What does it all mean?

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Pharmacists confused over what is, and isn’t an expanded service, a new study reveals

A study has found that while many pharmacists express interest in providing ‘expanded services’, they are often unsure what these services actually entail.

Researchers from James Cook University, Townsville, conducted a detailed survey and pilot study with 19 rural pharmacists.

While over two-thirds of the participants claimed knowledge that extended pharmacy services (EPS) were being delivered in community pharmacy, there “appears to be some confusion as to which services constitute expanded practice, with blood pressure monitoring, provision of dose administration aids, blood sugar screening, weight management, and smoking cessation being listed as expanded services,” the authors said.

“Although expanded practice has been described as a distinct knowledge and skill base that is in addition to the recognized scope of the pharmacy profession, pharmacists might see any service other than the traditional supply of medicines as expanded practice”.

Expanded pharmacy services have been defined as pharmacists working to their “full” or “enhanced” scope of practice, involving the performing of activities usually provided by other health professionals, the authors explained.

The findings demonstrated the need for the pharmacy profession to provide clarity regarding the terms used, including “full scope of practice”, “enhanced practice” and “expanded practice”, they said.

“Clear understanding of this is required for expanded services to be successfully implemented”.

The surveys confirmed the barriers to EPS in pharmacy that had previously been identified in research literature, such as lack of time,  lack of training for pharmacy staff, little or no remuneration for services, staff shortages, poor support from other health professionals, low patient engagement or awareness of services and poor support from other pharmacy staff or employers.

“These issues could be addressed with the provision of training and education, staff support, and effective advertising and promotion of services,” the authors said.

“In order to allow pharmacists to provide effective and successful delivery of EPS, recommendations include the implementation of evidence-based guidelines or protocols to assist with assessment and diagnosis; thorough documentation and integration of care via collaboration with GPs and other health services, referrals and follow-up; the availability of a consult room to ensure patient privacy and confidentiality; patient consultation with pharmacists rather than other pharmacy support staff; and greater public awareness of pharmacy services are essential.”

“Furthermore, governance and drive from the Australian professional pharmacy associations is essential for EPS to be successfully implemented,” they said.

These are the ten ‘most important’ extended pharmacy services, as listed by the survey respondents:

10 Most Important EPSService Currently Provided n (%) YesWould Like to Provide Service n (%) Yes± %
Conducting basic mental health assessments using screening tools0 (0)15 (79)+79%
Assessing a patient’s suicide risk2 (11)14 (74)+63%
Refer patients to specialist respiratory services3 (16)10 (53)+37%
Refer patients to infectious disease services, eg GP, sexual health clinic8 (42)13 (68)+26%
Refer patients to specialist drug services6 (32)11 (58)+26%
Refer patients to available and appropriate mental health services10 (53)14 (74)+21%
Conduct examinations for acute ocular conditions, eg conjunctivitis13 (68)14 (74)+6%
Refer patients to oral health services13 (68)14 (74)+5%
Provide treatment for acute ocular conditions, eg conjunctivitis11 (58)12 (63)+5%
Provide treatment for acute feet conditions, eg tinea pedis16 (84)16 (84)+0%

The study was published in the Journal of Multidisciplinary Healthcare

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  1. Greg Shearing

    The biggest question here is, who are the 42% of pharmacists who reckon they don’t/can’t treat conjunctivitis or the 16% who reckon they can’t/don’t treat tinea?!?

    • Jarrod McMaugh

      I think you have to look at this in context of the survey

      Who has a service dedicated to these conditions, rather than engaging with people as a standard part of pharmacy practice.

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