Pharmacists Counseling for Community Health: Prevention of Skin Cancer

Andrea L. Wall, RPh.

It has been stated in a variety of publications that the pharmacist is exceptionally qualified to provide comprehensive services to the public because of their extensive education and training.i The pharmacist is accessible and often the first line of healthcare to patients especially in areas where there may be limited access to other healthcare providers. The pharmacist can play a major role in prevention of many medical conditions by providing information, assessing the patient's problems and making recommendations to patients regarding non-pharmacologic interventions as well as recommendations for nonprescription medications. According to Kotecki, the public is well-served by pharmacists who can provide objective knowledge as a resource of nonprescription medication information.ii The Healthy People 2000 initiative was a strategy to encourage change about the state of healthcare in the U.S. The initiative's three goals were to increase the span of healthy life for Americans, decrease the disparity of health among Americans and to give all Americans access to preventive services.iii One study published in the Journal of Community Health examined pharmacists' perceptions of healthy people goals specifically in economically disadvantaged cities in New Jersey. The authors concluded that pharmacists found value in providing preventive services to patients, that they had an increased understanding of community health issues and that the potential exists for pharmacists to be more intimately involved in the objectives of Healthy People 2010.iv The objectives for Healthy People 2010 are to decrease health disparities and provide preventive healthcare. One area that stands out as an opportunity for pharmacists to promote health and prevention is the recommendation for the use of sunscreens for prevention of sun related skin disorders and cancers such as melanoma. The third focus area of Healthy People 2010 relates to skin cancer. It states that action should be taken to reduce the rate of melanoma deaths, and increase the proportion of persons of all ages that use at least one of the following protective measures that may reduce the risk of skin cancer: avoid the sun between 10AM and 4PM, wear sun protective clothing when exposed to sunlight, use sunscreen with an SPF of 15 or greater, and avoid artificial sources of ultraviolet light.v This would provide the sound counseling information the pharmacist would need to counsel patients. Casper and Mehta in the article, "Healthy Skin for Women: A Review of Common Conditions and Therapies," concluded that pharmacists can play an important role in promoting self-care and educating patients about skin health.vi Consumers often make decisions about product choice from advertisements found in magazines. One study evaluated the ads for sun care products in 24 magazines published from 1997 to 2002. The authors found that the information contained in the advertisements was incomplete and that none of the ads contained all of the recommendations for prevention.vii This suggests that pharmacists have the opportunity to work with the public to reinforce the safe use of nonprescription sunscreens. The FDA classifies sunscreen products as over-the-counter (OTC) drug products. A product should be chosen for protection against UVB and UVA radiation. Ingredients contained in sunscreens are classified as UV absorbers or UV blockers. Most OTC sunscreens contain a combination of both to improve SPF factor.viii The consumer should be warned that sun-tanning products do not contain a sunscreen and will not protect against sunburn or other potential harmful effects to the skin.ix Pharmacists should counsel patients about the correct application of sunscreens, including the need to apply 20-30 minutes prior to exposure and reapply every 2 hours or more often if in water. According to the American Cancer Society®, consider the phrase "slip, slop, slap and wrap" as a way to describe to both children and adults four steps to protection: slip on a shirt, slop on the sunscreen, slap on a hat and wrap on sunglasses for eye protection. Many communities have become involved in motivation of the public through awareness campaigns relating to preventing skin disorders and cancer. Two noted in the literature are the Rhode Island Sun Smart Project: A Scientific Approach to Skin Cancer Prevention and a trial in New Hampshire, A Community Based Randomized Trial Encouraging Sun Protection for Children. Both of these studies underscore the impact that public awareness campaigns can make.x,xi The National Cancer Institute has identified a 5-step process for use by healthcare professionals to develop a cancer control plan. This 5-step process provides evidence-based tools that would be of value for a pharmacist who is providing information on safety and prevention to the public. The steps include: assess program priorities, identify potential partners, research review of different intervention approaches, find research tested intervention programs, and plan and evaluate your program.xii To support the pharmacist as a leading healthcare provider in prevention in community health the National Association of Chain Drug Stores has developed a program entitled "Planning a Community Outreach Program."xiii This could be a useful tool for the pharmacist who is interested in beginning a program, such as, promoting sunscreens for protection against skin cancer. --------------------------- i Handbook of Nonprescription Drugs, 14th edition. ii Kotecki JE. Factors related to pharmacists' over-the-counter recommendations. J Com Health. August 2002; Vol; 27(4). iii Healthy People 2000 www.healthypeople.gov. iv Suh, DC, Greenberg, MR, Schneider, D, Colaizzi, JL. Pharmacist's perceptions of healthy people goals in economically stressed cities. J Com Health. April 2002;Vol; 27(2). v Healthy People 2010 www.healthypeople.gov. vi Casper, KA, Mehta BH. Healthy skin for women: a review of common conditions and therapies. J Am Pharm Assoc. Vol; 42(2):206-15. vii Lee ET, et al. Sun care advertising in popular U.S. magazines. Am J Health Promotion. 2006; Vol; 20(5). viii Moloney FJ, Collins S, Murphy. GM. Sunscreens: safety, efficacy and appropriate use. Am J Clin Derm. 2002; Vol; 3(3). ix Food and Drug Administration Center for Food Safety and Applied Nutrition "Required Warning Statement for Tanning Products Without Sunscreens" May 2000. x Weinstock MA, Rossi JS. The Rhode Island Sun Smart Project: a scientific approach to skin cancer prevention. Clin in Dermatol. 1998; Vol; 16:411-413. xi Dietrich AJ, et al. A community based randomized trial encouraging sun protection for children. Pediatrics. 1998; Dec.102(6). xii cancercontrolplanet.cancer.gov (Accessed 06/19/06). xiii www.nacdsfoundation.org (Accessed 06/19/06). Return to Top