Discourse has been brewing over the suggestion pharmacists manage chronic disease.
Recent comments from the Pharmacy Guild of Australia president Professor Trent Twomey have sparked discourse on when pharmacists can assist with the treatment of chronic diseases.
An expansion of the pharmacist scope of practice to enable pharmacists to manage chronic health conditions, Professor Twomey suggested at a pharmacy conference in Sydney last week, would provide greater access to healthcare for patients.
“When you do the training, you will realise, clinically it’s not that different,” Professor Twomey said at Pharmacy Connect, according to the Australian Journal of Pharmacy.
“I know there is a larger appetite for the acutes and the scope-of-practice journey, because that’s the immediate stuff before me – an acute occasion of service is something I can see once, diagnose, resolve and they’re on their way.
“A chronic disease is me taking responsibility for something that is going to be there in perpetuity with that individual, and that’s the difference.
“It is not more difficult to treat a chronic disease than it is to treat an acute occasion of service.”
The expansion of pharmacist scope to cross over GP practice scope is no new concept with the pharmacy pilot program in Victoria also panned by GP bodies for how it would fragment effective care.
Collaboration between GPs and pharmacists is not being discouraged by health bodies but groups such as the AMA and RACGP have expressed concern over how it hinders the establishment of effective cross-disciplinary care.
“Siloed approaches, with people trying to take on individual, new and different roles, isn’t the answer,” AMA president Dr Danielle McMullen told The Medical Republic.
“Working collaboratively and using our unique skill sets is the way forward.
“Whether it’s pharmacists, nurses, allied health practitioners, we all have unique and important roles to play in the care of people with a chronic illness, and it’s really important that we work together to do that.”
The AMA said it was interested in exploring the idea of incorporating pharmacists into general practice as an expansion of practice care teams.
General practice being at the forefront of chronic disease management remains the AMA’s position, with GP a fundamental place for patient continuity and coordination of care.
“Australians expect that when they have a health condition that they have a doctor involved in that care, and in fact, a regular GP taking the lead in that care,” Dr McMullen told TMR.
“Evidence could show that having a strong general practice sector and having a regular GP improves your health outcomes.”
The RACGP also stated its high regard for pharmacists but reiterated its stance that general practice is the most effective discipline to coordinate chronic disease management.
“Expanding pharmacy scope to move chronic disease diagnosis and management to retail pharmacy settings, disconnected from their usual care, is not in the best interest of patients,” RACGP president Dr Michael Wright told TMR.
“Extending powers in chronic disease management is particularly concerning, this is a complex area of healthcare, requiring a lot of integration of care.
“Patients experiencing chronic disease must be carefully monitored and cared for by a GP who knows them, and their history.
“GPs value the work of pharmacists; however, they are simply not trained to diagnose these complex conditions.”
