Community pharmacies are increasingly recognised as accessible providers of public health services. Integrating cardiovascular health checks and behaviour change strategies with the community pharmacy vaccination service has the potential to improve population health outcomes. This scoping review aims to identify potential pharmacist-led cardiovascular-related services suitable for such integration, and to explore the acceptability and feasibility of pharmacy-led services among both service users and providers.

MEDLINE, EMBASE, CINAHL and Web of Science were systematically searched for UK-based empirical studies published between January 2013 and December 2024.

Primary studies reporting on pharmacist-led cardiovascular-related interventions (eg, blood pressure monitoring, cholesterol screening, smoking cessation) delivered to adults (≥18 years) in community pharmacy settings and reporting on clinical outcomes, feasibility or acceptability were included.

Data were extracted using a standardised form on Excel and synthesised narratively. Key domains of interest included intervention characteristics, facilitators, barriers, perceived outcomes, delivery mode and intervention content including behavioural change strategies or components to support implementation.

Of 8322 records screened, 53 studies met the inclusion criteria. Cardiovascular-related interventions were broadly feasible and acceptable to both patients and pharmacy staff. High patient satisfaction was attributed to the accessibility and convenience of pharmacy locations, as well as the ability of pharmacy staff to establish rapport during interactions. Facilitators of service delivery included private consultation spaces, structured training and access to digital screening tools (eg, devices for atrial fibrillation detection). Barriers included workload constraints and limited public awareness of pharmacy services. Five studies described successful integration of lifestyle interventions within pharmacy-based settings, but the long-term clinical outcomes produced by the intervention were rarely reported. Patients valued the convenience and trusted relationships with pharmacists, though concerns about privacy were raised. Pharmacists reported the need for clearer clinical protocols, and multidisciplinary support and training to improve their confidence in delivering health checks as part of their routine work.

Community pharmacies offer an optimal setting for integrating cardiovascular-related screening interventions with the vaccination service delivered within community pharmacy. Successful implementation will require attention to the identified facilitators including the quality of staff training, competing priorities and optimisation and utilisation of pharmacy space. Future research should prioritise definitive controlled trials and cost-effectiveness analyses to assess long-term health outcomes. Policy action is also needed to support service integration and expand pharmacists’ public health roles within the wider National Health Service.

Depressive symptoms are common in the growing geriatric surgical population and are associated with important patient-centred surgical outcomes, including postoperative delirium, discharge to postacute care facility and decline in functional status. Few interventions have been developed to address depressive symptoms in the perioperative setting.

We designed a feasibility and acceptability study of a nine-session problem-solving therapy (PST) telehealth perioperative intervention aimed at reducing postoperative functional decline and depressive symptoms among at-risk older adults undergoing major surgical procedures. Acceptability will be evaluated using a patient-centred five-question survey, assessing participant satisfaction and perceived usefulness of the perioperative intervention. A feasibility assessment will rely on objective measures including ease of participant recruitment, frequency and timing of delivery of intervention sessions and retention of participants throughout the duration of the intervention. With respect to the efficacy of the proposed PST intervention, the primary outcome of interest is postoperative functional status, as measured by the WHO Disability Assessment Schedule 2.0 at the 6-month postoperative time point. The secondary outcome of interest is the degree of depressive symptoms as assessed by the Patient Health Questionnaire-9 at both 3 months and 6 months postoperatively. The broader goals of this study include: (1) assessing the feasibility of implementing a PST perioperative intervention for older surgical patients at risk of postoperative functional decline, (2) demonstrating the acceptability of the PST intervention and (3) assessing the preliminary impact of the PST intervention on postoperative functional status and depressive symptoms.

The study received ethical approval from the University of California San Francisco Institutional Review Board. Results of this study will be published in peer-reviewed scientific journals with further dissemination at local institutional meetings and professional conferences.

NCT06174701.

To estimate the direction and magnitude of socioeconomic inequalities in outcome, experience and care among adults consulting for a musculoskeletal pain condition.

Multicentre, prospective observational cohort with repeated measures at three waves (baseline, 3 months and 6 months after index consultation).

30 general practices in North Staffordshire and Stoke-on-Trent, England.

1875 consecutive, eligible, consenting patients, aged 18 years and over, presenting with a relevant SNOMED CT-coded musculoskeletal pain condition between September 2021 and July 2022.

Standard care.

Primary outcome was patient-reported pain and function using the Musculoskeletal Health Questionnaire (MSK-HQ score, 0–56). Secondary outcomes were patient experience (overall dissatisfaction with consultation experience, dichotomised) and an indicator of care received (opioid prescription within 14 days of index consultation). Using multilevel models, we examined inequalities in primary and secondary outcomes by area deprivation (Index of Multiple Deprivation derived from patient residential postcode), before and after adjusting for sociodemographic and survey administration variables, clinical case-mix and selected practice-level covariates.

Compared with patients from the least deprived neighbourhoods, patients from the most deprived neighbourhoods had significantly poorer MSK-HQ scores at baseline (mean 22.6 (SD 10.4) vs 27.6 (10.1)). At 6 months, the inequality gap in MSK-HQ score widened (difference in mean score after adjustment for all covariates: 1.94; 95% CI: –0.70 to 4.58). Opioid prescription was more common for patients living in the most deprived neighbourhoods (30% vs 19%; fully adjusted OR: 0.69; 95% CI: 0.44 to 1.08). Only 6% of patients overall reported being dissatisfied with their consultation. Analysis of multiply imputed data produced a similar pattern of findings to complete-case analysis.

Substantial inequalities in the chronicity, severity and complexity of musculoskeletal pain problems are already present at the time of accessing care. Inequalities in pain and function do not reduce after accessing care and may even widen slightly.

ISRCTN18132064; Results.