Home' Australian Pharmacist : Australian Pharmacist September 2014 Contents Australian Pharmacist September 2014 I © Pharmaceutical Society of Australia Ltd.
and that means the professional staff
‘ We also have a supply arrangement
with a consultant pharmacist –
in addition to the supply pharmacists
– who independently reviews the
residents’ medications and attends the
centre to do this.
‘ The clinical file of the resident is central
and there are also direct discussions
with our staff.
‘ This is above and beyond what the
supply pharmacist is attending to and
we have done this to remove a conflict of
interest between the supply pharmacy
and the consultant pharmacist.’
TRUST AND RESPECT
Geoff March of the University of South
Australia believes that electronic
communication is not the answer.
‘ The issue is partly about employed
staff struggling with medicines and
their knowledge around medicines so
they appreciate the help a pharmacist
can provide. I don’t agree that the
role of pharmacist can be filled totally
electronically or virtually,’ he said.
‘I still think there is a role to create trust
and respect between people and I
think you can only do that face to face.
When you look at GP land they survive
on trust when they refer someone to
another specialist or GP it’s usually to
someone they know and respect.
‘ Through the Models Practice Project
in the late 1990s there was a deliberate
strategy on our behalf to get the
pharmacist to talk to the GP and getting
them talking around professional issues
rather than the prescription police role
we were generally known for.
‘You could see that professional
relationship building as the GP could
understand what the pharmacist was
all about and that the pharmacist could
actually bring value to their patients
and that was a really important role
in building trust and I see the same
sort of things here. That building of
trust between staff and other health
professionals is very important.’
Dr March said he was committed to
pharmacists being employed in the
‘One of my main aims for a long time
now has been to try to get a pharmacist
employed in the aged-care sector
because I see the role as critical,’ he said.
‘ The need is massive. The first stage of
the vision was to send students to aged
care facilities firstly to introduce staff
to pharmacists. Students undertook a
number of projects the staff identified
as needing around medication
management. The students reported
back their findings to the staff and got
them thinking about the value and role
of pharmacists and how they could help
both staff and clients.
‘I just see the real need for a pharmacist
being there, if not fulltime, then three or
four days a week. Pharmacists can work
in the aged care facility and also spend
time supporting those that provide
home care services. It’s all part of being
an allied health professional.’
Andrew McLachlan says even if
pharmacists are not on staff fulltime
there are many roles in aged care and
one is problem solving around medicines
and other issues, including swallowing
and crushing (see page 31).
The debate over a greater pharmacist
involvement revives talk of the need
for greater collaboration between
pharmacists and doctors, a need
acknowledged by those spoken to by
Cynthia Payne said tensions between GPs
and pharmacists were a little less that in
the past but some ‘old-school doctors’
may be a little resistant to collaboration.
‘But when you have a good pharmacist
who puts forward evidence then how
can a doctor not have regard for that?
We all share the interests of the best
outcomes for the consumer. That’s what
unites all of us,’ she said.
‘If you can’t get that collaborative
environment to be focused on the best
outcomes for the consumer then you
will have problems and nobody can
afford that inefficiency.
‘ There is a balancing act in there because
the pharmacist is trying to identify
unnecessary polypharmacy and remove
unnecessary drugs to achieve a better
clinical outcome for the patient and even
perhaps a financial one for their family.
The resident is central to our model.’
Professor McLachlan said: ‘We know
there needs to be a substantial rethink
of the medicines the older and frail are
taking. We have a lot of support from the
medical profession and often we get the
sense that GPs are saying “thank you” for
having someone to share in the care of
their patients who are vulnerable.
‘GPs are often looking for support
and many openly welcome the input
‘ They see a respectful role for
pharmacists and those pharmacists
who are providing services to age care
facilities are in close communication
with the doctors. They have to work
collaboratively, even if just for economic
reasons and to ensure the legality of
supply is met and for remuneration.’
PSA’s Grant Kardachi sees great
collaboration developing between
doctors and pharmacists.
‘I know of some facilities where
pharmacists visiting to undertake
reviews have regular meetings with
doctors and staff to discuss patient
needs and issues. These meetings have
proved to be extremely beneficial
for everyone involved, and have
strengthened the team approach to
providing better care,’ he said.
But the last word goes to Geoff March
who stresses that the profession
needs to act now on grasping the
opportunities presented in aged care.
‘We are starting see to innovative
models of services being put in place
and it would be nice if we got our foot in
the door early.’
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