Pharmacists’ role is too limited: Duckett

Guild welcomes Grattan Institute leader’s comments in favour of a broader role for pharmacists in Australia

Doctors are seeing patients for conditions that allied health professionals such as pharmacists could manage, says the Grattan Institute’s director of health programs Dr Stephen Duckett.

Health sector roles are “essentially the same as they were 50 years ago” despite improvements in the education of nurses, pharmacists, physiotherapists and occupational therapists, Duckett writes in The Australian.

“Our health professionals now have much greater skills than they used to, but are not always allowed to practise their skills to the fullest,” he says.

“What is frustrating is that at the same time some people can’t get to see a doctor, doctors are seeing patients for conditions that other professionals could manage. An obvious step is to make better use of pharmacists’ skills.

“Pharmacists are highly trained, have deep expertise in medicines, and are located in communities throughout Australia. But their role is far more limited in Australia than in many other countries.

“With the agreements of GPs and patients, pharmacists should be able to provide repeat prescriptions to people with simple, stable conditions,” says Duckett.

“They should also be able to provide vaccinations and to work with GPs to help patients manage chronic conditions.”

Not everyone agrees however. The recent expansion of vaccination services into community pharmacies in Australia caused outcry among medical groups including the AMA and continues to do so – despite being common practice in several countries around the world including Canada, the US, Portugal, Ireland and the UK.

The AMA has also expressed outrage at the expansion of pharmacists’ roles to include management of chronic disease and concomitant medications.

Meanwhile the Pharmacy Guild of Australia has expressed its support for Duckett’s comments.

“Pharmacists are highly trained medicine experts who are underutilised in Australia compared to other countries. With community pharmacies being the most accessible and visited primary healthcare destination in Australia there is a tremendous opportunity to deliver great health outcomes for Australians,” says Anthony Tassone, Victorian Branch President of the Guild.

“The recent expanded role of pharmacists with adult influenza immunisation across Australia is one such example, but a greater role in primary and preventative care through the utilisation of Pharmacy Trial Program funds in the Sixth Community Pharmacy Agreement is much needed,” says Tassone.

AJP recently looked at pharmacists’ role in Canada. A trial was run to see what impact pharmacists could have when providing specialised care for those at high risk of developing cardiovascular disease.

Results after three months of pharmacist intervention revealed a 21% relative reduction in estimated risk for cardiovascular events compared to the control group; a reduction in systolic blood pressure, smoking rates and LDL cholesterol; and better glycaemic control.

“In Canada, pharmacists have got legislated a much more expanded scope of practice, where they can prescribe and order laboratory tests, and they can actually access test results as well from a central database. And they are indeed able to obtain remuneration from government for providing these services,” Kevin McNamara, a senior research fellow at Deakin University’s School of Medicine, told AJP.

“Australian pharmacists are underutilised, that’s probably not in dispute,” says McNamara, adding that to expand their scope of practice in Australia you would need to get GPs on board.

Read Duckett’s full editorial here.

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