There is an increase rate of cholesterol and uric acid. In this stage there is a prevalence of getting hypertension, diabetes type 2. The burden of stress is higher as life is getting serious on working and starting a family. There has been a decrease in hormones production of testosterone, however in this stage, it is not manifest yet.

In age 40s there is a decreasing in physical vitality, not as energetic as 20s. Choice of sports must be considered more carefully as there may be any occurrence of having muscle and joint problems. General check up to detect any degenerative diseases should be conducted at least once a year, especially when risk factor is increasing. Sexual drive in this stage has lower down as testosterone hormone also has been decreasing. Quantity and quality of spermatozoa are also decreasing. It is not recommended to have a baby in this stage (Lunenfeld, 2005)

Guidelines for preventive Activities in general practice:

RAISING AWARENESS AND EDUCATION NEEDED

A short-term strategy could involve redeploying some of the funding currently used to finance men's health toward primary and preventive health care services for men. The first step in this process is for local communities to take a full inventory of the sources and uses of funds now allocated to men's health. This would include national programs and local initiatives.

Raising Awareness

Social marketing and other mass communication strategies are an important part of effective public health practice and should be included in all approaches by government or health systems to provide better prevention. The techniques have been refined and improved and are now a part of day-to-day public health practice in the US and internationally. They should also become part of the growing regimen to attack the disparities in men's health in an effective manner.

Worldwide approaches to conceptualization, research and analysis, advocacy, and local programming and implementation efforts are highly desirable. A global framework for capturing and describing disparities and social determinants of health establishes the men's health field as an authoritative perspective on broad structural concerns facing the world community. Perhaps most powerfully, such a global orientation would lead to inclusive systems of care and health services infrastructure that counter the effects of marginalization among vulnerable groups of men (Jadad and Delamothe, 2004).

The techniques of social marketing adopted from the commercial world can focus on specific educational levels and be tailored in such a way to be culturally sensitive and specific. Therefore, it is to be hoped that many more campaigns in the media will promote men's health and be published so that others in world-wide communities can learn important lessons to improve the health of men and therefore, that of those they love and the communities they interact in, as well (Rumm, 2005).

Education

Improving of future generation of men must include enhancing the quality the quality of educational institutions. Increased educational outreach efforts targeted men are also required.

A recent Harlem study highlighted the need for more health education. Educational outreach must includes enhancing men’s awareness that effort to redefined the cultural meaning of manhood in positive way will require parallel changes in cultural institution and social structures to reinforce positive health behaviour in men over the life course (Williams, 2003).

PHARMACIST INTERVENTION TO IMPROVE MEN’S HEALTH IN THE UK

In the UK, Pharmacies have an advantage - people visit them when they are well, not just when they are sick. Pharmacists roles are changing and they are now providing smoking cessation courses; measuring blood pressure and body mass index, to actively support public health campaigns on smoking, diet, physical activity and reducing obesity (Sinclair, Bond and Stead, 2004).

The government made clear in A Vision for Pharmacy in the new NHS published in July 2003 its intention to ensure an NHS where people have the greatest choice about the time and place they can seek advice and help. And this should apply to everyone, including men (Gender Equity Audit Report, 2005).

The new NHS contract and recent legislative changes in pharmacy facilitate the development of new roles and responsibilities in community pharmacy for the benefit of patients in the UK.

According to the MHF, pharmacies may have particular value in term of delivering services to men and their potential to do so must be explore. To address that, in partnership with the DPP: Developing Patient Partnerships, MHF on a new campaign 'Pop down your local' to inform men about the services available from pharmacies and encourage more men to use the pharmacy for health advice and treatments. The campaign - 'Pop down your local' - launching in April 2004 has been developed in partnership with a number of organisations including The Royal Pharmaceutical Society of Great Britain, The Consumer Health Information Centre (CHIC), National Pharmaceutical Association, and Blood Pressure Association (Male’s Health Forum, 2005).

In June 2007, MHF has launched a £30,000 Department of Health-funded project designed to improve the use men make of high-street pharmacies. MHF president Dr Ian Banks said: ‘Pharmacy services have a potentially significant role to play in improving the unacceptably poor state of men’s health.

In October 2007, The MHF’s ‘Men & Pharmacy’ project, which aims to find why men make only limited use of pharmacies at present and how this might be improved, will be targeting men in a large work-place – a Royal Mail site - with specially-designed, ‘male-friendly’ information which will explain what services are offered by local pharmacies and encourage men to use them.

The Forum is now developing a project in partnership with the Royal Pharmaceutical Society of Great Britain and the Department of Health to pilot the development of the information, resources and support pharmacies will need to work with men effectively (Department of Health (2007).

The project will be completed next summer and it is hoped that the findings will encourage the roll out of similar initiatives across the country (Male’s Health Forum, 2007)

AREA OF IMPROVEMENT AND FURTHER STUDY

Actually there are a lot of pharmacist interventions in promoting healthcare for men and it works both way in which MHF is very proactive to run some projects to improve men’s health. However, the result seems cannot be gained in short time of period. There must be continuous education, raising awareness to give positive impact in the future.

Besides, there is very few researches or trials on trained pharmacist to give interventions, can give positive effect to the patients, specifically to improve men’s health. Further improvement also need to address the clinical and cost effectiveness of co-ordinated interventions in public health area.

The future community pharmacy should cover chronic illness and integrate community pharmacy’s contribution to other healthcare practitioner, along the current emphasis to improve men’s health.

Not only promoting men’s health by mean preventing diseases or early detections, further challenge is to prevent mortality by improving mental health. It is required to have patient’s safety standard that be able to monitor. There is a need to conduct regular research on public attitudes towards the usage of pharmacies for general health advice to track whether and how these change over time.

SUMMARY

From the findings of current fact about men’s mortality is higher than women all over the world has raised men’s health issue of inequalities of healthcare services and also some aspects related to physiological, social, cultural, environmental. This health’s is issue has been raising awareness in the area of public health in governmental as well as independent association. In the UK, men’s health issue has been addressed well by MHF and so far there are some project that has been done or on going, coordinated with NHS and RSPGB to campaign about pharmacy and men’s health improvement. Some studies not related to men’s health has shown that pharmacist interventions are effectiveness to promote patient safety, counselling, advice giving, other skill-trained practice such as smoking cessation, obesity and other lifestyle related to improve public health. This will link to the future action that indicate the area of improvements and progress for further study about promoting men’s health.

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Pharmacist Intervention in Promoting Men's Health (Literature Review)

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