Obesity Management

1

• Obesity Management
• with
• associated risk factors programme
• Presentation
• To
• Health Well-being Partnership board
• Meera Sharma BPharm (Hons), MRPharmS, PGDip
• Professional Services Manager

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Objectives

• Background
• Pharmacy pharmacist selection
• Service process
• Training Communication Skills
• Progress to-date
• Future Vision

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Obesity Coventry Teaching PCT

• Coventrys population 300,848
• 50 adult population overweight
• 23 clinically obese 51,622
• 60 eat less 5 portions of fresh fruit
  vegetables
• Only 22 travel to work by foot bicycle public
  transport
• Coventrys vision for public health
• Improve peoples dietary habits and increase
  physical activity
• To provide weight management services to reduce
  mortality and morbidity
• Improving the health of the local population

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Aim of Service

• To provide a weight management service for
  patients with a BMI (30-
• 38kg/m2) with at least ONE diagnosed or
  established risk factor. Risk
• factors include
• Hypertension
• Type -11 Diabetes
• Hyperlipidaemia
• Increased waist circumference Male 102cm (40
  ins) Female 88cms (35ins)
• Why Community Pharmacy?
• Ready accessibility for advice support
• Ideally located for improving public health
• Part of primary healthcare team
  inter-professional working
• Community pharmacy contract provides foundation
  for quality, cost-effective patient services

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Pharmacy and Pharmacist Selection

• Criteria included
• Pro-active pharmacist and support staff
  enthusiastic about opportunity presented by
  programme,
• Pharmacy has consultation area that has been
  verified during monitoring visits to meet
  contract specification
• Consultation area has sink available for use
• Pharmacy has achieved a satisfactory contract
  monitoring report 2006-7
• Pharmacist is HEI accredited for providing MUR
  service
• Pharmacist is providing MUR service (gt 10 MURs
  completed, claimed and documented)
• Pharmacy has demonstrated through past
  performance that it will actively engage and
  support local intimates and services
• Suitable pharmacy location (to ensure good
  geographical distribution)
• Selection was carried out jointly by Coventry
  Teaching PCT LPC

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Acknowledgements
To all who were involved in the development of
this programme
Dr Terry Maguire

• Equipment training for measuring the following
  parameters

BMI Weight Height
HbA1c
Blood Pressure
Total Cholesterol
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Pharmacist and support staff training

• 1- day training programme provided by Dr Terry
  Maguire, which covered
• Behavioural change
• Facilitating healthy choices by patients
• Techniques to change dietary, lifestyle and
  exercise habits
• Sustainable, realistic and gradual modification

• Motivational interviewing technique skills
• Patient wins challenges
• Patients typical day in terms of diet,
  lifestyle and exercise
• Provision of tailored, bespoke information
• Working towards target systematically
• Facilitating decision making, without jumping
  in with answers

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Successful engagement with patient

• Express empathy with patient
• Develop structured, personalised plans
• Avoid confrontations/challenges with the patient
• Roll with patient resistance to change
• Work within boundaries that the patient is
  comfortable with
• Active listening

Planning with the patient

• Create a tailored plan
• Be realistic
• 2lbs per week
• Old habits die hard!!!
• Small Changes Big Benefits

Aim for a 500 calorie reduction in calorie intake
per day to achieve a 1-2lb weight loss per week
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Resources available

• Local resources
• Expert Patient Programme
• Exercise Specialist
• Dietician
• Coventry Teaching PCT personnel
• Expert resources
• GPs nurses
• UniChem Professional Services Team project
  facilitation
• Equipment suppliers and pharmaceutical Industry
  support
• Academic experts e.g. Dr Terry Maguire,
• Department of Health guidance
• National resources
• Websites e.g. Diabetes UK, British Heart
  Foundation etc.
• National publications e.g. NICE guidance, Skills
  for Health National Workforce Competency
  Frameworks

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Progress to-date

• 29 patients enrolled onto service since launch on
  10th January 2007
• 1 peer-review meeting held, which was productive
  and allowed all pharmacists to feedback on
  successes/challenges
• Future vision
• To gather programme data and outcomes for
  academic research and evaluation of service for
  publication
• To develop a Weight Management Programme for
  Children and Adolescents
• Pharmacy to be seen as first port of call for
  patients and GPs to see pharmacy as a valuable
  patient referral pathway
• To provide a sustainable and cost effective
  programme through out Coventry PCT for the people
  of Coventry

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Implications for Health Well Being Partnership

• Estimated obesity rate for West Berkshire is
  21.5, which is higher than the regional average
• The above Coventry Teaching PCT model can be
  adapted for roll-out within West Berkshire
• Similar selection, training and recruitment
  process
• Can adapt patient inclusion exclusion criteria
  according to local needs
• Engagement with local healthcare professionals
  can be built into the model for seamless patient
  care

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Supporting the patient
Patient
Pharmacist
GP
PCT
Expert Patient Group
Dietician
Exercise Expert
Partner organisations
Together Everyone Achieves More
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Thank you Questions?