Non-dispensing pharmacist pilot extended

Image: Katja Boom (right), Pharmacist at YourGP@Crace in the ACT, educates a patient about asthma management. Courtesy Roz Lemon

A pilot program aimed at examining the benefits of pharmacists in GP practices has been extended following initial success

Capital Health Network, through the ACT PHN program, places non-dispensing pharmacists in three local general practices. 

CHN Chief Executive Gaylene Coulton says that the initial findings from the pilot have been promising.

“Following the success of the first year of this innovative pilot, CHN has extended the pilot for another 12 months,” she says.

“We’ve already seen a number of benefits from having an in-house pharmacist based within a general practice. For example, this can improve the communication between the practice and the patient’s usual community pharmacist.”

The three practices participating in the program are Isabella Plains Medical Centre, National Health Co-op and YourGP@Crace.

Katja Boom, pharmacist at YourGP@Crace, says the pilot has enhanced collaboration between Pharmacists, GPs and other health care workers, thus improving health care for patients through improved quality of prescribing, and better management and prevention of chronic disease.

“Together with the nurse and GP, I am part of the healthcare assessment undertaken for patients aged over 75,” says Ms Boom.

“I review their medication, adjust the medication list, give the patient a medication list print out, provide education to the patient about their medication and recommend changes to medication regimen where necessary to reduce medication load.”

Dr Joe Oguns, Medical Director at the National Health Co-op says the pilot has enabled increased access between non-dispensing pharmacists and GPs which has been helpful in optimising prescribing, patient adherence to their medications and improved health outcomes.

“Having a pharmacist in general practice has resulted in de-prescribing of medications which are not essential to patients’ current health needs which reduces pill burden and improves compliance with important medications,” Dr Oguns says.

“It has also been beneficial in identifying and avoiding potentially significant medication related adverse events.”

An external evaluation is being conducted by the University of Canberra.

Capital Health Network is the ACT’s primary health network supporting health professionals to improve the coordination of care so that patients receive the right care in the right place at the right time.

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  1. Drugby

    Great news for the exciting project. I like that in their experience the practice pharmacist improves the links between the practice and the patient’s usual community pharmacy. The evaluation will be critical to more widespread uptake and funding.

  2. TheRedShirt

    Can’t help but think that having pharmacists in GP practices will only erode the need for HMR pharmacists based on the description of what they are currently doing.

  3. Grant

    And also erode the work and role that the existing community pharmacist does. If asthma management, compliance, medication profiles are done in GP practice, what is left for the patients community pharmacy to do? Nothing. Absolutely nothing. “No thanks I don’t need that service, did it with the pharmacist at the GP”. So it won’t matter if communication with the GP practice improves, there will be less to actually provide the patient in the community pharmacy. And yes agree with post about also eroding the need for HMRs . I think this idea is very sound in terms of its intentions to patient care. However I think it is actually very threatening to the existing roles of pharmacists outside GP practice and also believes it only increases the GP centric model of care which may not necessarily be the best impartial model for patient care . Careful what we wish for pharmacy industry. Could your championing of this Debbie Rigby, also threaten the future of something else that you previously championed ? HMRs outside the GP preactice? Food for thought.

    • amanda cronin

      I guess we have to look at the big picture what is best for the patients. I can see this role being done well and renumerated to reflect the experience of the pharmacist could be fabulous for patients and surgeries. greater acceptsble of pharmacist knowledge is great for everyone with patients having increased understanding of what their local pharmacist could offer.

      My concern is exploitation. Big bulk billing practices paying as little as possible and pocketing the money and the potential for less the. Useful pharmacists getting the roles. LIke Nurse practitioners these roles should be specialised and have post graduate qualifications.

      We can all try and protect our traditional corner of pharmacy or change with the times and adapt.

  4. Kevin Hayward

    In my own role as a practice support pharmacist (PSP) in the UK, I found that I was increasing the paid workload of my local community pharmacies.

    For a start in a 7 Dr FTE practice there is no way you can physically see all the patients you identify in one session per week. So they had to be referred to the community pharmacists.

    My role was mainly to identify the patients in need of intervention within the key prescribing indicators, then to engage the patients with an appropriate intervention. This may have been a repeat script management project, webster pack, smoking cessation pilot etc. etc.

    We did not have HMR, but I am pretty certain that in the Australian scenario, PSPs would identify many more patient in need of a medication review than they would have the capacity to undertake. In a project I have looked at recently the practice support pharmacists have been told not to undertake HMRs just refer.

    I should also point out that in my own pharmacy, and, in many others I worked with as a PSP I increased engagement with the GP and the community pharmacy. Although it was not intentional in our own pharmacy script numbers with the GP surgery where we had a PSP did increase, we were more involved with local (paid) pilots and had a better working relationship with members of the health and social care team.

    In the case where I worked with other community pharmacies it was my understanding that they experienced the same, as long as they were prepared to become involved with the primary care team.

  5. Tim Hewitt

    1. Are the financial details of this trial public? (i.e. pay rates for pharmacies, money trail etc?.. how does remuneration compare with HMR remuneration?)
    2. has trial affected the number of HMR referrals from the practice(s) involved? (if indeed they were using HMR in the first instance), i.e. increase/decrease/ no change?
    3. Have the pharmacists involved needed extra training/accreditation (e.g. by AACP?)
    4. Is there a ‘model of care’ (flow chart or whatever,) that shows how this all fits in with existing ‘model’, i.e. medschecks/ HMR/ etc?

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