HEALTH SCREENING SERVICES IN COMMUNITY PHARMACY: A TEACHER’S COMPREHENSIVE GUIDE
Welcome, future pharmacists and healthcare professionals!
Health screening services are defined as services provided by healthcare professionals to the general public and patients. In general, for most adults depending on age, a basic health screening involves a schedule of screenings that includes routine physical examinations, body mass index (BMI) assessments, skin examinations, blood pressure and cholesterol assessments, blood sugar assessments, eye exams, lung function tests, bone density assessments, immunisations, and screening for sexually transmitted infections.
Screening is described as the use of rapid tests or examinations to presumptively identify people with unrecognised diseases so that prompt treatments can be made to stop the disease from progressing. Early screening can lead to early treatment, such as intense hyperglycaemia and hypertension control; and hence a better illness prognosis.
Dpharmguru’s exam insights:
In my years of teaching community pharmacy, I have observed that health screening is one of the most important services pharmacists can provide. Remember: Early detection through screening can mean the difference between simple treatment and life-threatening complications. This is a key topic that frequently appears in exams!
OBJECTIVES OF HEALTH SCREENING
- Early Detection: The goal of health screening is to find risk factors or diseases that are seen in healthy individuals. Early condition detection enables prompt intervention and improved results.
- Risk Assessment: Screening can help to evaluate person’s risk factors for various diseases. This evaluation aids in the customisation of focused interventions and preventative actions.
- Prevention: It is essential to actively monitor for disease among those who appear to be in good health. By spotting any health problems before they get worse, screening helps us avoid illness.
- Treatment Optimisation: To avoid the serious risk of diseases, early detection of diseases followed by suitable treatment and effective disease management should be done.
SCOPE OF HEALTH SCREENING
- Screening: It can help to lead longer and healthier lives. It is also important in identifying symptoms in individuals who do not show any signs yet.
- Mass Screening: It is often recommended and can be cost-effective for certain diseases. Its aim is to improve health outcomes. For example, the detection of high blood pressure at an early stage.
- Medication and Counselling: It can help to prevent stroke and heart disease, which detected in the early stage by changes in lifestyle, for example, cutting down on salt, regular exercise, losing weight, and giving up smoking.
- Future Need: It will become even more important in the future. Some companies do a genetic profile of a person and offer their services. They then provide a risk profile of possible disease that they may be susceptible to.
Dpharmguru’s exam insights:
A common exam question is: “What are the objectives of health screening?” Remember: Early Detection, Risk Assessment, Prevention, and Treatment Optimisation. These are frequently tested!
ROLE OF PHARMACIST IN HEALTH SCREENING
Pharmacists should offer health tests as part of their Medication Therapy Management (MTM) services. Blood glucose and blood pressure readings, cholesterol levels, Opioid Use Disorder (OUD), and mental health screenings are done by pharmacists as part of preventive care.
Pharmacists can be alerted to seek for risk indicators by using technology. Pharmacists in MTM practise settings are in a unique position to perform screenings to improve patient health outcomes and eliminate racial inequities. Through health screenings, pharmacy students can have a significant impact on patient care.
To prevent drug overdoses, pharmacists can play an important role in OUD screenings in the community. During the peak of COVID-19 epidemic, more over 96,000 drug overdose deaths occurred between March 2020 and March 2021, according to the CDC.
Pharmacist also plays an important part in ensuring that patients have access to naloxone, a life-saving medicine for opioid overdose reversal. The Resources Encouraging Safe Prescription Opioid and Naloxone Dispensing (RESPOND) tool kit was created to help community pharmacies improve their opioid safety screening and communication procedures.
IMPORTANCE OF HEALTH SCREENING SERVICES
- Health screening services are provided by healthcare experts to check on the health of people who have or do not have positive signs and symptoms.
- Health screening is critical for spotting signs of sickness in early stages.
- Early detection might mean the difference between basic treatments and life-threatening consequences that necessitate lengthy and costly hospital stays.
- A better likelihood of cure exists when a disease is detected early. For example, checking blood pressure can assist in identifying one of the risks associated with heart disease.
- Health screening services can be offered by health professionals or trained technicians in hospitals, clinical and community pharmacies, or any other acceptable environment that meet the minimal requirements.
In Routine Monitoring of Patients
- The most frequent screening test for obesity is the Body Mass Index (BMI), which is simple to calculate and highly reliable.
- Waist circumference and waist-to-hip ratio may represent the elevated cardiovascular risk associated with central adiposity in non-obese people.
- Depression screening can be done by having people complete the Hamilton Depression Rating Scale (HAM-D) questionnaire.
- Lipid profile provides a thorough examination of high cholesterol levels, including HDL (good cholesterol), LDL (bad cholesterol), and triglycerides.
- Blood sugar and blood pressure can be checked.
- Addiction, abuse, and misuse of drugs can be assessed.
- Pulmonary function tests can be performed.
- Nutritional assessment can be done.
- Health awareness and adherence rating can be determined.
- Bone density testing can be done.
Obesity
Obesity is a condition in which a person’s weight has increased to the point where it is compromising his/her health. While some people are more genetically predisposed to obesity than others, obesity is always caused by an excess of caloric intake over energy expenditure.
BMI Formula: BMI = Weight in kilograms / Height in meters²
| Classification | BMI (kg/m²) | Risk of Diseases |
|---|---|---|
| Underweight | < 20 | Low (but increased risk of other clinical problems) |
| Desirable/Healthy Range | 20-25 | Average |
| Overweight | 25-30 | Increased |
| Obese Class I | 30-35 | Moderate |
| Obese Class II | 35-40 | Severe |
| Morbidly Obese Class III | > 40 | Very Severe |
Blood Cholesterol
A total cholesterol blood test measures cholesterol and triglycerides levels in blood. To check the level of cholesterol in blood, total cholesterol testing is required. Body uses cholesterol to make hormones and create cells. Excess cholesterol in bloodstream can clog arteries and cause plaque to form. Plaque build-up can raise the risk of heart disease.
Blood Glucose
A blood glucose test measures the amount of glucose (sugar) in blood to check for diabetes. Fasting blood glucose levels should be between 70-99 mg/dL (3.9 to 5.5 mmol/L). Pre-diabetes or diabetes may be indicated by higher levels.
| Diagnosis | A1C (%) | Fasting Plasma Glucose (FPG) | Oral Glucose Tolerance Test (OGTT) | Random Plasma Glucose (RPG) |
|---|---|---|---|---|
| Normal | Below 5.7 | 99 or below | 139 or below | – |
| Prediabetes | 5.7-6.4 | 100-125 | 140-199 | – |
| Diabetes | 6.5 or above | 126 or above | 200 or above | 200 or above |
Dpharmguru’s exam insights:
Remember the diagnostic criteria for diabetes: FPG ≥ 126 mg/dL, RPG ≥ 200 mg/dL, or A1C ≥ 6.5%. These are frequently tested in exams! Also, remember that BMI is calculated as weight (kg) divided by height (m²).
Blood Pressure
Hypertension is a prevalent illness that affects about half of all adults. High blood pressure is defined differently by different organisations, the limit for what is deemed high ranges from >130/80 mmHg to >140/90 mmHg.
Lung or Pulmonary Function Tests
- Spirometry: This test determines how much air a person can inhale and exhale. It also determines how quickly he/she can expel air.
- Body Plethysmography: This test analyses how much air is present in the lungs when a person takes a deep breath.
- Lung Diffusion Capacity: This test determines how efficiently oxygen is transported from the lungs to the bloodstream.
Radiological Investigations
Ultrasounds, X-rays, and mammograms are used to look for structural abnormalities, tumours, and stones. CT scans are recommended only after consultation with the patient to avoid substantial radiation exposure.
In Early Detection
Maintaining excellent health and a higher quality of life requires health screening, as well as a nutritious diet and exercise. Health screening and timely or frequent testing are critical for recognising early warning signs of illness, as well as providing the drive to better understand one’s health and make changes as needed.
Screening for Cancer:
- Breast Cancer: Those with a family history should have her genes tested for mutant BRCA. Those over 45 years of age would benefit from a mammogram.
- Prostate Cancer: For men between 50-70 years, a PSA assay and digital rectal examination may be performed.
- Cervical Cancer: All sexually active women should get a Pap smear test.
- Kidney Cancer: A urine test may be performed to see if blood is present.
In Referral of Undiagnosed Cases
- Cancer Screening: Mammography, Colonoscopy, and Pap Smear Test
- Cardiovascular Screening: Blood Pressure Measurement, Lipid Profile Test, and Electrocardiogram
- Diabetes Screening: Fasting Blood Glucose, and HbA1c Testing
- Osteoporosis Screening: Bone Mineral Density Testing
- Infectious Disease Screening: HIV Testing, and Hepatitis Screening
Dpharmguru’s exam insights:
Health screening services are an essential part of community pharmacy practice. Remember: The key screenings include BMI, blood pressure, cholesterol, blood glucose, and cancer screenings. These are essential topics that frequently appear in pharmacy exams!
REFERENCES AND FURTHER READING
- World Health Organization (WHO). (2022). Screening and Early Detection Guidelines. Retrieved from https://www.who.int.
- Pharmacy Council of India (PCI). (2022). Health Screening in Community Pharmacy. New Delhi: PCI.
- International Pharmaceutical Federation (FIP). (2022). Community Pharmacy Health Services. Retrieved from https://www.fip.org.
- Centers for Disease Control and Prevention (CDC). (2022). Health Screening Resources. Retrieved from https://www.cdc.gov.
- Smith, M. C., & Wertheimer, A. I. (2021). Social and Behavioral Aspects of Pharmacy Practice. Pharmaceutical Press.
Disclaimer: This article is for educational purposes only and does not constitute medical advice. Always consult qualified healthcare professionals for medical concerns.
written by:
Dr. N. Sujith Kumar
