From Mr T. Mahmood, MRPharmS
SIR,—Now that bupropion is on the market, it sure is keeping pharmacists
very busy. In particular, I think that this is due to the extra counselling
necessary to encourage smokers to stop smoking. I welcome the move by the National
Health Service to make bupropion prescribable on FP10.
There are two points to be made here. The first is that it is now an opportune
time to make nicotine replace therapy (NRT) prescribable on the NHS on a similar
ground to bupropion. I would like to see a change that recognises and gives
NRT a place in the treatment of nicotine dependence as soon as possible. This
would give the professionals a choice of effective treatments endorsed by the
NHS. In Barking and Havering, where I work, a mechanism is now in place to train
around 20 pharmacists to be intermediary counsellors in helping smokers quit
their habit.
The second point I would like to make is that NRT should become prescribable
by pharmacists. This is because pharmacists are capable of titrating the dose
of NRT to smokers and screen any unsuitable clients to reduce adverse events.
This would certainly develop our role immensely.
Hopefully, with the impending launch of emergency hormonal contraception it
is time for a new pharmacist prescribable category to be instigated for NRT,
emergency contraception and possibly bupropion in due course as experience builds
on its use. These agents would certainly necessitate training, protocols, record
keeping and an acceptance of responsibility. I believe that community pharmacists
can use these agents safely and contribute to the health of the nation.
Tariq Mahmood
Romford, Essex