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What are some of the vital roles that community pharmacists can provide during a pandemic? 

Although the main focus of healthcare services over the coming weeks and months will undoubtedly be on responding to COVID-19, people will also continue to develop other non-COVID-19 related symptoms and conditions that require attention.

Depending on the nature and severity of these ailments, research has shown that a sizeable proportion of cases can be effectively managed in the community pharmacy setting with a high degree of patient satisfaction, say researchers.

Irish and UK pharmacy academics have reviewed research from a number of countries, including Australia, and listed some of the key areas in which community pharmacists could make “substantial contributions” during the current COVID-19 pandemic.

“These are currently implemented to varying extents across different countries. In restructuring existing health services to respond to the current public health crisis, it is important that governments, public health bodies and policy makers review existing services and make full use of any unrealised potential among community pharmacists and other frontline health service providers, said the authors, from Queen’s University, Belfast and the Royal College, Dublin.

“it is important to examine ways in which the profession can assist with the public health response to COVID-19 and maintaining the continuity of healthcare services,” they said.

The areas they listed were:

Managing minor ailments 

Important areas identified include allergies and skin rashes, coughs and colds, and gastro-intestinal complaints.

These “serve to highlight the vast range of symptoms and conditions that can be managed in the community pharmacy setting”, the authors said. 

Extended prescribing roles and related activities

In countries where community pharmacists do not currently have prescribing rights, there are numerous challenges to overcome in expanding the scope of their current practice, including socio-political barriers and resourcing issues, the authors said.

“In such cases, extending prescribing rights for pharmacists may not be realistic or actionable in the midst of the current pandemic. However, there are other related activities that may be amenable to more immediate modifications in pharmacists’ current working practices and help to reduce the burden on general practice.

These include the dispensing of repeat prescriptions and emergency supplies of medications at the request of patients”.

Balancing supply and demand

“Pharmacists are well positioned to reduce risks of further medication shortages arising from COVID-19 by reassuring patients and members of the public of the continued availability of OTC and prescription medications based on rational levels of demand and implementing policies to prevent unnecessary stockpiling,” the authors said.

“These could include limits on the quantity of medication dispensed (e.g. one month’s supply at time). Preventing stockpiling of OTC medications may, however, prove more challenging”.

Promoting continued medication adherence

“In addition to protecting continuity of medication supply at the community pharmacy level, it is equally important that patients maintain adherence to their current medication regimens in order to prevent any deterioration in their current health status that could ultimately place additional demand on currently overburdened health services,” the authors said.

They cited studies involving patients with chronic medical conditions who were affected by Hurricane Katrina which reported negative impacts of this natural disaster on medication adherence.

Although COVID-19 is a pandemic as opposed to a natural disaster, it too is creating challenges for patients in terms of its impact on normal day-to-day routines (e.g. through social distancing and self-isolation requirements), employment and access to healthcare services which will ultimately create new barriers to medication adherence, they said.

“Community pharmacists have an important role to play in promoting medication adherence through the provision of evidence-based interventions”.

Other areas

Other roles and activities for pharmacists that should be considered included chronic disease management and a greater involvement in general practice activities as practice-based pharmacists.

“In order to maximise community pharmacists’ contribution to the health service and potential to alleviate GP workload, a whole system-level approach will be required,” the authors said.

In addition, they highlighted the need for innovative and extended methods of practice in this crisis.

“For example, in order to promote social distancing and facilitate self-isolation while ensuring that patients continue to have access to vital pharmacy services, new methods of service delivery will play an increasing role. These could include medication delivery services and video-based consultations.”

The article was published in the journal Research in Social and Administrative Pharmacy  

 

 

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1 Comment

  1. Kevin Hayward
    08/04/2020

    In emergencies we tend to concentrate on the acute presenting episodes, but the COVID pandemic is more than an acute event, all pharmacists in all sectors will have an essential role, practising to their full professional capacity, ranging from the critical care pharmacist in ICU through to the need for ongoing chronic disease state management from community pharmacists, keeping secondary care admission to a minimum.

    For this to happen we need leaders to develop a more flexible strategic approach to service provision and provide us with the tools to do it.

    In my own role as a medicines review pharmacist this has yet to occur. Many weeks into the pandemic we are still stuck with providing home visits to vulnerable patients, and without the provision of any form of PPE, thankyou to Bunnings for picking up where Govt has failed to deliver.

    Many of my patients are self isolating as advised, they are not attending the GP surgery The patients referred to me, identified as at risk of medication related misadventure are cancelling appointments. Some of these vulnerable patients are now inevitably at increased risk of secondary care admission. The last place we need them to be is in a high risk hospital environment.

    I understand that a Tele Health option has been on the table for some time now. As an experienced on line and distance teacher of many years, I am certain that accredited pharmacists have the skills to deliver a quality outcome product. But again the Govt has failed to deliver.

    It has to be realised that pharmacists are not top of the pile when it comes to dealing with this crisis, but the whole point of strategic planning is to see the bigger picture, to have contingencies in place for all events in all sectors.

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