Home' Australian Pharmacist : Australian Pharmacist June 2012 Contents Australian Pharmacist June 2012 I © Pharmaceutical Society of Australia Ltd.
where their client has lost control, and
given the fact that a large proportion of
ORT clients could correctly be assumed
to have a blood-borne virus, it might not
be surprising to find evidence of stigma
towards people perceived as having
hepatitis C. However, in this study there
was none. How can the less favourable
treatment given by pharmacists to people
with hepatitis C in our earlier studies then
be explained?7,8 One possibility might
be the ground rules under which the
pharmacist operates, explained at ORT
induction. Where these are considered
by a client with hepatitis C to be overly
restrictive, they may perhaps misperceive
the pharmacist as being discriminatory,
based on their hepatitis C status.
An unexpected finding from this study
was the lack of support felt by pharmacists
for the many stressful situations they
encountered. A possible source of support
is the Drug and Alcohol Clinical Advisory
Service, which is available to anyone
seeking advice on a drug or alcohol-related
issue. No pharmacists in this study had
used such a service for support. The study
findings suggested that there is a need
to explore whether pharmacists are
adequately trained to manage disruptive
situations. In a review of community
methadone services carried out in Victoria
10 years ago, recommendations were made
for improved training of pharmacists in
brief counselling and crisis interventions.11
However there are few opportunities for
this to occur, at least in Victoria. In both of
the pharmacy degree courses available in
this state [Victoria] there is a single two hour
session on ORT programs which includes
interaction with a client.
Since 2007 the percentage of Victorians
receiving ORT has increased by around 15%
to the current level of more than 13,000
clients.12 Over 90% these clients have their
medications dispensed in community
pharmacies, and approximately 40% of
pharmacies dispense ORT.
A strength of this study is that it was
conducted on a largely under-researched
topic which is of relevance to over a third
of Victorian pharmacies. A limitation of
the study was that it was conducted in
While some pharmacists might be
reluctant to provide services to injecting
drug users, pharmacists in this study
seemed to be extremely supportive of
their clients, a finding which has been
reported anecdotally.13 Even though,
on occasion, pharmacists might have made
an assumption about clients’ hepatitis
C status, there was no need for them to
treat these clients differently because of
it. Some pharmacists had had disruptive
experiences with a small number of clients
on ORT, but this was unrelated to hepatitis
C status. The study found that in relation to
dispensing ORT, professional isolation was
not uncommon, and that some pharmacists
perceived they had limited support.
Pharmacists dispensing ORT may benefit
from regular access to collegiate support.
The Pharmacists’ Support Service, a free
service run by pharmacists for pharmacists
provides support to pharmacists in Victoria,
South Australia and Tasmania, and the
Northern Territory. Phone 1300 244 910.
The service can assist with work-related
stress, trauma from a hold-up, professional
and personal concerns. In addition to being
a listening ear, the volunteer counsellors
provide information, support and referrals to
1. The Kirby Institute for Infection and Immunity in Society.
HIV/AIDS, viral hepatitis & sexually transmissible infections in
Australia. Annual Surveillance Report 2011 Sydney: The Kirby
Institute, 2011. At: www.med.unsw.edu.au/NCHECRweb.nsf/
resources/2011/$file/KIRBY_ASR2011.pdf. Accessed Nov 3,
2. Kirby M. HIV and Hepatitis C. Policy, discrimination, legal and
ethical issues. Australian Society for HIV Medicine, 2005.
3. Anti-Discrimination Board of NSW. C -Change. Report of the
Enquiry into Hepatitis C Related Discrimination. Sydney: Anti-
Discrimination Board of NSW 2001.
4. Hopwood M, Treloar C, Bryant J. Hepatitis C and injecting
related discrimination in New South Wales, Australia. Drugs:
Education, Prevention and Policy, 2006;13(1):61–75.
5. Richmond J. Is there an association between health
professionals’ hepatitis C knowledge and attitudes and the
care they provide for people with hepatitis C? Thesis (Ph.D),
University of Melbourne, School of Nursing, Faculty of
Medicine,Dentistry and Health Sciences, 2005.
6. Van de Mortel TF. Registered and enrolled nurses’ knowledge
of hepatitis C and attitudes towards patients with hepatitis C.
Contemp Nurse 2003;16:133–44 .
7. Gifford S. Australian women’s experiences of living with
hepatitis C virus: Results from a cross-sectional survey. J
Gastroenterol Hepatol 2003;18:841–50.
8. Gifford SM, O’Brien ML, Smith A, et al. Australian men’s
experiences of living with hepatitis C virus: Results from a cross
sectional survey. J Gastroenterol Hepatol 2005;20:79–86 .
9. Schmerling A, Schattner P, Piterman L. Qualitative research in
medical practice . Med J. Aust 1993;158:619–22 .
10. Temple-Smith M, Jenkinson K, Lavery J, Gifford S, Morgan M.
Discrimination or discretion? Exploring dentist’s views on
patients with hepatitis C. Aust Dental J; 2006;51(4)318–23.
11. Lintzeris N, Koutroulis G, Odgers P, Ezard N, Lanagan A,
Muhleisen P, Stowe A. Report on the Evaluation of Community
methadone services in Victoria. Turning Point Alcohol and
Drug Centre, 1996.
12. King T, Ritter A, Berends L. Victorian Pharmacotherapy Review.
2011, Sydney : National Drug and Alcohol Research Centre.
13. Churchus C, Doupe A. Pharmacies working with drug users.
Anex Bulletin, 2007;5(4):6–7 .
Table 1: Demographics of participants
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