Factors contributing to pharmacists' intention to provide weight management service in community pharmacy settings: A systematic review

Background: Obesity is one of the health problems which could cause health impacts, as well as economic and social impacts. Community pharmacists are accessible primary health care providers who can play a role in counselling on diet and exercise to control weight and correcting medication misuse for weight control. Literature has shown the effectiveness of weight management services (WMS) provided by community pharmacists, but the percentages of this service provision were low. Objective: To systematically review contributing factors for community pharmacists' intention to provide weight management services. Results: The systematic review included 3,884 participants from 24 studies. There were four major dimensions of weight management service in community pharmacies: 1) patient recruitment, 2) problem identification and referral, 3) counselling, and 4) monitoring. Pharmacists indicated difficulty in starting a conversation about weight with patients. Most pharmacists performed diet and weight-loss product counselling, but few pharmacists monitored patients' progress and adherence to WMS because of the follow-up difficulty. They recommended the use of mobile applications and social media to facilitate monitoring. Pharmacists viewed that those weight-loss products needed to be better regulated. Therefore, it should be pharmacists' responsibility to correct the irrational use of these products. Pharmacists' authority, inadequate pharmacist staff, lack of patient awareness, patients' demand, and private counselling areas were the barriers to weight management service. Knowledge and training, accreditation, time for pharmacists to study, reimbursement, multidisciplinary collaboration, and health resource support could motivate pharmacists to provide WMS. To start WMS, pharmacists reported the need for knowledge about diet, lifestyle modification, weight-loss products, and improving patient engagement in weight management programs. Conclusion: The study provided a conceptual framework for WMS. Most pharmacists had a positive attitude toward and intention to provide WMS. The support of weight management knowledge and skills and resources were needed to start WMS in community pharmacy.