What does a GP pharmacist really do?

Nearly 2,000 medication discrepancies were identified and more than 600 high-risk interventions provided in just six months of this GP pharmacist program

In just half a year, one PHN program saw more than 11,800 activities undertaken by general practice (GP) pharmacists, including 2,500 patient consultations.

GP pharmacist Mayli Foong, from Perth in Western Australia, shared data from 10 of 21 participating practices with the WA Primary Health Alliance (WAPHA) Program, which provided a funded pathway from 2017 to June this year.

Ms Foong joined the program at the beginning of 2018. When the GP pharmacists first started in the program, they only had nine hours a week to work in each practice.

“Within that time, we needed to see patients, talk to doctors, try to integrate within the team as well as capture this awesome amount of data,” Ms Foong told delegates at the PSA21 conference on Sunday.

During a six-month period across 10 practices, GP pharmacists were found to have undertaken a total of 11,809 activities.

Around 46% of these were patient-level activities—meaning patient consults, medication reconciliation and adherence, and providing preventative care, among others.

A further 48% included system-level activities, such as talking to other health professionals, updating patient records and improving quality prescribing.

The remaining 7% were practice-level activities such as assisting with accreditation, reports, education, providing medicines information, following up on HMR referrals, contributions to billing and case conferences.

In the same six-month period, there were 2,545 patient consultations and GP pharmacists identified 1,926 medication discrepancies.

For example, patients not taking beta blockers when they should have been, or high-dose oxazepam prescribed in addition to amitriptyline at night, explained Ms Foong.

Meanwhile GP pharmacists also provided 621 high-risk interventions, 2,513 communications to health professionals, 1,586 transitions of care, 200 HMR referrals identified, 794 medication reconciliations, 557 medication adherence and 393 drug usage evaluations.

Over the duration of the program, pharmacist hours were eventually raised to 15 hours per week as GPs found value in their professional offering.

“Within our program, we found the GPs responded really well to us updating patients’ medication lists because it really saved them a lot of time,” said Ms Foong.

She also highlighted the importance of pharmacist involvement in transitional care activities.

“Transition points of care are particularly prone to unintended changes in medication regimes and other medication errors. This rate can be as high as 50%. Transfer within the hospital can also be an important caveat for medication errors,” she said.

“Patients are often confused about their medicines and often don’t know what they’re taking because others were administering their medicines in hospital.”

She pointed out that recent studies have shown integrating a GP pharmacist reduced the number of unplanned re-admission of patients recently discharged from hospital.

Embedded GP pharmacists also strengthened the relationships between local community pharmacies and general practices.

The idea of pharmacists in a general practice setting “has a lot of legs and [is] something we can really make a difference in,” said Ms Foong.

“What can a GP pharmacist do? The possibilities are literally endless.

“But when you start working as a GP pharmacist you have to think about what you can do and what you’re good at. Or you can end up doing a lot of little things without focusing on doing one thing really, really well.”

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