Graduate / "a community pharmacist" - Masters of public health Personal Statement [2]

Hello. I am applying for a masters in public health and i would appreciate it if my essay is thoroughly scrutinised. Feedback welcomed. It's a bit long.

As a community pharmacist, I have always been involved in public health. Providing information and treatment to maintain and improve health has been second nature to me. As a final year pharmacy undergraduate, I was assigned a project to investigate the harmful effects of constituents present in mainstream and side stream passive cigarette smoke. To my surprise, my findings concluded that side stream smoke has just as much potential to affect one's health in adverse ways as mainstream smoke. Furthermore, passive smokers have an increased risk of heart disease and lung cancer compared to non-smokers. Although public health strategies (ban on smoking in public places, regulation on tobacco constituents, limitation on point of sale advertisement) that affect populations as a whole makes fractional contributions to smoking cessation, research shows that such policies has not substantially increased the motivation of smokers to stop nor has it reduced exposure of non-smokers to passive smoke within the home environment.

As a pharmacist, a growing interest in this area compelled me to undergo the stop smoking training programe for healthcare professionals commissioned by the local primary care trust. The accreditation enables me to offer an easily accessible, cost-effective smoking cessation service with prescribing and dispensing of nicotine replacement therapy, buproprion and Champix, together with advice, support and information. Providing smoking cessation service to patients living in different geographical areas of the country exposes the glaring gap in health inequalites between the rich and poor people.

Whilst working in the most deprived part of London, a lady walked into my clinic desperate to quit smoking. With tears in her eyes, she asked for the most effective product that would help her not smoke again. On questioning her reasons for wanting to stop smoking, she broke down in tears and explained that her two year old had been diagnosed with pneumonia; the consultant told her that her son's constant exposure to passive smoking would have been a contributory factor. On questioning the single parent, she started smoking at the age of 11, a habit she developed from her parents. She also smoked whilst pregnant because of the pressures of meeting standard basic needs and it helped calm her nerves. She intensively smokes 30 cigarettes per day, mostly within the home environment due to budgetary constraints and lack of regular income. The lady was put on a weekly stop smoking session with extensive behavior modification counseling for a total period of 12 weeks. Her compliance was verified a weekly basis by exhaled carbon monoxide tests. My experience from practice shows that helping smokers stop reduces the risk or progression of other smoking related diseases bringing immediate and long-term health benefits.

Although I have been successful in looking after my own practice populations, I feel the need to understand the broader concept of public health, which focuses on improving health at a population level.

Almost every professional activity in which I am involved in as a pharmacist has implications for public health. Services such as emergency hormonal contraceptive, chlamydia screening and treatment, supply and supervision of methadone, supply and administration of vaccines and advice on sexually transmitted diseases are ones that I readily associate with public health. In addition my participation in providing needle and syringe exchange schemes helps to reduce the spread of HIV and other blood borne diseases in drug misusers and the wider community.

With the new community pharmacy contractual framework encouraging pharmacies to systematically provide more public health interventions than previously, a part of my present role within the community is to provide specific public health interventions as part of a broader NHS service, for example, cardiovascular risk assessment. Addressing patients about their diet, physical inactivity, excessive alcohol intake, smoking, blood pressure, lipids amid other modifiable and non-modifiable risk factors that can put them at a higher cardiovascular risk helps to prevent the prevalence and the risk of future cardiovascular disease, a leading cause of death in England and Wales.

As with smoking, similar pattern emerges between those at high risk of cardiovascular risk and social deprivation. However, I believe that intervening at the population level can bring about substantial benefits and greater changes in cardiovascular risk factor.

My current experiences as an anticoagulation pharmacist position me with responsibility of managing and monitoring patients on anticoagulation therapy, hence patient safety and care is paramount. More so I possess the necessary skills to singlehandedly implement changes to therapy decision. This requires savvy of theoretical application, timely feedback and patient assessment.

In my opinion, public health practice is about collaborative, organised effort thus mutual engagement with health care practitioners and commissioners through day-to-day activities facilitates influencing the attitude and priorities of prescribers and nursing staff in the delivery of safe, effective and economic drug treatment. As the medicines expert in the healthcare team, I gave advice about the potential adverse effects that a medicine or combination of medicines may produce as well as suggest the dosage and the most appropriate form of medication. In addition, helping patients make the best use of their medicines through structured medicines management services are ways in which I contribute to important health issues.

Nonetheless, with years of experiences in the industrial, clinical and community Pharmacy sector, I believe there is more to experience in my service to improving the public's health and reducing health inequalities. To date, I believe that my profession has focused on microlevel activities such as health promotion, medicines management and prescribing advice, rather than on wider public health issues.

Instead, I would like to maximise my input to public health thus making it structured, evidence-based, and capable of demonstrating real added value and focus on the needs of the population. It is my aim to contribute to the provision of public health at both strategic and operational level with responsibilities that relate to the whole population.

Studying at xxx will be vital to my future career as a pharmacist public health specialist because
I relish the opportunity to commence my career as a public health specialist and anticipate the challenges it will present.