Community pharmacy to fight for expanded role: Quilty

Community pharmacy: smiling pharmacist in shop

The industry needs to advocate “strongly and publicly” for a broadening of the role of community pharmacy and pharmacists in the wider health system, says Guild executive director David Quilty.

The push would unite pharmacy owners and the pharmacist profession in the interests of their patients, he writes in this week’s edition of Guild newsletter Forefront.

“Pharmacies are the most accessible health destination and pharmacists are consistently rated amongst the most trusted health professionals, relied upon by many millions of Australians,” Quilty says.

“For various reasons, Australia is lagging behind countries like the UK, Canada and New Zealand in recognising the role that pharmacies can play in delivering better and more cost-effective outcomes.”

He cites the UK example where the college of GPs works with the National Health Service and the Royal Pharmaceutical Society to publicly encourage patients to make pharmacy their first stop for treating minor ailments like coughs and colds.

“Doctors, pharmacists and the UK government recognise it is not a good use of GPs’ time or skills to have their surgeries and emergency departments clogged up by patients who can be readily treated by pharmacists,” Quilty writes.

“Nor is it an efficient use of the finite resources to run the public health system.

“In Australia, local pharmacies and pharmacists are consistently reconfirming their credentials as front line health providers in areas like pain management and the care of patients with chronic conditions such as diabetes, cardiovascular disease and asthma.”

He says the successful flu vaccination pilot by pharmacists in Queensland, which is now being extended to measles and whooping cough, has demonstrated that pharmacies can provide improved access to high quality health services.

“We must now grasp the unprecedented opportunity to utilise the convenience of pharmacies and the skills of pharmacists to deliver faster, cost-effective and better patient outcomes, including in regional, rural and remote areas where health gaps and doctor waiting times are more pronounced.

“At the same time, these pharmacy enhancements can take pressure off doctors and emergency departments and reduce the need for more expensive health interventions down the track.

“With up to 26 million doctor visits annually for minor ailments, it makes sense for pharmacies in Australia, as the first point of triage, to be able to more readily treat conditions like chlamydia and uncomplicated urinary tract infections like their counterparts in the UK and NZ, working in collaboration with GPs.”

A large body of data shows that well-targeted health prevention through basic health checks, screening and tackling lifestyle issues such as poor diet and smoking, produces significant health benefits and savings in the long run, Quilty writes.

“Pharmacies are a common sense destination from which to deliver a healthy dose of prevention – trusted and frequently accessed by at-risk patients who might otherwise fall between the cracks.

“It is high time that Australia got serious about medicine adherence and management. Patients with stable, long term conditions like diabetes, blood pressure and high cholesterol should be able to be issued extended repeat prescriptions by their pharmacies, increasing the likelihood of compliance and reducing unnecessary doctor visits.

“We also need a much greater focus on monitoring and adherence when patients commence a new medicine to identify and resolve any medicine-related issues and to promote adherence for overall better health outcomes.

“With medication-related hospitalisations costing an estimated $1.2 billion annually, it is unacceptable that Australia has no systematic approach to reconciling patients’ medicines when they leave hospital or transition between care settings.

“This failing exists in both the public and the private hospital systems. Yet private health insurers seem to be happy to pick up taxpayer-funded subsidies for alternative therapies like homeopathy, aromatherapy and rolfing.

“Wouldn’t that money be better spent making sure patients with chronic conditions and complex medicine regimen get their medicines right when they leave hospital, reducing the chances of costly and unnecessary re-admissions and the potential of medicine addiction?”

Pharmacies can also play an enhanced role in helping patients with mental health conditions, many of whom they already assist through the staged supply of medicines, he says.

“With the right training and support, pharmacists can help identify at-risk patients and refer them to specialist support by organisations like Beyond Blue and Lifeline as well as their GPs. Many of these patients suffer from other chronic health conditions and have a high likelihood of medicine non-compliance, so it makes sense for pharmacists to be a core part of their care teams.”

The industry “must argue passionately” for these changes and produce hard evidence to support their implementation, he says, as certain parts of the health system will fight to maintain the status quo.

“However, their time has arrived because they are indisputably in the interests of patients and a more cost-effective and sustainable health system.

“The only thing holding pharmacy back is our own timidity and reticence to embrace change.”

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