Background and Importance In the UK and globally pharmacy professionals (PPs) contribute to the delivery of local and national public/population health (PH) interventions.¹ However, there is paucity of information to what extent PPs have specialist/advanced skills/roles within PH practice.

Aim The mixed methods review, commissioned by the UK Chief Pharmaceutical Officers in 2020, aimed to explore PPs’ specialist PH contributions including barriers and opportunities.

Methods Databases available through PubMed were searched to retrieve articles published in English (2011- 2021) on seven topics including: emergency preparedness resilience and response (EPRR); integrating pharmacy to better support public health protection and improvement goals; public health skills and mitigating health inequalities.

Two independent electronic surveys were developed, piloted and deployed for pharmacy and public health specialists via email cascade and social media. The surveys explored the extent to which PPs are involved in PH roles including the barriers and opportunities.

Descriptive statistics summarised the data, and open-ended responses were themed. UK Health Research Authority tool identified ethics approval was not required; questionnaire included consent request.

Results Rapid Evidence reviews: Following assessment of 2,542 articles, 448 evidence statements were extracted from 135 relevant articles. They were predominantly from the USA (39%) and the UK (29%), with fewer high-quality reviews (17) or guidance (12), than moderate/low-quality reviews (42), single studies (33), or quantitative research (33).

Pharmacy and PH professionals Surveys: There were UK-wide responses from 128 PPs and 37 PH specialists. Responding pharmacists were from primary-care (34%, 43), secondary-care (26%, 33), community pharmacy (13%, 16), and PH bodies (13%, 16). Opportunities identified by PPs included: PH areas they directly contribute to (45%); qualifications, knowledge and skills (27%); strategic position in the community (19%), recent changing health landscape (4%). Barriers included lack of defined career pathway (20%); poor professional recognition (18%); limited resources (16%); lack of training and support (15%) and organisational and structural barriers (10%). Majority of the PHPs stated that it would be beneficial or very beneficial to have PPs specialising in PH (83%).

Conclusion and Relevance Pharmacy professionals make specialist contributions to PH despite barriers. Dedicated Pharmaceutical PH training and system-wide leadership are required to fully realise population-level benefits. Low responses to the surveys present a study limitation, however, there was consensus from the themes emerging from both surveys and rapid evidence reviews findings. Further investigation is required to identify how best to deploy advanced PPH resources. Future qualitative studies should be considered.

Acknowledgements The authors acknowledge all contributors to the development of the scope, workshops, discussions and recommendations, contributors of case histories and call for evidence.

Reference

1. Thomson K, Hillier-Brown F, Walton N, Bilaj M, Bambra C, Todd A. The effects of community pharmacy-delivered public health interventions on population health and health inequalities: a review of reviews. Prev Med. 2019 Jul;124:98–109.