How can community pharmacy help men open up and talk about sensitive health issues? Ade Williams and Steven Fung provide their insights…

 

The Male health picture still remains worrying. For a short while, it appeared that the life expectancy gap between men and women was narrowing but the latest figures now suggest that is no longer the case. A baby girl born in 2018 can expect to live almost four years longer than a baby boy.

Prostate Cancer UK grabbed everyone’s attention in February by reporting that the number of men dying from prostate cancer has overtaken female deaths from breast cancer for the first time in the UK.

The awareness and education campaigns around breast cancer continue to make a real difference in the lives of patients. Digging further into the report, it becomes apparent that advances in the diagnosis and treatment of breast cancer are paying off.

Population growth of older men is resulting in an increase in men getting and dying from prostate cancer. Better funding and patient education were identified as needed to reduce the deaths.

The challenges of educating men about health matters are well documented. Getting them to engage with health professionals may seem an even bigger mountain to scale.

Nevertheless community pharmacy, especially Healthy Living Pharmacy, can and does play a significant role in reaching out to these hard-to-reach patient groups. However, it requires innovation and a good strategy.

Bedminster Pharmacy is known to go into its local pubs to carry out blood pressure checks. Our annual men’s health initiative – the ‘Bemmy Challenge’ – is something we deliver with humour and professionalism and has the support of tattoo parlours, barbers and gyms.

They all encourage punters to come to the pharmacy to take part in the health screening we are offering. The free gift bag provided for participating is a further incentivisation to participate.

The Bedminster Pharmacy team have made a conscious effort to learn how to help men open up and talk about their health. In our experience, it starts with the simple things. As a Healthy Living Pharmacy, we are aware of our local health profile, which helps us to frame and deliver services.

For example, knowing that a large proportion of men in our community smoke, we have tailored the health displays to better speak to men. The blackened lung model showing cancerous growths alongside the lung which is drowning in smoke tar on our counter is a great conversation starter.

There is also a prominent sign in our pharmacy which points out that there is a private consultation room available and another pointing out that patients can request to speak to a female or male member of the team.

Getting men to know about and make use of our consultation room has resulted in many more conversations about sensitive issues such as erectile dysfunction and hair loss. In our experience, the stress associated with these two issues causes low self-esteem, depression and even relationship breakdown.

The relief of sharing their concerns and worry is self-evident even before we even start exploring the various ways we can offer help to a patient. Although male pattern hair loss is hereditary, the availability of effective minoxidil-containing treatment products over the pharmacy counter is not commonly known.

Enquires about erectile dysfunction are also not uncommon and our pharmacist, an independent prescriber, is able to offer clinically appropriate prescriptive medication as a service. Some do choose to take this up.

We use all our patient interactions to discuss mental health and wellbeing. Knowing how difficult it can be for men to open up and talk, we make the most of every opportunity to cover this area.

As a Healthy Living Pharmacy we understand that a lot of common health conditions are caused or aggravated by unhealthy lifestyle choices. Effectively passing on the message about this risk and, more importantly the support we offer, is key.

The Men’s Health Forum has a lot of really useful resources including apps and printed literature. They come with a good balance of humour and information. For less confident colleagues, they are excellent to help to lead a conversation about lifestyle choices such as poor diet, excessive alcohol consumption, weight and smoking.

We also invite local male public figures to lend support to our campaign. The Bristol Lord Mayor, a former firefighter and union officer, coming into our pharmacy to have his weight measured and his cardiovascular risk calculated is not only newsworthy but grabs the attention of our target men.

Asking him to share his experiences of his struggles in eating healthy and losing weight after being informed he was pre-diabetic was even more powerful – if he can do it, so can I, as they say!

This year we have a patient who is also a popular national TV personality lined up to headline our campaign. Getting men into your community pharmacy really does present opportunities to be harnessed. Normalising it as a ‘regular’ place in their eyes is a must, however. That must remain the long-term goal.

 

Ade Williams and Steven Fung are pharmacists at Bedminster Pharmacy in Bristol.

 

Men’s mental health

Mental health has been pushed into the spotlight recently with a plethora of media and advertising campaigns aimed at addressing what was for far too long an underestimated health issue, writes Neil Trainis

Community pharmacists are not psychiatrists of course but they can listen to the men who walk through their doors who need to talk to someone about a problem. And there are plenty of men out there who need a good listener.

According to the Men’s Health Forum, over three out of four suicides (76%) are by men and suicide is the biggest cause of death for men under 35.

Statistics reveal that 12.5% of men in the UK suffer from one of the common mental health disorders and men are almost three times more likely than women to become dependent on alcohol. Men are also more likely to use and die from illegal drugs. Tellingly, men are less likely to access psychological therapies than women.

So are men suffering from mental illness falling through the net? And if so, can community pharmacy step in and fill that role? A quiet, discreet chat, some healthy lifestyle advice and, if necessary, signposting to another healthcare professional all carried out in the consultation room is where pharmacists can play a significant part.

It is worth looking at the statistics again. Women are more likely to have a common mental disorder such as depression, anxiety, phobia, obsessive compulsive disorder and panic disorder. One woman in five compared with one man in eight suffers with any of the above. But men are there to be helped.

And as was suggested in the Journal of Psychiatry, the onset of particular forms of psychosis seems to occur earlier in the lifespan of men.

Much of this stretches into community pharmacy’s social care role. For instance, Crisis tells us that 87% of rough sleepers are men. Can community pharmacy teams involve themselves in shelters or housing projects to help get rough sleepers off the streets?

It has been said that men have less access than women to the social support of friends, relatives and the local community. Ah, there’s that word – community, at the heart of which are community pharmacies.

 

 

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