Glucagon-like peptide-1 (GLP-1) medicines have shifted obesity treatment toward chronic disease management rather than relying on willpower. As their use increases, public interest has also grown. Some view these drugs as legitimate medical treatments, while others consider them controversial, particularly when used outside established guidelines. This article reviews how these medicines work, their applications, benefits and risks, with particular attention to stigma, inequality and ethical considerations. 

Most commonly used weight-loss medications, such as Wegovy, Ozempic, and Mounjaro, all have the same mechanism of action. The active ingredient of these weight-loss medications is Semaglutide. This chemical acts asa  GLP-1 and GIP/GLP-1 agonist. The long-acting GLP-1 receptor agonist that enhances glucose-dependent insulin secretion and suppresses glucagon from pancreatic alpha cells. It slows gastric emptying and acts on the hypothalamic appetite centre to reduce hunger and energy intake.
Doses for these medicines are once-weekly by s.c. injection, titrated to reduce GI adverse effects. Typical regimen is 0.25 mg weekly for 4 weeks, then 0.5 mg, 1.0 mg, 1.7 mg, up to 2.4 mg as a maintenance dose for chronic weight management. 

Many people turn to weight-loss medication because repeated attempts at diet and exercise alone have not led to sustainable results, often due to biological factors such as genetics, hormones, or metabolic conditions. For others, these medications help manage obesity-related health risks like type 2 diabetes, cardiovascular disease, or joint problems, improving overall quality of life rather than appearance alone. They can also offer psychological relief by reducing constant food preoccupation, allowing individuals to engage more consistently in healthier behaviours without the burden of chronic hunger.(Heitmann, 2025)

Weight-loss medicines differ in their approved indications, formulations, excipients and eligibility criteria. Wegovy is licensed in the UK for chronic weight management in adults with obesity (BMI ≥ 30) or those who are overweight (BMI ≥ 27) with a weight-related condition and to reduce cardiovascular risk in at-risk adults. Mounjaro is licensed for the treatment of type 2 diabetes in adults and children aged 10 and older, and for weight management in adults with a BMI ≥ 35 and a weight-related condition. Ozempic is licensed for type 2 diabetes and is not authorised for weight management in the UK (GOV.UK, 2025). All three medicines are supplied as once-weekly injections however their formulations contain different excipients. Wegovy contains disodium phosphate, sodium chloride and water for injection (Novo Nordisk Limited, 2026);  Mounjaro contains sodium phosphate dibasic, benzyl alcohol, glycerol and pheno‌l (Eli Lilly and Company Limited, 2026); and Ozempic contains disodium phosphate, propylene glycol and phenol (Novo Nordisk Limited, 2025).

However, there are important disadvantages to consider, as well as potential side effects. Common side effects include nausea and vomiting, while more serious risks include drug-induced acute pancreatitis and a possible increased risk of thyroid cancer, especially in people with a family or personal history. Healthcare professionals are also concerned about long-term reliance on medication, as stopping medication may result in weight regain and loss of glycaemic control. This emphasises the importance of combining drug treatment with sustainable lifestyle changes, and the importance of healthcare professionals highlighting this to patients when prescribing weight-loss medications.  

Stigma around weight-loss medication often frames it around being a shortcut or a moral failing. This reflects on long-standing beliefs that weight should be managed solely through willpower and lifestyle change and should not be through the easy way of using medication. In the UK, this stigma is reinforced by cautious prescribing, limited NHS access, and the absence of direct-to-consumer advertising due to restrictions, which keeps these treatments relatively low-profile and medically framed. However in contrast in the US, there is a more widespread advertising of prescription weight-loss drugs presenting them as empowering, life-changing solutions, but this visibility can also fuel backlash and skepticism about over-medicalisation. Usage in both countries has risen sharply, driven by newer GLP-1 medications and growing recognition of obesity as a chronic condition rather than a personal failing.(Heitmann, 2025)

In clinical practice, weight‑loss drugs are prescribed as an adjunct to diet and physical activity. Typical medical use include:
Long‑term management of obesity to reduce risks of type 2 diabetes and cardiovascular disease
Improving control of existing conditions such as type 2 diabetes, hypertension, and obstructive sleep apnoea by reducing weight
Outside guideline‑driven care, GLP‑1 agonists have been adopted by aesthetic clinics and wellness spas for “cosmetic” weight loss in people who may not meet medical obesity criteria. Surveys of aesthetic plastic surgeons show that about a quarter report prescribing GLP‑1 agonists are for cosmetic weight loss or to optimise patients before body‑contouring surgery. 

Pharmacological weight loss interventions present significant ethical challenges related to social inequality and the perpetuation of fatphobia. Restricted access, often due to high costs and private prescribing practices, primarily benefits individuals from higher socioeconomic groups and exacerbates existing health disparities. Framing weight loss as a desirable outcome may portray larger bodies as inherently unhealthy and reinforce social expectations that favour thinness. These perspectives may contribute to the stigma experienced by individuals who are unable or unwilling to pursue treatment, by framing body size as a s personal failing rather than the result of complex, multifactorial influences. Furthermore, the increasing use of weight loss medications for cultural or cosmetic purposes may reinforce the perception that thinness is morally superior, thereby intensifying fatphobia and stigma towards those who do not utilise these treatments. If there is no thorough ethical review and fair access, these drugs could reinforce existing biases rather than promote health justice.

Weight loss medications demonstrate efficacy when combined with lifestyle modifications, particularly for individuals at high risk of cardiovascular and metabolic disorders. However, concerns persist regarding adverse effects, long-term safety and the increasing use of these medications for cosmetic purposes. Consequently, careful prescribing practices and comprehensive patient counselling are warranted. Framing weight as a moral issue or characterising these medications as a “quick fix” may exacerbate stigma. To enhance health outcomes and prevent increased inequity or fatphobia, equitable access and adherence to robust guidelines are essential. 


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Reference:
Moiz, A., Filion, K.B., Tsoukas, M.A., Yu, O.HY., Peters, T.M. and Eisenberg, M.J. (2025). Mechanisms of GLP-1 receptor agonist-induced weight loss: A review of central and peripheral pathways in appetite and energy regulation. The American Journal of Medicine, [online] 138(6). doi:https://doi.org/10.1016/j.amjmed.2025.01.021. 
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Tamayo-Trujillo, R., Ruiz-Pozo, V.A., Cadena-Ullauri, S., Guevara-Ramírez, P., Elius Paz-Cruz, Raynier Zambrano-Villacres, Simancas-Racines, D. and Ana Karina Zambrano (2024). Molecular mechanisms of semaglutide and liraglutide as a therapeutic option for obesity. Frontiers in nutrition, 11. doi:https://doi.org/10.3389/fnut.2024.1398059. 

Heitmann, B.L. (2025). The Impact of Novel Medications for Obesity on Weight Stigma and Societal Attitudes: A Narrative Review. Current Obesity Reports, 14(1). doi:https://doi.org/10.1007/s13679-025-00611-5. 

GOV.UK (2025). GLP-1 medicines for weight loss and diabetes: what you need to know. [online] GOV.UK. Available at: https://www.gov.uk/government/publications/glp-1-medicines-for-weight-loss-and-diabetes-what-you-need-to-know/glp-1-medicines-for-weight-loss-and-diabetes-what-you-need-to-know. (Accessed: 8 February 2026)

‌Novo Nordisk Limited (2025). Ozempic 0.5 mg solution for injection in pre-filled pen - Summary of Product Characteristics (SmPC) - (emc) | 9750. [online] Available at: https://www.medicines.org.uk/emc/product/9750/smpc? (Accessed: 8 February 2026)

Novo Nordisk Limited (2026) Wegovy 0.25 mg, FlexTouch solution for injection in pre-filled pen - Summary of Product Characteristics (SmPC) - (emc). [online] Available at: https://www.medicines.org.uk/emc/product/13799/smpc. (Accessed: 8 February 2026)

‌Eli Lilly and Company Limited (2026). Mounjaro KwikPen 10mg solution for injection in pre-filled pen - Summary of Product Characteristics (SmPC) - (emc). [online] Available at: https://www.medicines.org.uk/emc/product/15484/smpc. (Accessed: 8 February 2026)

NHS (2023). Treatment - Obesity. [online] NHS. Available at: https://www.nhs.uk/conditions/obesity/treatment/.

DiabetesontheNet. (2025). NICE overweight and obesity guidelines – what’s new? - DiabetesontheNet. [online] Available at: https://diabetesonthenet.com/diabetes-primary-care/factsheet-nice-obesity-whats-new/. 

Zhang, S., Manne, S., Lin, J. and Yang, J. (2016). Characteristics of patients potentially eligible for pharmacotherapy for weight loss in primary care practice in the United States. Obesity Science & Practice, 2(2), pp.104–114. doi:https://doi.org/10.1002/osp4.46. 

Han, S.H., Ockerman, K., Furnas, H., Mars, P., Klenke, A., Ching, J., Momeni, A. and Sorice-Virk, S. (2024). Practice Patterns and Perspectives of the Off-Label Use of GLP-1 Agonists for Cosmetic Weight Loss. Aesthetic Surgery Journal, [online] 44(4), pp.NP279–NP306. doi:https://doi.org/10.1093/asj/sjad364. 

Guidelinecentral.com. (2026). NICE Overweight and Obesity Management Guideline Summary - Guideline Central. [online] Available at: https://www.guidelinecentral.com/guideline/4223736/ [Accessed 10 Feb. 2026].

Minerva, F. (2025). Ethical Issues Related to the Use of GLP‐1 Receptor Agonists Such as Ozempic and Mounjaro: Impact on Individuals and Society at Large. Bioethics. [online] doi:https://doi.org/10.1111/bioe.70068.

Written by: Aalaa Y, Alina K, Keni S and Seojung K

Effective communication between healthcare professionals is essential for safe medicine use. However, miscommunication frequently occurs at transition points such as hospital discharge, veterinary prescribing, and cross-border healthcare within the EEA. These gaps can compromise medication safety and continuity of care. This article examines common communication failures encountered in pharmacy practice and their impact on patient outcomes. 

The trouble often begins at transition points: admission, transfer between wards, and discharge. These are the moments when medication charts are rewritten, new medicines are started, and old ones are stopped or adjusted. 

Common pharmacy–hospital communication gaps usually have several patterns that are easy to spot:

• Unclear or missing discharge summaries, especially when doses are changed in the hospital, but the reasons are not explained.
• ​No direct contact details for the hospital prescriber or ward, forcing pharmacy staff to spend valuable time phoning through switchboards to clarify urgent questions.

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For patients, these communication failures are not abstract; they translate into very real risks. Confusion about complex regimens—such as anticoagulants, insulin, or high-risk immunosuppressants—can cause preventable hospital readmissions, side effects, and, in the worst cases, life-threatening events. Delays while the pharmacy tries to contact the hospital mean patients may go without essential medicines for days, or they may simply give up and improvise based on what they have at home. 

Another healthcare profession where miscommunication often occurs is with vets. Communication gaps often arise when pet owners arrive with a handwritten or non-standardised prescription from a vet. Unlike prescriptions from a GP/hospital for humans, veterinary scripts can vary widely in format and dosing conventions, depending on the practice or the clinician. Often omitting essential information, such as animal species, weight, diagnosis, and previous treatment, increases the chances of medication errors arising. 

Although pharmacists are heavily trained in human medication, veterinary pharmacology involves species-specific considerations that most pharmacists feel they are incompetent to handle. On the other hand, veterinarians assume that pharmacists have specialised veterinary knowledge, leading to incomplete prescriptions or the omission of critical warnings, such as the fact that benzoic acid derivatives are harmful to cats. (Davidson,2017)

Furthermore, pharmacists would greatly benefit with tailored CPD modules on veterinary medication or even quick reference guides on the common medicines prescribed. 

Miscommunication among healthcare professionals within the EEA (European Economic Area) can occur, especially when pharmacists are required to interpret or validate prescriptions from other countries. Directive 2011/24/EU underscores that the language barrier is one of the major reasons that lead to cross-border communication challenges, which compromise medication safety. Of the 7.7 million prescriptions presented annually outside their country of origin, nearly 46% are unlikely to be dispensed. Pharmacists consistently encounter barriers such as unclear drug names, unfamiliar abbreviations, inconsistent clinical terminology, and insufficient prescribing details. These challenges can be particularly highlighted when healthcare professionals use different languages. Such linguistic gaps can then hinder the confirmation of prescriber identity, the verification of prescription authenticity, and the identification of correct medicines, delaying or potentially causing harm in the safe supply of medications. 

Although EEA pharmacists are required to demonstrate English language proficiency for professional registration, this requirement does not ensure confident or accurate communication in practice. Pharmacists may still experience uncertainty when contacting colleagues in other countries, particularly under time constraints in busy dispensaries where opportunities to clarify ambiguous information are limited. Consequently, pharmacists may then rely on improvised strategies such as online searches or patient-provided translation, which may be incomplete or inaccurate. These language-related miscommunications reflect risks present within single healthcare systems, and are intensified in cross-border contexts, where misunderstandings can abuse medicine safety. 

Miscommunication between healthcare professionals poses significant risks to patient safety, particularly when prescribing information is unclear or incomplete. These challenges are amplified in complex settings such as hospital discharge, veterinary prescriptions, and cross-border care. Improving standardisation, communication pathways, and pharmacist training is vital to reducing medication errors and supporting safe, effective patient care.




References:
Tiwary, A., Rimal, A., Paudyal, B., Sigdel, K.R. and Basnyat, B. (2021). Poor Communication by Health Care Professionals May Lead to life-threatening complications: Examples from Two Case Reports. Wellcome Open Research, [online] 4(1), pp.1–8. doi:https://doi.org/10.12688/wellcomeopenres.15042.1. 

Davidson, G. (2017). Veterinary Compounding: Regulation, Challenges, and Resources. Pharmaceutics, [online] 9(1), p.5. doi:https://doi.org/10.3390/pharmaceutics9010005. 

European Commission Directorate General for Health and Food Safety and Tetra Tech International Development Sp. z o.o, empirica Communication and Technology Research GmbH, Asterisk Research and Analysis (2022). Study supporting the evaluation of the Directive 2011/24/EU to ensure patients’ rights in the EU in cross-border healthcare (SANTE/2021/B2/01). [online] Available at: https://health.ec.europa.eu/system/files/2022-05/crossborder_evaluation-dir201124eu_study_annexes_en.pdf.

Written by: Aalaa Y, Alina K, Keni S and Seojung K

With patient

Sometimes, a misunderstanding in healthcare can cost a life.

This was the case for a Romanian child who had been referred for an MRI scan that required a general anaesthetic. The family received support in spoken translation, however letters from the hospital were not translated, despite the trust being aware that the family required translations. The family did not realise that the MRI scan required the child to be fasting beforehand. This resulted in the scan being cancelled. After an 11-week delay, the scan was rebooked and the child still had not fasted, resulting in a second cancellation. The MRI scan was carried out the following day, however the child died. (NHS England, 2025) Despite whether the child’s death being due to the delayed MRI scan is contested, this case still emphasises a systemic issue in the NHS and how non-English speaking families are let down by a system that overlooks their needs.

In the UK, there is a reported 1 million people with limited or no English proficiency, putting them at high risk of miscommunication when accessing healthcare services. Lord Darzi’s independent review of the NHS highlighted, ‘Those in greatest need have the poorest access to care’, and inconsistent translation services exacerbate inequalities. (NHS England, 2025) Miscommunication between a pharmacist and a patient can result in misunderstandings about directions for use of a medicine, side effects, food/drug interactions or medical device use. It can make it difficult for patients to communicate their symptoms, resulting in inaccurate diagnoses and inaccurate medicine selection.
However, it is not only non-English speaking patients that face health disparities and an increased risk of medication errors.

According to NHS Employers and the Business Disability Forum, 1 in 5 people have a disability, and of those, 80% have a hidden disability. Despite this, patients with disabilities remain at a high risk of medication errors.(General Pharmaceutical Council, 2024)
A case investigated by the Care Quality Commission (CQC) in 2016 found that a patient with dementia in a Manchester care home was given another patient’s heart medication instead of her own painkillers, resulting in her blood pressure dropping and causing the patient to be hospitalised – the patient fortunately recovered. This happened as staff mixed up medication charts due to similar patient names and did not verify the resident’s identity. Since the patient had dementia, she was unable to clarify her medication. In this case, her condition meant that she was unlikely to notice or be able to advocate for herself, highlighting how cognitive impairment in patients with dementia can increase the risk of medication errors if additional safety nets are not put in place for them. (Caring for Care, 2025)

A study by Zaal et al showed that 47.5% of a sample of older patients with an intellectual disability had at least one prescription error compared to around 20% prescription error rates in general outpatient settings. This is only one example of how patients with disabilities grapple with a healthcare system that is not always designed to meet their needs.(Zaal et al., 2013)

Addressing these risks for patients with disabilities and limited English proficiency requires systemic solutions. This can include translated Patient Information Leaflets with simple diagrams, pictograms and a wider use of interpreters. (Barros et al., 2014) Pharmacies can also do more for patients with disabilities including; designing protocols for involving carers/family when a patient has been assessed as needing additional support in communication, implementing accessible information formats, simplified medication regimens and additional disability-specific training for healthcare professionals.(General Pharmaceutical Council, 2024)
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Ultimately, miscommunication between patients and pharmacists presents as a healthcare barrier and not just a language barrier. When instructions are not understood by the patient, their safety and treatment outcomes are at high risk. By investing in making communication accessible for all patients, including those with limited English proficiency or disabilities, we can promote an equitable healthcare system where all patients can access the level of care they need. Being able to communicate with the pharmacist isn’t just a bonus – it is essential for effective counselling, dosage guidance and safety advice.




References:
 England, N. (2025). NHS England» Improvement framework: community language translation and interpreting services. [online] England.nhs.uk. Available at: https://www.england.nhs.uk/long-read/improvement-framework-community-language-translation-and-interpreting-services/.

 Barros, I.M.C., Alcântara, T.S., Mesquita, A.R., Santos, A.C.O., Paixão, F.P. and Lyra, D.P. (2014). The use of pictograms in the health care: A literature review. Research in Social and Administrative Pharmacy, 10(5), pp.704–719. doi: https://doi.org/10.1016/j.sapharm.2013.11.002.

 Zaal, R.J., van der Kaaij, A.D.M., Evenhuis, H.M. and van den Bemt, P.M.L.A. (2013). Prescription errors in older individuals with an intellectual disability: Prevalence and risk factors in the Healthy Ageing and Intellectual Disability Study. Research in Developmental Disabilities, 34(5), pp.1656–1662. doi:https://doi.org/10.1016/j.ridd.2013.02.005.

 Caring for Care (2025). Medication Error Cases: Lessons from the UK & US. [online] Caring For Care. Available at: https://caringforcare.co.uk/medication-errors-cases/.

 General Pharmaceutical Council. (2024). Providing pharmacy services to people with hidden or non-visible disabilities | General Pharmaceutical Council. [online] Available at: https://www.pharmacyregulation.org/about-us/news-and-updates/regulate/providing-pharmacy-services-people-hidden-or-non-visible-disabilities. 

Written by: Aalaa Y, Alina K, Keni S and Seojung K

Heart attacks (myocardial infarctions) and strokes are considerably more common in diabetics. One of the main causes of death for this population is still cardiovascular disease. The good news is that statin therapy can significantly lower these risks if started early, according to recent research.

​Based on data from more than 7,000 diabetics, the study discovered a significant difference in outcomes between those who started taking statins right away and those who waited about 2.7 years. Just 6.4% of the early starters had a heart attack or stroke over a ten-year period. On the other hand, such events occurred in 8.5% of those who delayed. Waiting to start treatment alone results in a nearly 50% increase in risk.
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What causes this to occur? Long-term exposure to elevated LDL cholesterol levels is a significant contributing factor. Early starters of statin therapy had an average LDL level of approximately 99 mg/dL, while those who postponed treatment had an average of approximately 126 mg/dL. Over time, elevated cholesterol leads to the accumulation of plaque in arteries, which is a major cause of cardiovascular events.

​Statins slow the development of atherosclerosis by lowering LDL cholesterol. Even in those without known heart disease, statins have been demonstrated to help prevent heart attacks and strokes in landmark trials such as WOSCOPS and JUPITER. This new study supports that evidence by showing that starting statins at a specific time has a big impact, in addition to whether you take them at all.

For clinicians, this emphasizes the importance of early intervention. Time really is muscle—and brain, when it comes to strokes. For patients, it’s a reminder that waiting “just a few years” to start statins can have real long-term consequences. Addressing concerns early, discussing side effects honestly, and emphasizing the proven safety of statins can help guide more people toward making timely decisions about their heart health.
In short, early statin use isn't just a good idea—it could be the key to preventing major health events down the line. For people with diabetes, this could be one of the simplest and most effective tools in reducing their lifetime cardiovascular risk.

References

• Starting statins early may prevent MI and stroke. Pharmacy Magazine. Published June 6, 2024.
  https://www.pharmacymagazine.co.uk/clinical-news/starting-statins-early-may-prevent-mi-and-stroke
  
• Statin. Wikipedia – Statin Mechanism and Use.
  https://en.wikipedia.org/wiki/Statin
  
• West of Scotland Coronary Prevention Study (WOSCOPS). Wikipedia.
  https://en.wikipedia.org/wiki/WOSCOPS
  
• JUPITER trial. Wikipedia.
  https://en.wikipedia.org/wiki/JUPITER_trial
  

As January 31st marked one year of Pharmacy First, the UK has seen significant contributions to community pharmacy since the launch of the NHS service.
 
What is Pharmacy First?
 
Pharmacy First is a free NHS consultation service that allows pharmacists to treat seven common conditions without patients needing to book an appointment with a GP (NHS England, 2024). It serves as an extension and replacement for the NHS Community Pharmacist Consultation Service (CPCS) which launched in October of 2019. With the aims of minimising pressure on primary and urgent care services, CPCS was introduced to enable patients to get an appointment at a community pharmacy for a minor illness or urgent supply of a regular medicine (Centre for Pharmacy Postgraduate Education, 2024). Building on what was previously provided in CPCS, Pharmacy First includes the addition of clinical pathways for the following conditions (Community Pharmacy England, 2023):

• Acute otitis media (aged 1-17 years)
• Impetigo (aged 1 year and over)
• Infected insect bites (aged 1 year and over)
• Shingles (aged 18 years and over)
• Sinusitis (aged 12 years and over)
• Sore throat (aged 5 years and over
• Uncomplicated urinary tract infections (women aged 16-64 years)

 
In terms of funding, pharmacies are paid £15 for every clinical pathways consultation completed (Community Pharmacy England, 2023). Monthly consultation thresholds have also been set for pharmacies to receive an additional fixed monthly payment of £1,000 for achieving targets.
 
 
Successes of Pharmacy First
 
Major successes have been observed since the introduction of the NHS service, with almost two million Pharmacy First consultations being carried out over the past year.
 
Although Pharmacy First is an example of an advanced service within the NHS Community Pharmacy Contractual Framework (CPCF), meaning that it is not compulsory for all pharmacies to offer it, roughly 98% of community pharmacies are registered to provide the service as of 2025. Massive contributions have been made to relieve pressure on other areas of the NHS as a result of this.
 
The Company Chemists’ Association revealed that in the first month of Pharmacy First, almost 50,000 clinical pathways consultations were delivered by CCA members, equating to almost 1,500 daily consultations. The impacts were particularly seen in areas of higher deprivation, with two and a half times more consultations taking place compared to less deprived areas – this highlights the difference made from improved access to care (Company Chemists’ Association, 2024).
 
On launching, it was said by NHS England that Pharmacy First, in addition to pharmacy blood pressure and contraception services, would save up to 10 million GP appointments annually. Moreover, with a greater proportion of the workforce qualifying as independent prescribers, we can expect Pharmacy First to form the foundation of a more robust community pharmacy prescribing service including more clinical pathways in the future (McQuillan, 2025).
 
 
Challenges of Pharmacy First
 
Despite the launch of Pharmacy First achieving many successes, there have been several challenges that have accompanied them.
 
Whilst some pharmacies have been able to stay on target, some independent pharmacies have expressed their struggles with meeting the minimum number of clinical pathways consultations to receive the fixed monthly payments of £1,000 (Trainis, 2025). Although many pharmacists agree that Pharmacy First has been a great development to community pharmacy, some believe that the funding is not proportionate to the workload they are receiving. To deliver the service well, pharmacists invest a lot of their time into training, ensuring that safe and effective care is provided to patients. Some pharmacists have suggested raising the fees for each consultation completed to support the sustainability of the service in the long run. With the thresholds continually being on the rise, several pharmacies have found it increasingly difficult to reach targets and have lost hope in reaching the new thresholds for future months.
 
Struggles to meet the monthly thresholds could be linked to other issues over the year such as IT system disruptions and lack of public promotion (Community Pharmacy England, 2025). Incorrect GP referrals have also posed an issue as some pharmacies reported patients being referred to Pharmacy First despite not meeting the eligibility criteria for certain conditions (Chemist and Druggist, 2024). As responsibilities continue to increase, the need for at least two pharmacists to be working at every community pharmacy must be established in order to cope with the shift in pressure from GP clinics (The Pharmacists’ Defence Association, 2022).
 
 
With the immense amount of pressure the NHS is under, a collective agreement can be made that Pharmacy First is a step in the right direction for patients to get access to the care that they deserve. By developing ways to further increase public awareness and increase GP referral rates, Pharmacy First has the potential to change the trajectory of healthcare in the UK for the better.
 
 
References:
 
Bowie, K. (2024) Sector calls for ‘clearer Pharmacy First messaging’ amid patient aggression: Chemist and Druggist. Available at: https://www.chemistanddruggist.co.uk/CD138007/Sector-calls-for-clearer-Pharmacy-First-messaging-amid-patient-aggression/ (Accessed: 9 February 2025).

Centre for Pharmacy Postgraduate Education (2024) NHS Pharmacy First service: Centre for Pharmacy Postgraduate Education. Available at: https://www.cppe.ac.uk/services/pharmacy-first/ (Accessed: 9 February 2025).

Community Pharmacy England (2023) Pharmacy First service: Community Pharmacy England. Available at: https://cpe.org.uk/national-pharmacy-services/advanced-services/pharmacy-first-service/ (Accessed: 9 February 2025).

Community Pharmacy England (2025) Reflections on Pharmacy First: One Year On: Community Pharmacy England. Available at: https://cpe.org.uk/our-news/reflections-on-pharmacy-first-one-year-on/ (Accessed: 9 February 2025).

Company Chemists' Association (2024) First month of Pharmacy First shows the NHS service is enhancing patient access and directly tackling health inequalities: Company Chemists' Association. Available at: https://thecca.org.uk/first-month-of-pharmacy-first-shows-the-nhs-service-is-enhancing-patient-access-and-directly-tackling-health-inequalities/ (Accessed: 9 February 2025).

McQuillan, H. (2025) Pharmacy First: A year of transformation for community pharmacy: The Pharmacist. Available at: https://www.thepharmacist.co.uk/community/views/pharmacy-first-a-year-of-transformation-for-community-pharmacy/ (Accessed: 9 February 2025).

NHS England (2024) Pharmacy First: NHS England. Available at: https://www.england.nhs.uk/primary-care/pharmacy/pharmacy-services/pharmacy-first/ (Accessed: 9 February 2025).

The Pharmacists' Defence Association (2022) PDA publishes innovative proposals around opportunities for post-Covid-19 pharmaceutical care: The Pharmacists' Defence Association. Available at: https://www.the-pda.org/pda-publishes-innovative-proposals-around-opportunities-for-post-covid-19-pharmaceutical-care/ (Accessed: 9 February 2025).

​Trainis, N. (2025) Independents reveal struggles with Pharmacy First as service marks one year: Pharmacy Magazine. Available at: https://www.pharmacymagazine.co.uk/news/independents-reveal-struggles-with-pharmacy-first-as-service-marks-one-year (Accessed: 9 February 2025).
 
Written by: Li Wei Law

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Cardiovascular disease (CVD) remains one of the leading causes of morbidity and mortality globally. Within the United Kingdom, significant progress has been made to combat this issue through innovative healthcare strategies. A recent NHS England report portrays that pharmacist-led interventions in CVD prevention yield the highest return on investment (ROI) among public health initiatives, showing the important role of pharmacists in improving patient outcomes and optimizing healthcare spending (1).
 
The Impact of Pharmacist-Led Interventions 
Pharmacists are uniquely positioned to play a central role in CVD prevention due to their accessibility, expertise in medication management and finally the ability to provide specific patient care. These interventions typically focus on early detection, lifestyle changes as well as medication optimisation. Examples include conducting blood pressure checks, managing cholesterol through lipid-lowering therapies, and supporting adherence to antihypertensive or anticoagulant medications.
According to the NHS report, pharmacist-led approaches demonstrated a higher ROI compared to other CVD prevention strategies. This is due to pharmacists’ ability to reach a broader population, address gaps in care, and reduce the burden on primary care physicians (1). Early detection and prevention efforts lead to fewer hospitalizations, reduced emergency admissions, and lower long-term treatment costs.
 
Cost-Efficiency Meets Clinical Efficacy 
The financial implications of CVD are massive with billions spent every year on treatment and associated complications. The NHS report indicates that pharmacist-led interventions not only improve patient outcomes but also reduce these costs by preventing disease progression and minimising expensive interventions such as surgery or hospitalisation (1). For example, regular blood pressure checks and cholesterol management can delay or prevent the onset of conditions like myocardial infarction or stroke.
In addition to cost savings these interventions empower patients to take control of their health. Pharmacists take part in motivational counseling, addressing barriers to lifestyle changes such as diet, smoking cessation, and exercise. This holistic approach ensures sustainable health benefits that extend beyond immediate clinical outcomes.

Bridging Gaps in Healthcare Access 
Another important element influencing pharmacist’s efficacy in preventing CVD is their accessibility. Preventive care is made more convenient by the availability of community pharmacies in busy locations. In these pharmacies patients can obtain treatments and advice without making an appointment. Furthermore, underprivileged communities with limited access to general practitioners benefit greatly from these services.
Pharmacist-led interventions are typically successful in identifying high-risk individuals who could otherwise go undetected, according to the NHS analysis. For instance, undiagnosed hypertension, also known as the "silent killer," might result in serious consequences. Pharmacists can prevent these cases from developing by providing regular examinations and follow-up care, which will greatly lower the burden of disease (1).
 
 
Challenges and the Way Forward 
Despite the clear benefits, some challenges remain. A critical issue is the integration of pharmacist-led services into broader healthcare systems. Collaboration between pharmacists, general practitioners and other healthcare providers is essential for ensuring high quality care. Additionally, adequate funding and resources must be allocated to support these initiatives and expand their reach.
Training and professional development are also vital. Pharmacists must continue training in areas such as cardiovascular risk assessment and chronic disease management to maximize their impact.
 
Conclusion 
The NHS report provides compelling evidence that pharmacist-led interventions are a cost- effective and clinically effective strategy for reducing the burden of cardiovascular
disease. By leveraging pharmacists’ expertise and accessibility, healthcare systems can achieve substantial improvements in patient outcomes while optimising resource allocation. As the UK continues to face rising healthcare costs and an aging population, pharmacist-led CVD prevention initiatives represent a scalable, sustainable solution.
References 

1. NHS England. Pharmacist-led cardiovascular disease interventions provide highest return on investment, says NHS report. Pharmaceutical Journal [Internet]. 2025 [cited 2025 Jan 14]. Available from: https://pharmaceutical-

journal.com/article/news/pharmacist-led-cardiovascular-disease-interventions- provide-highest-return-on-investment-says-nhs-report

1. NHS England. NHS community pharmacy blood pressure check service [Internet]. England: NHS England; 2023 [cited 2025 Jan 26]. Available from: https://www.england.nhs.uk/primary-care/pharmacy/pharmacy-services/nhs- community-pharmacy-blood-pressure-check-service/

From the 18th to the 24th of November is World Antimicrobial Resistance Awareness Week (WAAW), which focuses global attention on a covert crisis threatening the health of humans, animals and the environment: antimicrobial resistance (AMR).[1] A hurdle in healthcare systems and an obstacle for the efficacy of once impervious life-saving antimicrobial drugs, AMR endangers progress in modern medicine and now renders once easily treatable diseases life-threatening.[2] This blog will cover what AMR is, how it occurs, its global impact, the role of pharmacists in combating AMR, and the often neglected human and future financial cost of AMR.
 
What is AMR
When infectious microorganisms (like bacteria, fungi, viruses or parasites) evolve to become more resistant to their antimicrobial treatments, AMR occurs. This could mean bacteria are less affected by antibiotics or viruses are less affected by antivirals, resulting in infections caused by them being harder to treat.[3] Although AMR is a natural phenomenon driven by genetic changes in target organisms, its prevalence is primarily accelerated by the misuse of antimicrobial medications in humans and animals.[4]
 
What causes AMR?
AMR is the consequence of several coalescing factors, which can accelerate the birth of new ‘superbugs’. Superbugs are resistant, infectious microorganisms that cannot be killed by medicines that are usually the first choice for treating them.[5 6] One of these factors is the misuse of antimicrobials. For example, the overprescription of antibiotics for mild or even viral infections like colds and flu is a significant contributor to antibiotic resistance, with the sharing of medicines or failure to complete a course of one’s medicine only exacerbating the problem, as if not all of the infectious bacteria is eliminated from a patient, some stragglers can undergo genetic changes to become more resistant to the medicine and multiply to infect other people. The same principle applies to fungal or even parasitic infections.[7] Similarly, veterinary medicine in farming, whereby large amounts of cattle are given medicine to prevent disease, is another ‘hot-pot’ for the development of antimicrobial resistance.[8] A lack of awareness of the consequences of AMR resistance means careless behaviour regarding antimicrobial medications is encouraged, while a lack of regulation means that in some nations, the use of antimicrobials without a prescription is perfectly legal, resulting in overuse and improper use. Poor infection control is another factor that can lead to antimicrobial resistance. This is where poor hygiene practices in some hospitals and community settings increase the spread of superbugs, while poor sanitation and a lack of drinking water in developing countries worsen this problem, which highlights the fact that AMR is not a crisis unique to developed nations.[9] When unused drugs are improperly disposed of, and agricultural runoff containing antibiotics reaches the environment, they may present in low concentrations in water and soil. This furthers the spread of resistant microorganisms even outside of settings where medicines are used the most.[10]
 
The Global Impact of AMR
Antimicrobial resistance can be detrimental to modern society since it has substantial global consequences. Economic expenses are one of the most significant impacts of AMR. AMR generates large direct and indirect costs. Direct expenses include costs required while treating the disease at hospitals and pharmacies. Pathogens being resistant to their medications makes it more challenging for healthcare providers to deliver adequate treatment to the patient. This can result in a prolonged treatment period and increased charges. Moreover, AMR puts immense pressure on pharmaceutical companies, as there is a greater demand for alternative antibiotics, while there are more difficulties in the research process.

In addition to the direct costs, AMR may also result in indirect costs due to the loss of output due to the lack of effective labour supply. This is because AMR leads to increased morbidity, disability, and premature death of workers.[11] According to the World Bank, the direct cost of AMR is predicted to be over $1 trillion over the next fifteen years. Furthermore, the GDP loss is expected to reach $ 1-3.4 trillion USD per year by 2030.[11]
 
The Role of Pharmacists in Combating AMR
Pharmacists could take part in a number of steps to address this worldwide issue. Firstly, pharmacists can help ensure the responsible use of antibiotics. This involves determining if antibiotics are necessary for an individual and providing the proper type, dosage, and frequency of treatment for the patient. Furthermore, pharmacists are responsible for educating patients about antibiotic misuse and encouraging safe and effective self-care.[1] Another strategy to help reduce AMR is to prevent infections from occurring in the first place. Infection rates can be reduced by encouraging vaccinations and promoting hygienic practices, including appropriate handwashing and food safety. Finally, pharmacists can assist in enhancing the general understanding of AMR risks. They can offer educational sessions in schools, workplaces, and local communities or actively engage in initiatives such as Antimicrobial Awareness Week to inform the public about the AMR.
 
The Importance of Action
The importance of pharmacists in preventing AMR becomes even more apparent when considering real-life cases like Rosa’s, where multidrug-resistant infections lead to severe complications. Rosa was 6 weeks old when she had a seemingly simple respiratory illness that turned out to be multidrug-resistant Klebsiella pneumonia. This led to three years of surgical operations, various unsuccessful antibiotic treatments, rehabilitation, and concerns about her future.[12]

Antimicrobial resistance is a complex global issue that requires immediate action from everyone. Simple steps, such as raising awareness, using antibiotics responsibly, and maintaining proper hygiene, can significantly reduce the number of patients affected by this growing threat. By tackling antimicrobial resistance today, we can prevent a devastating healthcare crisis in the future and safeguard our health.
 
Reference List
1. WHO (2023) Antimicrobial resistance, World Health Organization. Available at: https://www.who.int/news-room/fact-sheets/detail/antimicrobialresistance?gad_source=1&gclid=Cj0KCQiA6Ou5BhCrARIsAPoTxrDNqGzwS2D61DKznm3lBvudzMNMCBCuBCfVgA0YqXPoWx1PgL5UR4YaAiiEEALw_wcB (Accessed: 18 November 2024).
2. NHS Inform. (n.d.) Antimicrobial Resistance (AMR). Available at: https://www.nhsinform.scot/campaigns/antimicrobial-resistance-amr/ (Accessed: 20 November 2024).
3. NHS England. (n.d.) Antimicrobial Resistance (AMR). Available at: https://www.england.nhs.uk/ourwork/prevention/antimicrobial-resistance-amr/ (Accessed: 20 November 2024).
4. World Health Organization (WHO). (n.d.) Antimicrobial Resistance. Available at:
https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance (Accessed: 20 November 2024).
5. Mayo Clinic. (2023) What in the World is Antimicrobial Resistance? Available at: https://newsnetwork.mayoclinic.org/discussion/what-in-the-world-is-antimicrobial-resistance/ (Accessed: 20 November 2024).
6. Cleveland Clinic. (n.d.) Superbug Infections. Available at: https://my.clevelandclinic.org/health/diseases/superbug  (Accessed: 20
November 2024).
7. Dignity Health. (2016.) Why Is Finishing Antibiotics So Important? Available at: https://www.dignityhealth.org/articles/why-is-finishing-antibiotics-so-important (Accessed: 20 November 2024).
8. Wang, Y., Li, X., Wang, Y., Zhang, T., Liu, J., Zhu, L. and Du, X. (2023) ‘Understanding Antimicrobial Resistance: Progress and Challenges’, Frontiers in Microbiology, 14, p. 10044628. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC10044628/  (Accessed: 20 November
2024).
9. Prestinaci, F., Pezzotti, P. and Pantosti, A. (2015) ‘Antimicrobial resistance: A global multifaceted phenomenon’, Antimicrobial Resistance and Infection Control, 4, p. 22. Available at: https://aricjournal.biomedcentral.com/articles/10.1186/s13756-017-0208-x (Accessed: 20 November 2024).
10. Liu, Y., Gu, Y., Zhang, Z., Yang, C., Zheng, S., and Xie, L. (2023) ‘Intensive Agriculture and Antimicrobial Resistance: Potential Risks and Consequences for Human Health’, Frontiers in Public Health, 11, p. 10482381. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC10482381/ (Accessed: 20 November 2024).
11. World Bank Group (2017). Drug resistant infections, a threat to our economic future. Available at: https://documents1.worldbank.org/curated/en/323311493396993758/pdf/final-report.pdf
Ecdc (Accessed: 18 November 2024).
12. European Center for Disease Prevention and Control (2024). Patient story: Rosa. Available at: https://antibiotic.ecdc.europa.eu/en/patient-story-rosa (Accessed: 18 November 2024).

Written by Yoobin Cho and Zion Lindsay