Home' Australian Pharmacist : Australian Pharmacist April 2013 Contents 28 Australian Pharmacist April 2013 I ©Pharmaceutical Society of Australia Ltd.
ACCREDITED PHARMACIST SPECIAL INTEREST GROUP
Getting the message across
By Sarah Gillespie
One of the important aspects of the medication review process is the written
communication of the findings and recommendations from the patient/resident
interview to the relevant general practitioner (GP).
Teamwork, communication and collaboration
between health professionals are important
for the safe and effective delivery of health
care.1 This is especially the case for accredited
pharmacists performing medication reviews
both in the community and residential
aged care settings. The timely provision
of information to the GP to improve
medication management should be a prime
consideration when conducting reviews.
Ideally, accredited pharmacists and GPs
would have the opportunity to meet to
discuss the best way to communicate the
relevant issues discussed during the interview
and the pharmacist's recommendations.
Discussion points could include preferences
for delivery mode, style and layout of
report, required detail and method of
communication when urgent notification is
needed. Developing a working relationship
with the practice manager/nurse may assist
in facilitating GP contact and provide a useful
conduit for information transfer.
Pharmaceutical Society of Australia
Guidelines2 suggest that the following
information should be included in GP reports:
• the date and location of the interview;
• the name of the referring GP and HMR
• the name of the patient's community
pharmacy (if consent provided);
• advice and resources provided to the
patient during the interview;
• the ability of the patient to manage and
administer their medicines;
• other medicines taken of which the
GP may be unaware e.g. purchased
• details of medicines not taken according to
the GPs instructions;
• issues of adherence e.g. swallowing
difficulties, inability to open packs, memory
• the reason for referral.
The report to the GP should mention issues
discussed during the patient interview
and any solutions provided at the time.
The recommendations to the GP for the
management of medication-related issues
need to be clear and succinct.
A useful method to draw on when
documenting recommendations to the
GP is the SOAP note. SOAP is an acronym
for subjective, objective, assessment, and
plan and is a method of documentation
employed by health professionals to write
notes in patient charts and to communicate
patient information. The use of SOAP notes
encourages maintenance of comprehensive
records, reduces unnecessary documentation
and provides a standardised record which
assists in the prompt and easy retrieval of
information. This method can be used when
writing GP reports to record assessment
details and recommendations.
Subjective data can include information
provided by the patient during the interview
such as a description of their current
symptoms e.g. troublesome pain, or difficulty
walking due to swollen ankles.
Objective data includes relevant vital signs
such as blood pressure readings, laboratory
results, body mass index etc. Objective
information can also include any relevant
physical findings, e.g. ankle oedema noted
Sarah Gillespie is a Consultant Pharmacist
with the Australian Association of
Consultant Pharmacy in Canberra.
at the time of interview. Objective details
can be noted by the pharmacist during
the interview or can be provided in the GP
The Assessment component relates to
the interpretation of the subjective and
objective data information provided,
and the medication-related issues noted.
For example, the assessment may be that the
noted ankle swelling may be related to an
insufficient dose of frusemide.
The final step is the Plan, when
recommendations for managing the
medication-related problems are
made. Recommendations may include
dose adjustment, change in therapy
and suggestions for follow up/further
monitoring, especially if there is a possibility
of occurrence of adverse effects.
The layout of the GP report should ensure
that priorities for action are clearly described.
The most important patient-focussed
aspects should be mentioned first, with
the less important issues discussed later.
The GP may only read the first few suggested
recommendations and consider whether or
not to implement these before any others.
It is important to focus on the key issues as
they relate to the patient when conveying
information to the GP.
Before submitting a report to the
GP, consider asking yourself the
• Will the GP be aware of the important
medication related issues as they apply
to this patient? Have the issues been
• Is my report clear, easily understood and
well laid out?
• Will the information in my report be
useful to the GP in relation to managing
• Are my recommendations
• Is my report the right length? If I was busy,
would I read the entire document?
• Have I checked the report for spelling
errors? Carefully check drug names!
1. Rigby D. Collaboration between doctors and pharmacists in the
community. Aust Prescr 010;33:191--3
2. The Pharmaceutical Society of Australia. Guidelines for
pharmacists providing Home Medicines Review (HMR) services;
2011 At: .www.psa.org.au/download/practice-guidelines/home-
medicines-review-services.pdf (accessed 25 Feb 2013)
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