Pharmacists need more information to do their job

Politics is taking precedence over patient care in the argument over longer prescriptions for chronic conditions as part of an ongoing stoush between several of the nation’s peak medical bodies.

The Royal Australian College of General Practitioners and the Australian Medical Association want the federal government to enable the prescription of 12-month scripts and allow pharmacists to dispense 60 days’ supply for 143 medicines for chronic conditions.

But they are facing stiff opposition from the Pharmacy Guild over concerns the plan could lead to significant medication shortages.

Both groups are making valid points, but it’s time we took the politics and power struggles out of the discussion and put the focus back on what is most important – patient care.

At the moment, the current practice of patient review is often time-based – see me in a month, see me in three months, see me in a year. But when we see the patient, their condition may be at its very best or very worst – that’s not something we can predict.

The reality is, health conditions wax and wane – asthma in winter compared to summer is one example.

Some conditions need their medication doses regularly reviewed and others need more monitoring at different stages.

But none of this is information pharmacists necessarily have access to, and that’s a big part of the problem, one that is rarely acknowledged.

A prescription is meant to be a communication, a transparent communication between all the people in the chain – the prescriber, the dispenser and the patient. Often that communication is lacking.

I can see the value in reducing the number of times patients with chronic conditions need to visit their GP, but what alternatives should the patient rely on and where is the clear guidance for what prompts a return visit to the prescriber?

There are so many new options available to us these days – diabetes patients are being monitored using smart watches, we have improved access to telehealth, and there may be circumstances and conditions where a visit to a practice nurse is appropriate. All these options could allow us to account for the differences in individual patients and conditions.

We need to give dispensing pharmacists sufficient information so they have the confidence to provide an increased supply. It could even be as simple as a pro-forma template that notes that the patient is stable and isn’t in need of further review for a specified time frame, or needs an extended supply due to travel, for example.

Under the present system that information is not forthcoming.

Another valid issue raised by pharmacists is confidence in their ability to supply medications at the volume and time requested. There are so many medicines that we cannot source, and that is the reality we are facing in a post-covid world.

Supplying more medication to one person risks another not being able to access it for another week or month until supply returns to normal.

Pharmacists shouldn’t be put in the position to decide who needs a medication more.

It’s time we took the politics out of this process and worked more collaboratively to support the people we collectively do this work for – our patients.