Bringing pharmacists into the fold
BY DR RICHARD KIDD, CHAIR, AMA COUNCIL OF GENERAL PRACTICE
It has been almost three years since the AMA put forward its proposal to make non-dispensing pharmacists a key part of the future general practice healthcare team. Our advocacy on this issue has not wavered and since we launched our policy more evidence has accumulated to support the valuable role pharmacists can play when they are integrated into the general practice team.
General practice pharmacists would enhance medication management and reduce hospitalisations from adverse drug events (ADEs). An independent analysis from Deloitte Access Economics (DAE), which was released with the AMA’s proposal, showed that integrating pharmacists into general practice would deliver a benefit-cost ratio of 1.56. If general practices were supported to employ non-dispensing pharmacists as part of their healthcare team, they would be able deliver real cost savings to the health system, of $1.56 for every dollar invested.
An in-house pharmacist would be able to assist GPs address overprescribing and medication non-adherence by patients. We would see better coordination of patient care, improved prescribing, improved medication use, and fewer medication-related problems. Hospitalisation rates from ADEs would fall and our patients’ quality of life would be improved as would their health outcomes.
A recently released research article in the International Journal of Clinical Pharmacy, titled Pharmacists in general practice: a focus on drug-related problems, shows that where pharmacists are working within a general practice that their recommendations are more readily accepted by practice GPs.
This bears out research published in 2013 titled An evaluation of medication review reports across different settings, which had similar findings. Access to the patient’s medical file and the relevant clinical information within when conducting a medication review enabled recommendations that were more targeted and less conjectural. The recommendations from these better-informed reviews resulted in greater acceptance of the pharmacist’s recommendations by the GP.
With chronic disease on the rise, and an ageing population, it is estimated that there are more than 700,000 patients with co-morbidities who would benefit from a review of their medications. This figure represents just the top 10 per cent of patients who could benefit from having their medications reviewed. In-house pharmacists could be a valuable resource for patients in understanding their medications and how to use them.
With over 230,000 medication related admissions to hospitals every year at a cost of $1.2 billion per annum and patient medication non-compliances estimated at 33 per cent, the time has well and truly come for action on this front.
With another trial; utilising non-dispensing pharmacists in 14 medical centres across the greater Brisbane area; winding up, the AMA Council of General Practice is looking forward to hearing the interim results.
With increasing evidence that where pharmacists are integrated within general practice patient care is improved, the AMA continues to advocate for Government funding to make this an everyday reality for general practice and for patients.