Pharmacists thriving in general practice

GPs, patients and pharmacists are all reporting positive outcomes from a Canberra trial

The Pharmacist within General Practice Pilot Program has been run by Capital Health Network (CHN), the ACT’s primary health network, since February this year.

CHN Chief Executive Gaylene Coulton says the program, which was originally 12 months long, has been extended due to its popularity.

“The feedback received to date has been positive from the GPs, consumers, and certainly from the pharmacists involved in the trial. Based on recommendations from the Project Governance Committee, we are extending it for another 12 months.

“The original plan was to extend the trial to more practices, but instead we are looking to evaluate the pilot over an extended period of time for the current three practices.”

Evaluation will be looking at the viability of the model and the benefits for those involved.

Coulton says CHN is hoping that “through the undertaking of this pilot there will be a well-articulated place for pharmacists within the general practice team”.

One of three pharmacists involved in the program, Anne Develin works within the National Health Co-operative, a “multidisciplinary practice” that has eight clinics across the state.

Develin is enjoying her time as part of the trial, which she is involved with two days a week, spending the rest of her working week in community pharmacy.

“I’m enjoying spending quality time with patients, assisting them with their medications, and providing quality care and specialised services such as smoking cessation,” Develin tells AJP.

“Actually having time with patients allows me to have a conversation to identify any medication problems, such as dosage issues. In a busy pharmacy there’s not always time to identify [these problems]. So that’s been really valuable for the patients and professionally rewarding for myself.

“The key difference is that I have time to spend with [the patients], whereas in community pharmacy, it’s such a busy environment that it’s hard to find the time.”

Develin says that contributing to continuity of care has been a highlight, particularly for older patients on several medicines who have been discharged from hospital.

“Changes to medicines and dosages often occur in hospital, and the transition back to the community can be a time of confusion for the patient and prescribers. Having a pharmacist at hand within general practice assists the prescriber and the dispensing community pharmacist to ensure changes are implemented and any issues identified,” she explains.

GPs and other health professionals within the practice have been “quite supportive”, says Develin, and she has been able to provide education session and coaching on medicines to both doctors and their patients.

There may be something of a “turf war” brewing, with concern that pharmacists in general practice are duplicating the role of community pharmacy.

However Develin is adamant that the two roles can coexist not only harmoniously, but to each other’s benefit.

“During the Pilot there’s been a lot of communication with community pharmacy. I see there’s a great deal of potential for ‘collaborative medication management’ between the two.

“I believe that there is much to be gained by embracing the concept of pharmacists working in general practice – it’s a great opportunity for pharmacist skills to be better utilised across the healthcare settings, which will no doubt benefit patients in the long run,” she says.

Dr Joe Oguns, who also works at the National Health Co-op as a GP, says having Develin as a colleague has enhanced the role of pharmacists within the team.

He says patients have approached him after seeing Develin saying, “I actually now know what this medication is for even though I’ve been on it for years” or, “the pharmacist told me about different options for smoking cessation than I didn’t even know about”.

“As a result of having a pharmacist within the practice, not only are interactions smoother with [Develin] but other pharmacists are also now seen as a key part of the team,” says Dr Oguns.

“The GPs with whom I have worked now better understand the value and skills of the pharmacy profession, be it in community or hospital settings,” Develin adds.

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