PHARMACISTS are routinely co-located in GP clinics in the US, UK, Canada, New Zealand and several other countries – so why not Australia?
Writing in The Conversation, Professor Lisa Nissen and Associate Professor Jean Spinks from the Centre for the Business and Economics of Health at the University of Queensland, addressed some of the issues that would need to be ironed out, prompted by the Royal Australian College of General Practitioners’ call for pharmacists to be based in general practice.
In its submission to the Productivity Commission, the RACGP stated that GP-based pharmacists “can contribute to higher prescribing quality and lower prescribing costs by working collaboratively with GPs to support the quality use of medicines”.
The peak body pointed to an independent economic analysis that found pharmacists in general practice could deliver an estimated $545 million in health savings systems over four years, through reductions in medicine-related harms, reduced emergency department visits and lower hospital readmissions.
“Currently, a lack of funding prevents many GP clinics from employing more pharmacists,” the submission noted.
Prof Nissen and Assoc Prof Spinks cautioned that the $545 million figure came from a 10-year old report based on even older studies, and patient complexity and treatment options have changed.
They also questioned whether there are enough pharmacists to fill these roles.
Improvements would need to be made to patient digital record-keeping at community pharmacy level to capture over-the-counter medicines, so GP-based pharmacists have a complete picture of the patient’s medicines.
There would undoubtedly be benefits to the move – for example, having an on-site pharmacist to conduct medication reviews may be more convenient for patients.
It could also help build trust between pharmacists and GPs, with GPs potentially more open to pharmacists’ suggestions around medication, the professors noted.
However, GP-based pharmacists would not dispense medicines, and patients would have to obtain them from a community pharmacy.
Having just completed a trial of pharmacists in GP clinics in Queensland, the authors said one learning was that “relationships and workflows between pharmacists and GPs must be negotiated on a practice-by-practice basis”.
“Both GPs and pharmacists need to agree on their role, and pharmacists need to be trained and supported to work in this general practice setting,” they said, adding that patients should also have a say in the type of services delivered.
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