The dispensing dilemma

Pharmacy should think carefully before devolving its primary dispensing role, experts warn

While the current trend is for pharmacy’s clinical role and responsibilities to expand, we should be careful before we devolve too much of dispensing to pharmacy technicians or assistants, experts have warned. 

In his editorial in the Journal of Pharmacy Practice and Research, Professor Chris Alderman said “it seems that enthusiasm for participation in the work of dispensing prescriptions is waning among contemporary practitioners”.

Clinical pharmacy in its various incarnations (e.g. specialist practice in various areas of therapeutics, home medicines review, pharmacy practice in aged care), medicines information, clinical trials etc. are all favoured ‘practice destinations’ for younger pharmacists, he said.

“It appears that a career based in the safe and reliable compounding and distribution of pharmaceuticals is a less attractive option for those entering the profession in the early 21st century”. 

Professor Alderman warned that while there is “great enthusiasm for devolving the traditional tasks of the pharmacy profession to those who don’t hold pharmacy-related tertiary qualifications”, this push does need to be questioned.

“Once transferred out of the hands of pharmacists, the unmistakable signal is that the traditional pharmacy-specific skill set is not essential to deliver these job functions,” he said.

“While the pharmacy profession seeks to reposition these tasks with pharmacy technicians, a dispassionate observer might well ask whether another workforce group such as enrolled nurses might be equally (or better) suited to take on this task”.

“Viewed through another lens, pharmacy practice where the profession is potentially divorced from drug distribution is a rather bleak vision, raising a future where a strong, distinct and unique skillset and practice focus is compromised or absent,” he concluded.

Alderman’s view was supported in another article, by Danielle Stowasser, program director, Electronic Medication Management Program, Metro North Hospital and Health Service, Brisbane.

She said that “in order to ensure safe prescribing, the full gamut of medication services is still required. Of most importance is medication supply, without which there is no medication treatment”.

“Handing over these services to pharmacy technicians, or nursing staff, may leave no pharmacy oversight of these complex processes,” she warned.

“It also reduces pharmacist responsibility and oversight in ‘[analysing] patterns of clinical data to improve quality of care, patient safety, and care delivery efficiency’ or, more importantly for prescribing safety, the functions of reconciliation and recognising patient choice in their medication management plan”.

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