Home' Australian Pharmacist : Australian Pharmacist June 2012 Contents 450 Australian Pharmacist June 2012 I ©Pharmaceutical Society of Australia Ltd.
Since accepting my PSA Young Pharmacist
of the Year award last year I have had many
pharmacists contact me wanting to nd
out more about my role as an accredited
pharmacist working in an integrative team
medical centre. With this in mind I have
prepared this article to address some of
When developing any new role or service it
is important to rst have an understanding
of the potential barriers to service
provision. In early 2011 we conducted a
survey of GPs, pharmacists, and patients
around the concept of integrating a
pharmacist into the general practice/
primary care setting. Speci cally we asked
the participants what roles they perceived
as appropriate for a pharmacist in this
environment. One GP responded with
a tongue-in-cheek comment -- 'Making
co ee'. Medical culture is just one barrier
for the provision of pharmacist services
based in primary care. However the GPs
I have spoken with perceive this to exist
more at an organisational level rather
than at an individual (practitioner) level.
Clearly, the largest barrier to the routine
introduction of pharmacists into primary
health care teams at present is the lack of
appropriate remuneration which makes it
So to the questions:
What do you actually do in the
Even now, after three years, my role
continues to evolve as overtime the GPs
I work with have come to realise the
Pharmacists in primary care
multidisciplinary teams: How
would you like your co ee?
By Chris Freeman
skills, we as pharmacists, possess beyond
dispensing and medication review. I believe
that services performed by a pharmacist in
this environment need to be exible and to
meet the needs of both the medical centre
and the surrounding community.
• Medication Review: this accounts
for approximately half of my time
at the medical centre. The patient
is identi ed mainly by the GPs or
nursing sta however the actual
referral is still completed by the GP.
The administration sta arranges the
appointments on my behalf with the
location of the consultation based on
patient preference. Although I am able to
conduct medication reviews within the
medical centre, approximately two-thirds
are still conducted in the patient's home.
There are two main bene ts I nd as
a pharmacist integrated in a primary
health care setting. Firstly, I have access
to the patient's medical le which allows
for a more comprehensive and focused
medication review. Secondly, there is
greater opportunity for communication
and collaboration with the GPs, nurses,
and allied health professionals.
• 'Therapeutic Consults': More frequently,
I am being asked by the GPs and
nurses for my 'opinion' around speci c
therapeutic option(s) for a given patient.
This is not a medication review as it is not
a comprehensive review of the patient's
medication regimen and is not simply a
drug information enquiry.
• Other roles: Drug information, student
supervision (pharmacy, medical,
and nursing), disease focused clinics
(COPD), medical software development,
education, research, quality prescribing
activities (such as prescribing audits and
feedback), and protocol development
How are you remunerated?
Claiming for direct referral HMRs provides
the basis of my remuneration. There are
other potential and indirect remuneration
sources to consider:
• Engaging the medical centre to
participate in the Quality Prescribing
Practice Incentive Payment (PIP) scheme.
• Privately funded consultations with
• Remuneration from the medical centre.
Do you need additional
You will need to be accredited to conduct
medication management reviews through
either AACP or SHPA. I envisage that this
role would be at an advanced practitioner
level (see: www.psa.org.au/archives/8467)
as the pharmacist is operating at a high
clinical pro ciency, regularly dealing with
complex therapeutic problems to provide
patient-centred care. Rarely is there an 'easy'
question or a 'straight forward' patient.
There are no set courses or training for
this role as yet, however it does help to
have post-graduate training in a clinical
Chris' top tips:
1. Go in with a well thought out plan -- don't
turn up to your local medical centre and
ask 'so when do I start?' How will the
service operate, what roles in addition to
HMRs are you willing/able to contribute
to the medical centre, do you have a
sustainable business model?
2. Start with one to two sessions a week/
fortnight/month and build from there.
3. Be exible -- services need to meet the
needs of the medical centre and the
4. In sight, in mind -- make sure you
regularly meet with the GPs in person
(this does not need to be formally, e.g. the
5. Engage the surrounding community
pharmacists: Meet with them, explain
what you are doing, and keep them
informed regarding patients who visit
Note: Nominations for the 2012 PSA Excellence
Awards, including the Young Pharmacist of the
Year, are now open. More information is available
Chris Freeman is a consultant pharmacist
at the Camp Hill Medical Centre, Brisbane
and a PhD candidate at the School of
Pharmacy, University of Queensland.
Chris is a member of the QLD Early Career
Pharmacist Working Group. He is also the
2011 PSA Young Pharmacist of the Year.
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