Because of their relationships with their patients, pharmacists can have an important role in encouraging relevant customers to have regular pathology tests, says a spokesperson for Pathology Awareness Australia, thus potentially saving lives.
The PAA launched a report today offering a snapshot of the pathology landscape, including the most common reasons for tests (which were diabetes, a general health check, high blood pressure, and lack of energy).
It highlights the role of pathology in helping manage diabetes, in managing down emergency department costs around heart attack, and in screening for bowel cancer.
“The reason Pathology Awareness Australia was established was to raise understanding and awareness of what pathology is – it’s the black box of health care,” says PAA chair John Crothers.
“We also like to call it the engine room. But most people don’t understand or appreciate the value of it, or that areas like cancer or diabetes or any clinical disease are really underpinned by pathology, whether that’s in early diagnosis, monitoring or ongoing management.
“Where pharmacists can really help is in helping their patients understand how important it is.”
He urged pharmacists to visit knowpathology.com.au and disseminate some of its information to relevant patients.
He said that ongoing monitoring of blood sugar levels in diabetes was a good example.
Diabetes related testing accounts for 10.5% of the growth in requesting from general practice and 6% of all GP orders for pathology.
1.7 million Australians have diabetes and this is forecast to rise to 3.5 million within 17 years. Diabetes complications account for 14% of preventable hospitalisations, 67% of Australian adults with diabetes have high blood pressure, and 68% die of heart disease or stroke.
The report notes that Type 2 diabetes prevention programs can save between $2,600 and $5,300 per life year.
Proactive action on regular HbA1c results can help keep levels normal in people with diabetes. A small sustained decrease can reduce the cumulative incidence over five years in: end stage kidney disease by 40%; amputation by 21%; advanced eye disease by 43%; and heart attack by 16%.
“There’s a key relationship between pharmacists and patients, and so the value pharmacists and pharmacies can bring to that is help with chronic disease management and good dialogue,” Crothers says.
“In diabetes, you need to know what your levels are, and it’s getting and knowing that three-month average of how well you’re controlling your sugar levels that lead to the long-term outcomes.
“Without that you’re flying blind. So there are rich opportunities for pharmacists to help people understand that.”
The report also highlighted that genetic testing has underpinned dramatic improvements in survival and reductions in deaths from colorectal cancer over the past decade, with the 5-year survival rate for metastatic colorectal cancer having risen dramatically up to 67%.
“Again, how often do people go into pharmacy?” said Crothers. “We know that certain age groups have been identified as at higher risk, and so the question to be asked is, ‘Have you by any chance done that test?’ and of course the trusted relationship in pharmacy comes through again.
“Early detection is so critical in the outcomes of bowel cancer, and we know it’s a hidden cancer – the one thing we can really do is manage it through these Government funded screening programs with the help of pharmacy.”
Heart attack was also examined: only about 20% of cases presenting to emergency departments will be for heart attack.
At current ED attendance rates, $167 million per year is required to triage chest pain patients prior to hospital admission or direct discharge.
The report notes that the Troponin blood test is an essential tool to diagnose and rule out heart attack. Recent advances in Troponin tests have allowed costs to be partially managed down. Newer Troponin tests may allow 40% of chest pain patients to be discharged earlier if used to their full potential.