chronic disease

Obesity has reaches epidemic proportional globally, it is the serious and growing public health problem which is not only restrained to developed countries but also in developing countries, Obesity is not receiving the attention they deserve from primary care practitioners. Obesity is a major contributor to the global burden of chronic disease and disability often co-existing in developing countries with under-nutrition. It is associated with serious medical, psychological, economical and social implications virtually affecting all age group. The global reason behind it is an energy imbalance between calories consumed and expended. In today’s diet increased intake of energy dense foods that is rich in fat and sugars but low in vitamins, minerals and other micronutrients and a trend towards decreased physical activity due to the increasingly sedentary nature of many forms of work, changing modes of transportation, and increasing urbanization.

There is a limited number of studies evaluate the performance of existing chronic diseases management and its outcomes in community pharmacy. This study aimed to evaluate published evidence in chronic disease management in community pharmacy internationally. A literature review was performed covering the period from January 2000 to March 2013 using EMBASE, Medline and International Pharmaceutical Abstracts. Published studies involving interventions carried out by community pharmacists with the evaluation of interventions in clinical, humanistic or economic outcomes focusing on five chronic diseases, namely; diabetes, cardiovascular disease, asthma, mental illness and cancer were included. Duplicate articles were removed electronically (Endnote®) and the remaining articles were screened to assess their eligibility according to the inclusion and exclusion criteria. Full copies of the potential eligible articles were obtained and each study was further reviewed by the reviewers independently. From 2,973 articles identified, 91 manuscripts were included in the final analysis. Limited number of interventions in cancer and mental illness was identified. Approximately 87% of total studies reported interventions in population with existing diseases. Less than 10% reported interventions in at risk and healthy population. Clinical outcomes were reported in majority of the identified studies (51%), while humanistic and economic outcomes were reported less frequently. Our review found positive evidences of community pharmacy-based intervention in five chronic diseases. Further intervention in healthy and at risk population is strongly encouraged, particularly in cancer and mental illness. Humanistic and economic outcomes should also be measured to allow evaluating the holistic impact of community pharmacists’ interventions.