Initiative

Healthy Ireland (HI) is a Government-led initiative which aims to create an Irish society where everyone can enjoy physical and mental health and where wellbeing is valued and supported at every level of society. Healthy Ireland Framework 2019-2025 is a roadmap for the development of a healthier Ireland. The goals of this framework are:

• To increase the proportion of people who are healthy at all stages of life;
• To reduce health inequalities;
• To protect the public from threats to health and wellbeing; and
• To create an environment where every individual and sector of society can play their part in achieving a healthy Ireland.

In line with the HI framework, Healthy Meath launched a Chronic Disease Risk Management Programme last September. This programme aimed to:

• Provide a free health check to eligible residents of County Meath and identify risk factors that lead to the development of certain chronic diseases including diabetes and cardiovascular disease. Funding was provided by Meath County Council under the Healthy Ireland Fund, supported by the Department of Health;
• Raise awareness of risk factors for the development of chronic disease among citizens of Couty Meath;
• Educate citizens of County Meath on how to reduce those factors and provide them with tools to achieve this;
• Elicit behaviour change through referral, personalised lifestyle advice and follow-up;
• Gather local data to identify trends and health needs in this area; and
• Achieve the project outcomes for The Healthy Ireland Fund 2023-2025: Local Strategy for Meath County Council.

This programme was delivered in partnership with a range of stakeholders, including the IPU; Kenlis Total Health Pharmacy, Kells; Lynch’s Total Health Pharmacy, Kells; McQuaids Pharmacy, Oldcastle; and Roche Diagnostics. The programme comprised the delivery of a series of health checks and lifestyle questionnaires followed by the provision of personal advice tailored to the patient’s health needs and referral to a healthcare professional where appropriate.

The programme was shortlisted under the ‘Best Community Health’ category at the 2023 LAMA — All Ireland Community and Council Awards.

Healthy Meath in collaboration with the IPU launched the County Meath Chronic Disease Risk Management Programmed Pilot Report on 18 April 2024 at the Ardboyne Hotel in Navan. The event was sponsored by Roche Diagnostics. The launch included a brief presentation that gave an outline of the development and delivery of the pilot, and the results obtained from the data gathered from the health checks and lifestyle questionnaire. The full report is available via the QR code on this page. Highlights of the report include:

• There were a total of 60 participants aged between 40 to 65;
• 68 per cent of the participants were female;
• 93 per cent of participants have a history of cardiovascular diseases including diabetes;
• 27 per cent of participants were smokers;
• 64 per cent of participants consumed alcohol;
• 56 per cent consumed less than the recommended five to seven portions a day of fruit and vegetables;
• 43 per cent of participants did not consume any oily fish weekly;
• 46 per cent of participants did not have optimal or normal blood pressure values; and
• 80 per cent of participants had a waist circumference measure above healthy parameters.

Four weeks after the health check, participants were contacted to assess the impact of the interaction. The following is an outline of the observations made:

• 97 per cent of participants had improved their awareness of risk factors linked to chronic disease;
• 81 per cent of those participants who received dietary advice had made a change to their diet;
• 67 per cent of those participants who received physical activity advice have made a change to their physical activity;
• 33 per cent of those participants who received smoking advice reported that they had quit or sought help to quit smoking;
• 36 per cent of those participants who received advice on alcohol consumption reported that they had reduced their alcohol intake;
• 75 per cent of those participants who were referred to their GP, visited their GP; and
• One individual was diagnosed by their GP with a health issue related to their health check results.

  At the end of the programme, participating pharmacists were given the opportunity to provide feedback on the service they provided and to share their considerations on delivery of the service. These are some of the thoughts the pharmacists shared with us: “Wanted to get involved to be able to offer more to clients . . . Pharmacists are qualified to offer more on our skills, rather than just compounding”.

“Exciting to take part in this chronic disease risk management programme, which meant we use our full potential and knowledge to improve health in the population and identify people at risk”.

“An advantage of participating was better interaction with clients through advice and referrals”.

“Wanted to get involved for professional development”.

 

Considerations for future pilots

The following learning was captured as possible considerations for future pilots:

• Education on adherence to the inclusion criteria, as it appeared that four individuals did not meet the inclusion criteria;
• Participants self-referred, therefore not a demographically representative sample;
• Review of minor issues when transferring the data onto the IPUnet (online portal used for the collection of the information);
• Capture of additional questions asked by pharmacists to support their professional judgement, as these were not recorded in phase one;
• Greater clarification on the outcome of the service provided, i.e. referrals to hospital (only referrals to GPs were recorded); and
• Develop a section to capture participant’s feedback, as this was not recorded in phase one.

 

Pictured at the launch of the Chronic Disease Risk Management Programme are: Leas Cathaoirleach of Meath County Council, Cllr Paul McCabe pictured with (from left to right): Cllr Gillian Toole; Barry Lynch, Director of Services, Meath County Council; Jim Curran, IPU; Aisling O’Donnell, Healthy Ireland Coordinator for Meath; Lara Marín, IPU; Sineád Murphy, Healthcare Development Manager at Roche Diagnostics; Jai Sokay, pharmacist at Kenlis Total Health Pharmacy; and Neil Sokay, pharmacist at Lynch’s Total Health Pharmacy.

 

Next steps

Based on the success of phase one, Healthy Meath (at Meath County Council), allocated additional funding to allow the extension of this initiative to the remaining five Municipal Districts in County Meath. Phase two of this programme is currently being delivered by these participating pharmacies across County Meath:

• Allcare Trim (Trim);
• Haven Pharmacy Kavanagh’s (Dunshauglin);
• Hickey’s Johnstown Shopping Centre (Navan);
• McCauley Navan Shopping Centre (Navan);
• McNallys Pharmacy (Duleek);
• O’Connors Pharmacy (Stamullen);
• O’Shaughnessy’s Pharmacy (Trim);
• Slane Pharmacy (Slane); and
• Your Local Pharmacy (Dunboyne).

 

Conclusion

The initiative has demonstrated that pharmacists are highly skilled healthcare professionals who have a privileged position in which they hold the public trust. They raise awareness and educate members of the public. In addition to this, the programme has shown the impact of pharmacists practising social prescribing as it empowers patients to take an active role in their health.

Community pharmacies are appropriate healthcare settings, widely accessible across Ireland, for the provision of health checks and screening programmes. Therefore, the implementation of similar programmes across the country would be beneficial to members of the public. The results of this programme demonstrate that having an ‘upstream’ policy in place based on cardiovascular diseases will be more effective, equitable and cost-efficient than a ‘downstream’ policy. Prevention is the key to achieving better healthcare outcomes.