Pharmacists call for more active role in treating chronic diseases

Pharmacists have called on the Government to give them a greater role in treating chronic diseases and in health screening

Prof John Nolan, consultant endocrinologist, St Jamess Hospital
Dublin, speaking at the Irish pharmaceutical Unions (IPU) 5th
Annual Healthcare Seminar on The Role of the Community Pharmacist
in Chronic Disease Management in Dublin yesterday.
Prof John Nolan, consultant endocrinologist, St Jamess Hospital Dublin, speaking at the Irish pharmaceutical Unions (IPU) 5th Annual Healthcare Seminar on The Role of the Community Pharmacist in Chronic Disease Management in Dublin yesterday.

Pharmacists have called on the Government to give them a greater role in treating chronic diseases and in health screening. Such a move could also entail investment by the Exchequer in pharmacies.

The pharmacists claim they are being under-utilised and could save the Exchequer millions if they were more involved in healthcare.

The Irish Pharmaceutical Union (IPU) has suggested this could be done through health screening for conditions such as blood pressure and cholesterol at pharmacies as well as involving pharmacists more closely with patients and their medication.

"We would like to see the Government investing a certain amount into serious integration [of pharmacists] into current primary healthcare teams," said IPU president Michael Guckian, although he did not put a cost on such investment.

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He said integration could be done by ensuring pharmacists, GPs, nurses and other healthcare staff combine to co-ordinate patients' healthcare, including ensuring screening results, for example, are sent to the right GP and there is feedback and follow-up for all parties.

"Quite often, we see patients who did not go to their GP because of cost or other issues, or else they are asking our advice on various issues because their doctor told them one thing and their consultant may have said something else.

"We have the network, with good access for patients,"said Mr Guckian, adding that there was one pharmacist for every 2,900 patients, a ratio which compared very well to other countries.

He said pharmacists were not trying to replace GPs, but were seeking a more active role.

Dr Martin Henman, from the school of pharmacy at Trinity College Dublin, said there was a need for a proper collaborative care system to be put in place.

Among other things, this would entail putting in a central medical records system, where pharmacists could access patient records and medications and adjust their medications in particular cases, if the need arose.

Mr Guckian said pharmacists had expert knowledge of specialty medicines to treat chronic diseases such as diabetes, asthma and cardiovascular disease.

Prof John Nolan, consultant in endocrinology and metabolism at St James's Hospital Dublin, said diabetes was a major health challenge and pharmacists could play a critical role in managing treatment "and indeed preventative health promotion for patients".

The IPU said other jurisdictions had established systems where pharmacists had a greater healthcare role to play.

Speaking after a conference on the issue in Dublin yesterday, Dr Ross Tsuyuki, professor of medicine at Alberta University, Canada, said a number of studies involving closer liaison between chemists and patients were ongoing in Canada.

"It generally involves identifying those at risk of conditions such as high blood pressure or cholesterol, asthma, diabetes, arthritis or osteoporosis."

Some of it was done by accessing previous patient records, held by the pharmacies themselves, and some through simple questionnaires when the patient visited the pharmacy itself.

"You can have the best drugs in the world," Prof Tsuyuki said, "but if you can't find the patients, you are nowhere."

Although healthcare costs can rise initially - because more diagnoses of conditions are made, leading to more treatments - Prof Tsuyuki believed treating people earlier led to savings in longer term secondary care costs.