You are discharged from the hospital for some painkillers, but you are not sure if you can safely take it with a heart medication or vitamin for several years. So you ask your GP. They recommend seeing a pharmacist in the next consulting room for advice on how to manage all medicines safely.
This is the future that Royal Australian College of General Practitioners (RACGP) wants to see. The government wants pharmacists to be more permanent settlers in the GP clinic.
RACGP It provides quality management more efficiently. The committee’s temporary report will be announced this week.
But will this proposal actually provides more efficient health care? And how will it actually work?
We just completed Loud test A pharmacist working at Queensland’s GP Clinic. The following is as follows. And there are some of the things we need to solve before this becomes a reality.
Do you want a pharmacist in the GP clinic?
There is a pharmacist It is jointly placed in routine At the GP Clinic of the United States, the United Kingdom, Canada, the Netherlands, Ireland, Brazil, New Zealand and Malaysia.
Their goal is to improve how the patient manages the medicine. They can help to clarify the reason for the need and how to take it. You can advise you about cheaper pharmaceutical options. When the patient is discharged from the hospital and needs to be treated at home, it is possible to contact medical professionals about problems related to medicines. You can also advise GPS on drug problems, such as prescribing drugs with side effects that are easy to stop or manage certain drugs.
According to Australia’s suggestions, these pharmacists will not distribute medicines while working at the GP clinic. The pharmacist will serve as a professional clinical role in medical management (also includes activities such as providing vaccinations). But patients still need to get medicines in a common way in a community pharmacy.
RACGP suggested that there will be a cost reduction in integrating pharmacists into general practices.
How is this possible? Perhaps it is likely to reduce the likelihood of taking medicines as the patient is indicated (thus maintaining health resources and using less health resources), reducing the level and seriousness of medical problems (e.g., side effects that need to be managed), and potentially reduced the number of drugs that people take.
These benefits are extensively plausible, but the size of the benefit is very uncertain. This estimation is based on the report. 10 years agoThis includes only small studies of almost 20 years of age. During this period, patient complexity and treatment options have been changed, so you need to take into account recent data and models.
Isn’t the pharmacist already reviewing the drug?
Australian community pharmacists are doing Drug review More than 20 years. They can review human drugs in homes, elderly nursing or community pharmacy.
However, there are some clear advantages to pharmacists who use expertise in the GP clinic.
Having on -site pharmacists can be convenient for patients who want further advice or review drugs outside the family or community pharmacy.
In the same location, if the pharmacist and GP work together, a reliable relationship can be formed. this Increases possibilities In response to the proposal of the pharmacist of the GP, we respond to the proposal to change the drug’s drug in comparison with the patient created by the pharmacist outside the practice.
But there is a potential rod block
This sounds promising, but it’s not clear if there’s enough pharmacist to fill this role. We need to maintain the drug review service, including the drug review service. Site in the elderly nursing And at the community pharmacy, while supporting expansion Pharmacist (Example: The ability to prescribe certain medicines).
Another problem is related to digital health records. Currently, the community pharmacist has related information about medicines purchased through the counter My health record. It is often impossible to know that a pharmacist working at the GP clinic bought a counter in a community pharmacy (like aspirin as a blood diluent).
This does not necessarily have a complete picture of the patient’s drugs. In order for RACGP to work well, it is necessary to better integrate various digital systems used in the health sector.
Therefore, the idea of a general practice -based pharmacist is good in principle, but the details should still be covered.
Does this work?
recent Australian study It was cost -effective when the pharmacist worked with GPS to support the patient who was discharged from the hospital with the GPS. The patient was less likely to be rebuilt or to the emergency room the following year.
But more specific evidence is required for the implementation of this role and the other aspects of the advantage.
For example, our team only has Completed the trial In Queensland, the pharmacist of the GP clinic can reduce the number of preventive medicines for patient groups (eg, diabetes).
Through this unpublished study, we have already learned that the relationship between the pharmacist and the GPS should be negotiated by practice. This process requires time, support and additional funds.
Both GPS and pharmacists must agree to their roles, and pharmacists must be trained and supported to work in this general practice environment.
The patient should also talk about the type of service provided by this model and how to provide it.
Finally, we can learn a lot of lessons about how it works in other countries, but we need a broader implementation test in Australia. It must be properly supported to collect good evidence for evaluation. Then, if you succeed, you can go to the stage rollout to ensure the value of money and better health results.
