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Cancer

Community pharmacies help weight loss and fall in cholesterol in men with prostate cancer, study finds

A study published in BMJ Open has shown that men living with, and after, prostate cancer can benefit from pharmacy lifestyle interventions that lower cholesterol and increase strength.

Community pharmacies have helped cancer survivors to lose weight, lower their cholesterol and improve their strength by providing accessible lifestyle interventions, a phase II feasibility study in BMJ Open has found.

In the first study of its kind, which focused specifically on men living with and beyond prostate cancer, community pharmacy teams across nine community pharmacies were trained to deliver a health assessment that included fitness and strength tests.

The pharmacies in the study included both mid-sized and large nationwide community pharmacy chains, and independent pharmacies.

The first pharmacy intervention, attended by 116 men with prostate cancer, included a personalised risk assessment comprising clinical history, cardiovascular risk, strength, fitness, physical activity and diet. After this, an algorithm was used to generate a lifestyle prescription which was issued to the patient by the pharmacist along with an intervention kit.

Following the first intervention, two follow-up calls were made at one week and six weeks after.

At 12 weeks, the pharmacists carried out a second intervention, attended by 99 of the 116 men, in which they repeated the personalised risk assessment and then issued another lifestyle prescription.

At three and six months after the second intervention the researchers carried out questionnaires, focus groups (with the pharmacists) and interviews (with the participants) to assess how the intervention had gone.

Overall, upper-limb strength had increased on average by 0.2±3.0kg by the second pharmacy visit, and lower-limb strength also increased. On average, the weight of participants fell by 1.0kg, the body mass index fell by 0.3kg/m3 and the total cholesterol fell by 0.4mmol/L.

It was also found that community pharmacies were considered easy to access for the participants and the pharmacy teams felt they had the skills and confidence to complete the training and deliver the intervention. The service was considered feasible for the providers and acceptable to the men with prostate cancer, across all three pharmacy models.

The researchers said that the intervention had the potential for testing at scale as it was hosted by a web-based system used by more than 26,000 different providers in the UK. However they added that the participants may need more support to maintain the benefits of the intervention in the long term.

“This study is an essential step towards [a randomised controlled trial] to evaluate the effectiveness and cost-effectiveness of this community pharmacy lifestyle intervention for men with prostate cancer,” they said.

Guidance from the National Institute for Health and Care Excellence recommends that people starting or having androgen deprivation therapy, a form of hormone therapy, should be encouraged to exercise at least twice per week for 12 weeks to reduce fatigue and improve quality of life.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2019.20206662

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