Nutrition Education and Community Pharmacy: A First Exploration of Current Attitudes and Practices in Northern Ireland

Abstract

Community pharmacist is one of the most prominent and accessible healthcare professions. The community pharmacists’ role in healthcare is evolving, with opportunities being taken to reduce pressure on primary care services. However, the question remains of how well community pharmacists are equipped for this changing role. This was a sequentially designed study using a mix of methods to explore nutrition education among community pharmacists in Northern Ireland. It consisted of two phases. Phase 1 was a cross-sectional exploration to map the attitudes and practice of Northern Ireland (NI) pharmacists towards diet-related health promotion and disease prevention. An online questionnaire with open and closed questions to gain both quantitative and qualitative responses was developed and distributed to community pharmacists practising in NI. A total of 91% considered nutrition important in reducing the global burden of disease. While the majority (89%) believed patients would value nutritional advice from a pharmacist, 74% were not confident in providing advice to a patient with diabetes. From the consensus gained in Phase 1 a nutrition education intervention (Phase 2) for pre-registration pharmacists was developed using the Hardens 10 question system. The training programme was advertised to pre-registration pharmacy students in NI. It was delivered by nutrition experts who have education qualifications. The intervention was evaluated using a before and after questionnaire that assessed knowledge, attitudes, and practice (KAP). Phase 2 did find sustained improvement from the baseline in KAP but there was a decline from immediately post-training to three months post-training. This suggests the need to further embed nutrition education. The education programme was found to be effective for the target population and sets the stage for the development of an implementation strategy for a wider roll-out with evaluation.

Role of Nutrition Education in Pharmacy Curriculum—Students’ Perspectives and Attitudes

“…Results of this study document that the majority of pharmacy students felt a course in nutrition is important and believe it should be incorporated in the pharmacy degree curriculum. These results are consistent with a recent study conducted on community pharmacists [ 12 ]. In the current study, 43.2% of pharmacy students stated that they had taken a nutrition course but it was taken as an elective.…”

“…Furthermore, definite links between diets and diseases are becoming evident, which means it is extremely important for pharmacists to prepare themselves with the necessary knowledge in the field of nutrition [ 11 ]. Many pharmacists have come to realize they do not possess enough knowledge in the discipline of nutrition [ 12 , 13 ]. However, whether pharmacy graduates of today are well prepared to accept these new challenges and roles is still unknown.…”

Advancing European nutrition – are pharmacists eligible partners in the process?

“…In addition to biases and unfounded assumptions about obese patients, absence of training in behavior-change strategies and scarce experience working within inter-professional teams impairs care of those patients [ 35 ]. In the contrary, in Poland (yet not universally across Europe [ 7 ]), thorough nutrition education is obligatorily included in a pharmacy curriculum. And indeed, the majority of our respondents had relatively good nutrition knowledge according to KomPAN but the score significantly decreased with age, which clearly emphasize the importance of nutrition education in life-long learning programs.…”

If You Don’t Eat Meat… You’ll Die. A Mixed-Method Survey of Health-Professionals’ Beliefs

“…Currently, the most up-to-date Ministry of Health New Zealand guidelines are the 2015 "Eating and Activity Guidelines for New Zealand Adults" [20], specifically written for healthcare practitioners who provide advice on nutrition and physical activity to New Zealand adults, with most of the evidence based on European and North American populations [20]. General practitioners [21] and other healthcare practitioners [10,22] are recognised as having the potential to provide nutrition advice and improve nutrition-related behaviours and risk factors in the context of lifestyle-related long-term conditions; there are few dietetic services available in primary care in New Zealand. However, with the low reported use of guidelines and specific resources, perceived inadequacy of nutrition knowledge amongst participants and an average estimated daily advice frequency of 2.4 times/day in this study, that potential is yet to be realised.…”

“…American medical schools expect 25 h of nutrition training although the national delivered average is 19 h, with graduates generally feeling dissatisfied with nutrition education [9]. Nutrition education is regarded as a core competency for nursing [6], and the majority of community pharmacists also feel inadequately prepared with their nutrition education [10,11].…”