US Pharm. 2015;40(8):3.

Health and wellness reports frequently feature statistics revealing men’s aversion to visiting their doctor. Surveys by Men’s Health Magazine/CNN and the Agency for Healthcare Research and Quality (AHRQ) show that approximately one-quarter to one-third of men do not go to the doctor for routine annual checkups. According to a CDC National Health Interview Survey published in 2014, 27% of men (compared to 14% of women) had had no office visits to a doctor or other health professional in the past 12 months. Even more alarming, say the AHRQ findings, as many as 9 million men hadn’t been to a primary care doctor in the past 5 years.

Why don’t men visit a physician more often? Male survey respondents indicate that they do not want to appear unmasculine, fear finding out something is wrong or appearing vulnerable, are embarrassed, or are in denial, says an American Medical Association study. In addition, according to an American Academy of Family Physicians survey, life simply gets in the way: Some 12% of the survey respondents said they didn’t have time, perhaps due to work schedules, to go to the doctor.

Whatever the reason, the ramifications of this aversion are serious. According to an AHRQ study, men are 22% more likely than women to neglect their cholesterol tests; 28% more likely to be hospitalized for congestive heart failure; 32% more likely to hospitalized for long-term complications of diabetes and more than twice as likely to have a leg or foot amputated as a result of complications from diabetes; and 24% more likely than women to be hospitalized for pneumonia otherwise preventable by immunizations (which pharmacists can administer without a prescription).

The well-publicized shortage of primary care physicians compounds the situation, limiting the availability of timely, convenient appointments. Can pharmacists help fill this void? In “Counseling Male Patients on Testosterone Replacement Therapy With Efficacy and Safety in Mind” (page 25), the authors contend that pharmacists can help manage hypogonadism and ensure patients attain optimal testosterone-level goals. Pharmacists, they point out, are the last healthcare professional men may see before taking their testosterone replacement therapy dosages. As such, pharmacists can warn of possible harmful drug interactions, including those that might arise from taking insulin, anticoagulants, or corticosteroids.

Pharmacists are also well positioned to help men with urinary incontinence (UI), since many cases of UI result from adverse drug interactions. It is crucial, the authors of “Pharmacists’ Role in Managing Urinary Incontinence” (page 35) point out, that pharmacists be involved in monitoring patients’ medication management plans when their UI is severe enough to warrant medications. Who knows more about the safety and efficacy of pharmaceutical interventions?

Yet another disease in which pharmacists can play a role in successful outcomes is epididymitis, a painful inflammation of the epididymis, located behind the testicle. In “Antibiotic Therapy for Epididymitis” (page 39), the authors highlight the pharmacist’s vital role in counseling for appropriate antibiotic therapy and dosing. Epididymitis, unchecked, can progress to a more chronic form with ongoing pain, and the disease can potentially cause testicular abscesses, death of testicular tissue, and even infertility.

It might well be in men’s DNA to put off or completely avoid medical checkups. The perilous statistics don’t lie, however, and there is no denying the deleterious effects of procrastination and stubbornness. As healthcare morphs into a model that places a premium on prevention as opposed to treatment, men also need to evolve. Pharmacists can help, initiating a health dialogue with male customers and moving them, perhaps kicking and screaming, into the healthcare continuum. After all, most men would agree that it is better to proactively manage important health markers than to enter the healthcare system, possibly on a stretcher, when there is no alternative.

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