Pharmacist interventions for obesity: improving treatment adherence and patient outcomes

Integrated Pharmacy Research and Practice Dovepress open access to scientific and medical research Review Integrated Pharmacy Research and Practice downloaded from https://www.dovepress.com/ by 54.37.163.172 on 12-Jul-2018 For personal use only. Open Access Full Text Article Pharmacist interventions for obesity: improving treatment adherence and patient outcomes This article was published in the following Dove Press journal: Integrated Pharmacy Research and Practice 8 July 2015 Number of times this article has been viewed Melanie A Jordan Jonathan Harmon College of Pharmacy – Glendale, Midwestern University, Glendale, AZ, USA Introduction Correspondence: Melanie A Jordan Department of Pharmaceutical Sciences, College of Pharmacy – Glendale, Midwestern University, 19555 North 59th Avenue, Glendale, AZ 85308, USA Tel +1 623 572 3578 Fax +1 623 572 3565 Email Obesity is currently a worldwide pandemic. Of the world’s population, an estimated 35% of adults are overweight – defined by the World Health Organization (WHO) as a body mass index (BMI) of $25 kg/m2.1 Globally, an estimated 12% of adults are obese (BMI $30 kg/m2), half of whom live within just a handful of countries, including the United States of America, People’s Republic of China, India, Russia, Brazil, Mexico, Egypt, Germany, Pakistan, and Indonesia.1,2 In Europe, more than 50% of adults are overweight and 20% of men and 23% of women are obese.3 Similar trends are seen in data collected from the United States National Health and Nutrition Examination Survey, where approximately 68.8% of adults are overweight or obese.4–8 The prevalence of obesity worldwide nearly doubled from the 1980s to 2008, and although the rate of increase has slowed, obesity remains a major global health concern.1,8 Globally, the annual cost of obesity-related diseases has reached $2 trillion according to a recent report by McKinsey Global Institute.9 In Europe, the WHO estimates that up to 6% of health care expenditures are due to obesity and obesityrelated diseases.10 Similar estimates are observed in the United States, with total health expenditures projected to reach $344 billion by 2018 and 16%–18% of health care 79 submit your manuscript | www.dovepress.com Integrated Pharmacy Research and Practice 2015:4 79–89 Dovepress © 2015 Jordan and Harmon. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php http://dx.doi.org/10.2147/IPRP.S72206 Powered by TCPDF (www.tcpdf.org) Abstract: Obesity is currently a worldwide pandemic, with overweight (body mass index [BMI] $25 kg/m2) and obesity (BMI $30 kg/m2) estimated at 35% and 12% of the global adult population, respectively. According to data collected from the United States National Health and Nutrition Examination Survey, approximately 68.8% of US adults are overweight or obese. Additionally, a large burden of health care costs can be attributed directly to obesity as well as multiple, potentially preventable, comorbidities such as cancer, cardiovascular disease, and diabetes. As a result, national and international organizations, such as the US Centers for Disease Control and World Health Organization, have made halting the rise of the obesity epidemic a top priority. Pharmacists, commonly considered one of the most trustworthy and accessible health care professionals, are ideally situated to provide counseling for weight and lifestyle management. This review presents examples of pharmacist-led as well as collaborative practices that have been somewhat successful in educating and monitoring patient progress in attaining weight-loss goals. Common barriers and potential solutions to administration of lifestyle counseling and monitoring programs, such as limited pharmacist time and resources, lack of expertise and/or confidence in program administration, and patient perception and awareness, are also discussed. Keywords: pharmacy, obesity, counseling, weight loss, lifestyle management Dovepress Integrated Pharmacy Research and Practice downloaded from https://www.dovepress.com/ by 54.37.163.172 on 12-Jul-2018 For personal use only. Jordan and Harmon costs by 2030.11,12 The WHO estimates that 44% of diabetes cases, 23% of ischemic heart disease cases, and 7%–41% of certain cancers may be attributed to obesity.12–14 Thus, a large burden of health care costs can be attributed directly to obesity, but more significantly to multiple, potentially preventable, comorbidities. The rise in obesity can be attributed to multiple factors, most notably modern lifestyles, which allow for easy access to inexpensive unhealthy foods, sedentary lifestyle, and environmental factors that limit access to healthy diet and exercise management.15,16 Effective management of the obesity pandemic requires the promotion and fundamental acceptance of healthy lifestyle habits, which in turn depend upon the availability of resources such as affordable nutritious food options and access to venues that promote exercise.15 In addition, counseling and guidance by health care professionals is necessary for disease state prevention and treatment. The WHO Global Action Plan for the Prevention and Control of Noncommunicable Diseases outlines several objectives to be attained by 2020, including increasing physical activity; decreasing the risk of premature mortality from cardiovascular disease, cancer, diabetes, and chronic respiratory diseases; and halting the rise in diabetes and obesity.17 Specifically, Objective 4, which focuses on strengthening health care systems, calls for the development of career tracks in the health care professions, including pharmacy, that focus on noncommunicable diseases. A position statement by the American Society of Health-System Pharmacists also recommends increased counseling by pharmacists to help obese patient manage lifestyle modifications.18 Because community pharmacists are generally easily accessible to patients at locations throughout the community on a walk-in basis (ie, no appointment is required), they might serve as an alternative source for lifestyle and weight-loss counseling. Previously, pharmacists have demonstrated success in disease state management, often in comorbid diseases, such as diabetes, hyperlipidemia, and hypercholesterolemia.19–22 In addition, pharmacists receive a comprehensive education that covers disease state etiology, risk factors, prevention, management, and treatment, which gives them a strong foundation for providing (...truncated)