Primary studies included in this systematic review

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Primary study

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The effectiveness of brief alcohol interventions delivered by community pharmacists: randomized controlled trial.

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Journal Addiction (Abingdon, England)
Year 2015
Links Pubmed DOI PubMed Central www.epistemonikos.org

This article is included in 1 Systematic review Systematic reviews (1 reference)

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Background and Aims To undertake the first randomized controlled trial to evaluate the effectiveness of a brief intervention delivered by community pharmacists to reduce hazardous or harmful drinking. Design This parallel group randomized trial allocated participants individually to brief alcohol intervention ( n = 205) or a leaflet-only control condition ( n = 202), with follow-up study after 3 months. Setting Sixteen community pharmacies in one London Borough, UK. Participants A total of 407 pharmacy customers (aged 18 years or over) with Alcohol Use Disorder Identification Test (AUDIT) scores 8-19, inclusive. Intervention A brief motivational discussion of approximately 10 minutes' duration, for which 17 pharmacists received a half-day of training. Measurements Hazardous or harmful drinking was assessed using the AUDIT administered by telephone by a researcher blind to allocation status. The two primary outcomes were: (1) change in AUDIT total scores and (2) the proportions no longer hazardous or harmful drinkers (scoring < 8) at 3 months. The four secondary outcomes were: the three subscale scores of the AUDIT (for consumption, problems and dependence) and health status according to the EQ-5D (a standardized instrument for use as a measure of health outcome). Findings At 3 months 326 (80% overall; 82% intervention, 78% control) participants were followed-up. The difference in reduction in total AUDIT score (intervention minus control) was -0.57, 95% confidence interval (CI) = -1.59 to 0.45, P = 0.28. The odds ratio for AUDIT ˂ 8 (control as reference) was 0.87, 95% CI = 0.50 to 1.51, P = 0.61). For two of the four secondary outcomes (dependence score: -0.46, 95% CI = -0.82 to -0.09, P = 0.014; health status score: -0.09, 95% CI = -0.16 to -0.02, P = 0.013) the control group did better, and in the other two there were no differences (consumption score: -0.05, 95% CI = -0.54 to 0.44, P = 0.85; non-dependence problems score: -0.13, 95% CI = -0.66 to 0.41). Sensitivity analyses did not change these findings. Conclusions A brief intervention delivered by community pharmacists appears to have had no effect in reducing hazardous or harmful alcohol consumption.

Primary study

Unclassified

Internet-based photoaging within Australian pharmacies to promote smoking cessation: randomized controlled trial.

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Journal Journal of medical Internet research
Year 2013
Links Pubmed Health Technology Assessment (HTA) DOI PubMed Central crd.york.ac.uk

This article is included in 2 Systematic reviews Systematic reviews (2 references)

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BACKGROUND: Tobacco smoking leads to death or disability and a drain on national resources. The literature suggests that cigarette smoking continues to be a major modifiable risk factor for a variety of diseases and that smokers aged 18-30 years are relatively resistant to antismoking messages due to their widely held belief that they will not be lifelong smokers. OBJECTIVE: To conduct a randomized controlled trial (RCT) of a computer-generated photoaging intervention to promote smoking cessation among young adult smokers within a community pharmacy setting. METHODS: A trial was designed with 80% power based on the effect size observed in a published pilot study; 160 subjects were recruited (80 allocated to the control group and 80 to the intervention group) from 8 metropolitan community pharmacies located around Perth city center in Western Australia. All participants received standardized smoking cessation advice. The intervention group participants were also digitally photoaged by using the Internet-based APRIL Face Aging software so they could preview images of themselves as a lifelong smoker and as a nonsmoker. Due to the nature of the intervention, the participants and researcher could not be blinded to the study. The main outcome measure was quit attempts at 6-month follow-up, both self-reported and biochemically validated through testing for carbon monoxide (CO), and nicotine dependence assessed via the Fagerström scale. RESULTS: At 6-month follow-up, 5 of 80 control group participants (6.3%) suggested they had quit smoking, but only 1 of 80 control group participants (1.3%) consented to, and was confirmed by, CO validation. In the intervention group, 22 of 80 participants (27.5%) reported quitting, with 11 of 80 participants (13.8%) confirmed by CO testing. This difference in biochemically confirmed quit attempts was statistically significant (χ(2) 1=9.0, P=.003). A repeated measures analysis suggested the average intervention group smoking dependence score had also significantly dropped compared to control participants (P<.001). These differences remained statistically significant after adjustment for small differences in gender distribution and nicotine dependence between the groups. The mean cost of implementing the intervention was estimated at AU $5.79 per participant. The incremental cost-effectiveness ratio was AU $46 per additional quitter. The mean cost that participants indicated they were willing to pay for the digital aging service was AU $20.25 (SD 15.32). CONCLUSIONS: Demonstrating the detrimental effects on facial physical appearance by using a computer-generated simulation may be both effective and cost-effective at persuading young adult smokers to quit. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry: ACTRN12609000885291; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12609000885291 (Archived by WebCite at http://www.webcitation.org/6F2kMt3kC).

Primary study

Unclassified

Thai community pharmacist involvement in weight management in primary care to improve patient's outcomes.

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Journal International journal of clinical pharmacy
Year 2013
Links Pubmed DOI

This article is included in 1 Broad synthesis Broad syntheses (1 reference) 2 Systematic reviews Systematic reviews (2 references)

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BACKGROUND: The community pharmacist has significant potential to assist in providing health advice aimed at the improvement outcomes pertaining to weight management, however, up to now, evidence regarding its effectiveness has been inconclusive. In Thailand, community pharmacy involvement in weight management is a novel idea and therefore needs an evaluation of its effectiveness. OBJECTIVE: To examine essential outcomes, comparing the pharmacist's interventions with a routine weight management service provided at a primary care unit (PCU). SETTING: Maha Sarakham province, Thailand. METHODS: A randomized controlled trial was designed involving sixty-six obese patients randomly assigned to either the control group or the experimental group. Participants in the control group received group counselling from the PCU staff as usual, while those participants in the experimental group received one-on-one advice from a community pharmacist along with the weight loss handbook for self-study. Both groups were followed up and clinical outcomes were monitored four times at weeks 0, 4, 8, and 16. Eating behaviours and knowledge about overweight and obesity were measured twice, at weeks 0 and 16. MAIN OUTCOME MEASURE: Clinical outcomes included weight, waist circumference, body mass index, measured by standard medical devices. Eating behaviours were measured by the theory of planned behaviour (TPB) questionnaire. Knowledge was measured by a questionnaire focusing on the subjects' level of understanding regarding overweight and obesity issues. RESULTS: Neither group showed improvement in clinical outcomes. The TPB average sum score significantly increased from baseline in the experimental group in terms of intention to perform healthy dieting behaviour, subjective norm, behavioural beliefs, normative beliefs, and control beliefs. (P < 0.05) In the control group, scores increased significantly from the baseline only for behavioural beliefs. (P < 0.05) Moreover, the knowledge score in experimental group increased significantly from 6.42 ± 1.94 to 8.75 ± 0.68 (P < 0.05). CONCLUSION: Thai community pharmacists can help to improve both eating behaviour and knowledge about weight and obesity among obese patients. However, since the effect on clinical outcomes is unclear, a long-term study is still needed.

Primary study

Unclassified

One-year outcomes and a cost-effectiveness analysis for smokers accessing group-based and pharmacy-led cessation services.

Journal Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco
Year 2011
Links Pubmed Health Technology Assessment (HTA) DOI crd.york.ac.uk

This article is included in 2 Systematic reviews Systematic reviews (2 references)

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INTRODUCTION: An observational study examining 1-year follow-up of clients of two National Health Service smoking cessation services in Glasgow was used to inform a cost-effectiveness analysis. One service involved 7 weeks of group-based support (n = 411) and the other consisted of up to 12 weeks of one-to-one counseling with pharmacists (n = 1,374). Pharmacological aids to quitting (e.g., nicotine replacement therapy) were available to all clients. METHODS: Quit rates were calculated for each service at 52 weeks after the quit date, and these were used for an economic evaluation of both the annual and the lifetime cost-effectiveness of the pharmacy- and group-based interventions in comparison with a baseline "self-quit" scenario. The annual cost-effectiveness model established the incremental cost per 52-week quitter, while a Markov model was developed for the lifetime analysis to estimate the potential lifetime outcomes in terms of cost per quality-adjusted life years (QALY) gained, to account for the benefits quitters will receive in terms of extended life years and improvements in quality of life from smoking cessation. RESULTS: The proportion of carbon monoxide-validated quitters from both services combined fell from 22.5% at 4-week follow-up to 3.6% at 52 weeks. The group service achieved a higher quit rate (6.3%) than the pharmacy service (2.8%) but was more intensive and required greater overhead costs. The lifetime analysis resulted in an incremental cost per QALY of £4,800 for the group support and £2,600 for pharmacy one-to-one counseling. CONCLUSIONS: Despite disappointing 1-year quit rates, both services were considered to be highly cost-effective.

Primary study / Primary study

Unclassified

Screening and brief interventions for alcohol misuse delivered in the community pharmacy setting: a pilot study.

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Authors Watson MC , Stewart D.
Conference International Journal of Pharmacy Practice
Year 2011
Links DOI Oxford Acaddemico

This article is included in 1 Systematic review Systematic reviews (1 reference)

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Primary study

Unclassified

Effectiveness of pharmacist counseling combined with nicotine replacement therapy: a pragmatic randomized trial with 6,987 smokers.

Journal Cancer causes & control : CCC
Year 2011
Links Pubmed DOI

This article is included in 3 Systematic reviews Systematic reviews (3 references) 1 Broad synthesis Broad syntheses (1 reference)

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UNLABELLED: Pharmacists may be effective health care practitioners to deliver smoking cessation interventions. This paper examines the short-term outcomes of smokers randomized to one of two models of a pharmacist-led smoking cessation intervention. METHODS: An open-label pragmatic randomized trial compared two models of a pharmacist-led behavioral intervention [Group A (3-sessions) vs. Group B (1-session)] in conjunction with 5 weeks of nicotine replacement therapy (NRT). Ninety-eight pharmacies in Ontario, Canada delivered the intervention. Baseline demographic and smoking behavior data were recorded, as were intervention characteristics. Self-reported, 7-day point prevalence quit rates were obtained 5-week postintervention start date. RESULTS: 6,987 individuals participated; 51.4% (n = 3588) randomized to Group A; 48.6% (n = 3399) to Group B. Approximately, 50% of Group A participants completed all three sessions. Quit rates were significantly higher among Group A, 3-session completers (27.7%; n = 478) compared to Group B participants (18.0%; n = 604). Multivariable results suggest that even when controlling for possible confounders and clustering across pharmacies, Group A participants who completed all three sessions were more likely to quit compared to Group B [OR = 1.72 (95% CI: 1.53, 1.94)]. CONCLUSIONS: Cessation outcomes are higher among participants completing three intervention sessions compared to one session; however, many do not return for follow-up sessions.

Publication Thread

Jolly K et al

This thread includes 2 references

Primary study

Unclassified

Evaluation of the Heart of Birmingham teaching Primary Care Trust (HoBtPCT) My Choice Weight Management Programme.

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Authors Bush J , Langley Ch , Patel A , Harvey J
Journal Aston University
Year 2011
Links Aston University

This article is included in 1 Systematic review Systematic reviews (1 reference)

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SUMARY: This report details an evaluation of the My Choice Weight Management Programme undertaken by a research team from the School of Pharmacy at Aston University. The My Choice Weight Management Programme is delivered through community pharmacies and general practitioners (GPs) contracted to provide services by the Heart of Birmingham teaching Primary Care Trust. It is designed to support individuals who are ‘ready to change’ by enabling the individual to work with a trained healthcare worker (for example, a healthcare assistant, practice nurse or pharmacy assistant) to develop a care plan designed to enable the individual to lose 5-10% of their current weight. The Programme aims to reduce adult obesity levels; improve access to overweight and obesity management services in primary care; improve diet and nutrition; promote healthy weight and increased levels of physical activity in overweight or obese patients; and support patients to make lifestyle changes to enable them to lose weight. The Programme is available for obese patients over 18 years old who have a Body Mass Index (BMI) greater than 30 kg/m2 (greater than 25 kg/m2 n Asian patients) or greater than 28 kg/m2 (greater than 23.5 kg/m2 in Asian patients) in patients with co-morbidities (diabetes, high blood pressure, cardiovascular disease). Each participant attends weekly consultations over a twelve session period (the final iteration of these weekly sessions is referred to as ‘session twelve’ in this report). They are then offered up to three follow up appointments for up to six months at two monthly intervals (the final of these follow ups, taking place at approximately nine months post recruitment, is referred to as ‘session fifteen’ in this report).

Primary study

Unclassified

Effectiveness of a smoking cessation intervention in Dutch pharmacies and general practices

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Journal Health Education
Year 2010
Links DOI http://dx.doi.org/10.1108/09654281011008726

This article is included in 1 Broad synthesis Broad syntheses (1 reference) 1 Systematic review Systematic reviews (1 reference)

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ABSTRACT: Purpose ? The purpose of this paper is to test the effectiveness of a computer?tailored smoking cessation intervention, distributed through 75 Dutch general practices (GP) and 65 pharmacies (PH) in a randomised control trial.Design/methodology/approach ? Respondents receive a tailored letter or a thank you letter (control condition). Main outcome measures are a quit attempt, seven?day abstinence and continued abstinence at follow?up (PH: three and 12 months, GP: six months). Effect of use and appreciation of the tailored letter are also tested.Findings ? In total, 1,019 smokers are recruited (545 in PH study, 474 in GP study). At 12?month follow?up (PH), respondents receiving the tailored letter report quit attempts significantly more often. No main effects are found in the GP sample. However, reading the tailored letter more than once (GP) and talking with others about the tailored letter (PH) are borderline significant predictors of quitting and point prevalence abstinence.Research limitations/implications ? Positive effects of the intervention in a previous efficacy study are not repeated. The possible influence of power, social desirability and testing effect, extraneous events, the availability of the intervention outside the study and data entry issues are presented.Practical implications ? Possible explanations for the results found in the study and improvements of the intervention are discussed. This can guide researchers in future smoking cessation intervention development and testing.Originality/value ? The paper aims to replicate findings from a previously conducted efficacy study under real?life circumstances.

Primary study

Unclassified

A tailored intervention to support pharmacy-based counseling for smoking cessation

Journal Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco
Year 2010
Links Pubmed DOI PubMed Central

This article is included in 5 Systematic reviews Systematic reviews (5 references) 1 Broad synthesis Broad syntheses (1 reference)

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Introduction: Pharmacists are uniquely positioned within the community to provide smoking cessation counseling to their patients. However, pharmacists experience significant barriers to providing counseling, including limited time, reimbursement, and training in counseling techniques. We tested a computer-driven software system, "Exper_Quit" (EQ), that provided individually tailored interventions to patients who smoke and matching tailored reports for pharmacists to help guide cessation counseling. Methods: A two-phase design was used to recruit an observation-only group (OBS; n = 100), followed by participants (n = 200) randomly assigned to receive either EQ-assisted pharmacist counseling or EQ plus 8 weeks of nicotine transdermal patch (EQ+). Both treatment groups were scheduled to receive two follow-up counseling calls from pharmacists. Results: Most participants in the EQ and EQ+ groups reported receiving counseling from a pharmacist, including follow-up calls, while none of the OBS participants reported speaking with the pharmacist about cessation. At 6 months, fewer OBS participants reported a quit attempt (42%) compared with EQ (76%) or EQ+ (65%) participants (p < .02). At 6 months, 7-day point-prevalence abstinence was 28% and 15% among the EQ+ and EQ groups, respectively, compared with 8% among OBS participants (p < .01), and EQ+ participants were twice as likely to be quit than were EQ participants (p < .01). Discussion: A tailored software system can facilitate the delivery of smoking cessation counseling to pharmacy patients. Results suggest that EQ was successful in increasing (a) the delivery of cessation counseling, (b) quit attempts, and (c) quit rates. Pharmacists can play an important role in the effective delivery of smoking cessation counseling. © The Author 2010. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco.