Room to grow

Pharmacies around the world are implementing strategies which are benefiting health enormously, says an award-winning pharmacist

Lucy Walker, owner of the Terry White Chemmart Goondiwindi in rural Queensland (which was 2017 Pharmacy of the Year), was recognised with a 2018 Churchill Fellowship – and says pharmacy in Australia can have a bright future.

Ms Walker has just reported on her findings from a world tour of pharmacy in practice, which the Fellowship helped fund.

“I think there are so many good possibilities for the future: there is room to grow,” said Ms Walker, who attended the International Pharmaceutical Federation congress in Abu Dhabi, and leading pharmacies in locations around the world including Scotland, New Zealand, the United States and Canada.

She told the AJP that she was particularly impressed with the collaboration she saw between doctors and pharmacists.

Fiona McElrea, a Scottish pharmacist owner, would drop into the local GP surgery every morning, before opening the pharmacy, which did a great deal to foster a positive working relationship, Ms Walker said.

“To become an independent prescriber, Ms McElrea completed her supervised time with the local GP. It was amazing to see how that did improve those relationships.”

Lucy Walker.
Lucy Walker.

She also praised Barbara Gobis, Director of the Pharmacist Clinic at the University of British Columbia in Vancouver.

“Students come and learn, with complex patients, how to do a medication review and to follow through on their recommendations.

“That was a really good learning experience, and made me realise that I could ​learn more and better care for my patients  if I followed up more of my recommendations.

“I saw that pharmacies really can be the health hub of the community.

“It actually inspired me to come home and try harder to build those collaborative links between all allied health professionals and doctors in my region, because for our role to grow, we’re going to need great relationships and trust,” Ms Walker says.

“For the patient to benefit, we need to work really well together.”

Ms Walker observed that generally, “practice follows funding” when it comes to pharmacy services.

She noted that Australia could do more with medicines adherence ​for chronic conditions, particularly when initiating them.​ Currently Australia’s mechanism for follow-up tends to be monthly dispensing, she said.

“We have no funded tool for checking in with our patients on how our recommendations are progressing.

“I found there is no incentive for Australian pharmacists to follow up a patient after a Medscheck or an HMR.

“In places where pharmacists were funded to provide further services like vaccination, there appeared to be high rates of vaccinations.”

And she warned that aspects of the US healthcare system were taking their toll on pharmacy.

“In the countries where pharmacies were under the most financial pressure, they were struggling to innovate, because they were focused so much on just staying alive,” she said.

“At independent pharmacies in the USA, corporate benefit managers are making their lives hell.”

In her report, Ms Walker makes a number of recommendations for Australian pharmacy, including encouraging Australians to visit pharmacies first as part of a common ailment scheme; ensuring the sustainability of Medicare, the PBS and the Community Pharmacy Agreements; and upskilling the pharmacy workforce to undertake future roles.

She says that monthly dispensing is “ideal,” citing the cases of New Zealand, Canada, the USA and UK were scripts are normally dispensed every 90 days – resulting in less compliance, more wasted medicines and poorer access to pharmacies.

She reports that pharmacist vaccination should be broadened to include vaccination against pneumococcal, shingles and meningococcal disease, plus a widening of scope to include travel vaccinations; and calls for the implementation of trials of pharmacists’ services.

Read Ms Walker’s full report here.

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