Ask the average person what the purpose of a pharmacist is and they’ll probably say to give them medications with instructions to take them safely. True, that’s an important part of our job. But as pharmacists, we know that we are much more than drug experts; we’re health professionals who are highly knowledgeable in the screening, prevention, and treatment of chronic diseases.
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That knowledge—and the fact that the pharmacy is among the most accessible forms of health care for many Americans—positions us for a bigger role in reducing the crisis of chronic disease in the United States. Six in 10 adults have been diagnosed with at least 1 chronic disease and 4 in 10 with at least 2. The costs of this tragedy, both in human suffering and dollars spent on health care, are enormous.
Pharmaceuticals are a critical and often lifesaving tool for managing disease, but we will never solve our chronic disease crisis through a mindset of mere management—prescribing increasing quantities of medications alone. To finally begin to provide “health care” instead of “sick care,” we must also address the root causes of these diseases to restore health. And the root causes of the vast majority of chronic disease are lifestyle-related.
That’s why I encourage pharmacists to explore lifestyle medicine, a growing, evidence-based medical specialty that uses therapeutic lifestyle interventions as a primary modality to treat chronic conditions, including cardiovascular diseases, type 2 diabetes, and obesity. Applying the 6 pillars of lifestyle medicine—optimal nutrition, physical activity, restorative sleep, stress management, avoidance of risky substances, and positive social connections—also provides effective prevention for these conditions.
My interest in lifestyle medicine grew from my own experience. I struggled with poor health my entire life and, by the time my second child was born, was tired of feeling exhausted and unwell. Committing to healthy lifestyle behaviors, I reduced my cholesterol by 60 points, improved my blood pressure to 110/70, and lost 40 lbs. I felt more energized, alert, and empowered than ever before. My passion became helping others address the underlying, lifestyle-related cause of their diseases so they, too, can live full and healthy lives.
I became certified to practice lifestyle medicine by the American College of Lifestyle Medicine (ACLM) and accredited as a certified health and wellness life coach. I began incorporating conversations, when appropriate, into patient consultations at the pharmacy where I work in Birmingham, Ala. More often than not, I’m communicating health information that the patient has never heard and is grateful to receive.
Patients on medications for type 2 diabetes are among the most engaged. Often, their physicians have told them to “eat better” but not what that means, much less how to achieve it sustainably. I talk to patients about the growing evidence supporting a predominately plant-based eating pattern to achieve remission, suggest books, and provide them resources from ACLM, such as shopping guides and recipes to make easy meals. Some I direct to lifestylemedpros.org, ACLM’s directory of lifestyle medicine-certified clinicians, to find help nearby.
Lifestyle change is not the best path for everyone and social determinants cause unique challenges that must be acknowledged. But many patients are surprised to learn that it may be possible to achieve remission in their diabetes by adhering to a whole-food, plant-predominant eating pattern.
For those spending between $300 and $400 a month for insulin, the idea of treating their disease through diet is intriguing. For some, our conversations are a springboard to engage their primary care physicians in deeper conversations about lifestyle. Patients who commit to making significant lifestyle behavior changes sometimes call the pharmacy to find out when I am working so they can discuss their progress with me or ask questions.
To be sure, such consultations are not always possible. Pharmacists can face the same overwhelming patient volume as physicians and just keeping up the demand of prescriptions to fill is sometimes the best we can do.
My hope is that health care leaders and employers will begin to recognize the immense value that pharmacists can contribute to the effort to reduce chronic disease and structure our roles to amplify our impact. I envision a future in which pharmacists are more deeply embedded into health teams to help patents achieve optimal health or collaborate to deprescribe medication following successful lifestyle medicine interventions.
As a first step, pharmacists and other clinicians can register for 5.5 hours of complimentary CE/CME coursework in nutrition and food as medicine offered by ACLM in support of the White House Conference on Hunger, Nutrition and Health. The free coursework helps establish a foundation of lifestyle medicine knowledge for health professionals.
To truly change the trajectory of chronic disease, we must go beyond managing symptoms and start addressing the root causes. Lifestyle medicine provides us the skills to do exactly that.
