Take the high road – Debbie Rigby, Advanced Practice Pharmacist

We build too many walls and not enough bridges (Isaac Newton)

An inconvenient truth is that drugs don’t work in patients that don’t take them.

Poor adherence to drug therapies still represents a largely unsolved problem. Innovate ICT platforms are part of the solution; but bidirectional communication between healthcare providers is essential if we want to improve medication-taking behaviours. GPs and pharmacists seems to be locked in turf wars – at least that’s how it plays in the medical and pharmacy media.

Another inconvenient truth is that medications are frequent reasons for avoidable hospital admissions costing the health system a fortune, and older people are prescribed inappropriate medicines.

So how are we addressing these facts? Some parts of the medical and pharmacy sectors just want to build walls, and not focus on patient needs and preferences. Patients visit community pharmacies on average 14 times a year. Patients trust and respect pharmacists, and show high satisfaction with the care and medicines information provided.

Community pharmacists do more than just dispense prescriptions. Accessibility and satisfaction for pharmacists demands a role for pharmacists in supporting patients to get the best out of their medicines to improve health and well-being.

There has been much discussion in various medical and pharmacy publications and by individuals on social media on expanded roles for pharmacists within our scope of practice. I cringe when I read pharmacy leaders justify this by saying “free up GPs” and “take pressure of GPs”.

The value to patients, GPs and health systems of expanded roles for pharmacists is a focus on identifying, preventing and resolving medication-related problems, not role substitution. Pharmacists can do this (but unfortunately don’t always) every time they dispense a prescription.

MedsChecks in pharmacies can address poor adherence and persistence to medicines. HMRs and RMMRs have quality evidence of improved medication management and yet are under-utilised. Why? Are the turf wars impeding safer medication use?

One model of care that there is agreement between medical organisations and pharmacy (at least PSA and some pharmacy thought leaders) is the role of practice pharmacists – pharmacists working in non-dispensing roles in general practice. Perhaps this agreement is because the pharmacist’s role does not duplicate care by GPs and community pharmacists – it fills the gap. The focus is on optimising medication use, at a patient level as well as a system or clinical governance level.

It’s time to find a common ground and stop derailing expanded roles for pharmacists. We must build bridges across our differences to pursue the common good.

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