Context

The "Research and Development" picture tends to be dominated by the published evidence. However, it is also recognised that the evidence base in health promotion needs to be both conceptually sound and practically useful¹ It is thus important that the learning from local initiatives and projects is synthesized and disseminated so that it can be built upon and incorporated into future planning of health services. As for many other areas there was no ready means of obtaining information on unpublished health development work involving pharmacy. Previous surveys^2,3 of activity have been conducted in the UK, but there has been no such data collection since 1998. Therefore the aim of this work, which was part of a larger study for the Pharmacy Health Care Scheme, was to identify recent and current development projects involving pharmacy. Our objectives were to: produce and describe a detailed picture of current and recent local health development projects in the UK involving pharmacists; Identify relevant health development initiatives in Europe, Australia and North America; and document the key features of current and recent health development work to enable sharing of information and experience.

Methods

As there was no existing sampling frame a number of strategies were used to reach the respondents who included; Health Promotion Units, CPPE tutors and Local Pharmaceutical Committee secretaries The European project report "Health promotion in primary health care: general practice and community pharmacy,"⁴ was used to identify exemplar projects. Selected key international informants were contacted individually to identify current activity and unpublished information from non-UK settings.

Results

The survey response rate was 64% after one reminder, slightly lower than the previous surveys^2,3, where telephone interviews to health authorities were the primary method. Thus while the survey has identified a large number of local development projects it is likely to underestimate the true level of activity. Overall a total of 108 projects were identified. Returns were received from 64 of the HA areas in England (97 projects), three Scottish Health Boards and three Northern Ireland Health Boards. Three projects were notified from Wales. The profile of activity generally reflects NHS priorities in areas where pharmacies can contribute to the achievement of health targets and to reduction in health inequalities. In this respect it is noteworthy that the profile of activities found in this survey shows a move away from traditional 'health promotion' topics towards more targeted areas. Furthermore the survey shows evidence of locality-based approaches where action was taken in response to an identified local problem or issue. This contrasts with previous HA-wide projects^2,3 and reflects current ways of working. There are noteworthy differences between UK and international patterns of activity, the former focusing on smoking cessation and sexual health. This altered profile is undoubtedly due to the availability of funding from, for example, HAZs and DH smoking cessation resources.

Conclusion

Since 1998 pharmacy has become more integrated and is addressing local needs in collaboration with other players in the healthcare team

References

1. 1. Learmonth A, Mackie P. Evaluating effectiveness in health promotion: a case of reinventing the millstone? Health Ed J 2001;59: 267-280
2. Anderson, C Community pharmacy Health promotion activity in England: a survey of policy and practice. Health Education Journal 1996;55: 194-202
3. Anderson C Guidance for the development of health promotion by community pharmacists Pharm J 1998;261: 771-775
4. http://www.univie.ac.at/phc/webindex.htm accessed 23/10/01

Acknowledgements

The work was funded and commissioned jointly by the Pharmacy Healthcare Scheme and the Royal Pharmaceutical Society of Great Britain.