Transforming and Supporting Patient Care - Health Professions ...

353Chapter 14 – Profession of PharmacyIn managing a patient, you sometimes haveto step outside a narrowly defined formularybecause each patient is different. Having alimited formulary will defeat the purpose. 30Clive JacksonCEO, UK National Prescribing CentreInterview with HPRAC, November, 2008The OCP cites preliminary data on the British minor ailment schemes thatdemonstrates increased access by the public to necessary health servicesfor minor ailments, increased access to physicians by patients who are moreseriously ill, and overall cost savings to the NHS. IMS Health analysedanonymous patient records from its database of 210 general practices acrossthe United Kingdom, covering four million patient records and 190 millionprescriptions. Data from 500,000 patients who had consulted their physicianabout a minor ailment suggested that, in 2006/2007, 51.4 million generalpractitioner consultations a year were solely for minor ailments. Estimatedat eight minutes per consultation, this represents 18 percent of a generalpractitioner’s workload or an hour a day for each general practitioner.What HPRAC FoundReadiness for ChangeBoth the OCP and OPA submit that pharmacists are appropriately trainedfor initiating a prescription for minor ailments. The OPA in its submissionstates that “pursuant to in-depth consultations with their patients,pharmacists have been assessing their symptoms and when appropriate,prescribing Schedule II and III medications for decades. Expansion of thisrole to include a limited number of minor ailments that might requiretreatment with Schedule I medications can be easily supported throughenhanced training ... perhaps in a multidisciplinary fashion alongsidemedical and nursing students.” The organizations also make it clear that notall pharmacists will undertake these activities, and see the expanded scopeas voluntary and not mandatory. The OCP maintains that it is, and willalways be, the pharmacist’s responsibility to practice within his or herindividual scope of practice.Managing the Risks of HarmUnlike medication therapy management, in a minor ailments program therewould not be an original prescription from another authorized prescriber;rather, the pharmacist would be the first point of contact for the patientand thus initiate drug therapy. Several safeguards would need to be in placeto minimize the risk of harm to patients, including interprofessionallydeveloped formularies, clinical protocols and mandatory referral protocols.30UK National Prescribing Centre Meeting Notes. November, 2008: 3.HPRAC Critical Links January 2009