A poor diet, insufficient exercise, inability to maintain a healthy weight, tobacco use, and excessive alcohol consumption are the root causes of most chronic diseases in the United States. Despite the fact that pharmacy is positioned to provide an answer to this problem, little has been done to help Americans maintain healthy lifestyles. Academic pharmacy is predominantly focused on drugs and diseases, with limited instruction in Wellness pharmacy. We need pharmacy education to take a leadership role when it comes to enhancing American wellness.
There have also been reports of pharmacists counseling patients on wellness and lifestyle change as part of advanced pharmacy practice experiences (APPE) at Duquesne University and Virginia Commonwealth University23,24. Access and interaction are easy, compounding the irony.
A brief introduction
It is estimated that most chronic illnesses in adults and some in children in America are self-inflicted. Neither do we consume foods in the proper quantities nor do we eat the right foods. The majority of people live sedentary lives and do not exercise enough. Many individuals should refrain from using tobacco and consume less alcohol.
The current eating habits and exercise patterns of Americans may contribute to obesity becoming America’s number one cause of death. To what extent is it the responsibility of the government to assist Americans in changing their lifestyles? Pharmacists, due to their strategic location within the community and ease of accessibility by patients, should be one of the primary agents of change within health care due to their strategic location.
Furthermore, pharmacy schools and colleges should prepare their graduates better to take on this significant public health challenge.
WELLNESS: A CASE FOR ACTION
In his book, In Defense of Food, Michael Pollan wrote that “it is easier, at least more profitable, to change a disease of civilization into a lifestyle than it is to change the way civilization eats.”
3 This disease of civilization is diabetes, which has been brought on by an epidemic of overweight and obese individuals in the United States. A third of the US population is overweight, a third is obese, and the remaining third is at ideal weight.
4 The same pattern applies to Americans’ commitment to exercise; one third exercises faithfully, another third exercises occasionally, and one third exercises rarely.5 In general, we are a nation of individuals who overeat, eat the wrong foods, and exercise insufficiently. People are looking for a “quick fix” to healthy living as a result
PHARMACY SCHOOL EDUCATION AND WELLNESS EDUCATION
Pharmacists and pharmacy education do mediocre jobs at best when it comes to promoting and enhancing society’s well-being. This general statement has limited, localized exceptions in the literature. The Creighton University School of Pharmacy and Allied Health Professions has published extensively on promoting lifestyle change to enhance wellness.16-19 In 2007, they reported that only four schools offer a lifestyle/wellness course, three in nutrition and one in smoking cessation.
20 Seven respondents offered at least one elective addressing nutrition, smoking cessation, weight loss, or alcohol use. According to this survey, only 4.5% of pharmacy schools offer a required course in wellness or lifestyle change, and 7.9% offer an elective course. About 88% of schools and colleges of pharmacy did not have a required or elective course related to wellness or lifestyle change at the time of the survey. .
MODEL FOR CURRICULUM
What can colleges and schools of pharmacy do to enhance pharmacists’ roles in promoting wellness? Instead of adding another course to an already overcrowded curriculum, we suggest four steps that will enhance wellness preparation for student pharmacists. By introducing such a program, pharmacists might be able to balance wellness with treating illness.
First, all pharmacy students should undergo a health assessment upon entering pharmacy school, including a weight, diet, exercise and sleep pattern assessment. A vision test, a bone density test, a blood pressure test, and a glucose test should be done on each student. In the first two weeks of school, students should receive instruction on achieving optimal health status, including exercises, nutritional diets, the physiology of weight loss, and sleep habits.
The students should be asked to develop a personal health plan and then incorporate the plan into their daily routines. As mentors, faculty members should also participate in the program and encourage 10-15 students.
FINAL COMMENTS
The pattern of inappropriate lifestyles in America is well documented. It seems that the healthcare sector is stymied in its efforts to make meaningful changes for the better, despite making small strides. If pharmacy schools and colleges placed a solid foundation of wellness, disease prevention, and lifestyle changes in their graduates, the pharmacy profession would be well positioned to assist in this effort.
Members of curriculum committees should inventory their wellness education efforts and implement instructional programs that prepare graduates to provide wellness education. It is then possible for pharmacists to play a more significant role in reducing chronic diseases in America.