The Pharmaceutical Journal
Vol 277 No 7414 p211
19 August 2006

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Review casts doubt on some new pharmacy roles

Simply adding specialists, such as pharmacists, to traditional primary care teams of GPs and nurses is not enough to achieve the Government's aim of shifting some current hospital care to the community.

This is one of the findings of a review of best practice in shifting hospital care to the community by the University of Birmingham Health Services Management Centre (PDF 1.2MB).

Having reviewed nine papers on integrating pharmacists into traditional primary care teams, the authors say that they could find no evidence that directly links expanding the pharmacist’s role to reduced reliance on acute hospital care.

On the other hand, they found that community-based clinical pharmacy services for the elderly reduced drug-related problems, although there was limited evidence of any effect on morbidity, mortality or health care costs.

Another study suggested that providing pharmaceutical counselling and discharge summaries for elderly people who leave hospital having been prescribed more than four items reduced unplanned GP visits and readmissions.

Steven Curtis, a community pharmacist in Leighton Buzzard, Bedfordshire, has experience of hospitals that provide discharge summaries and communicate with community pharmacies when patients are admitted and discharged and those that do not.

“When a patient leaves hospital on multiple medicines, if the community pharmacist is made aware of medication that has been changed he is less likely to make a mistake. That line of communication is fantastic when it has been opened up,” he said.

Sadia Khan, lead pharmacist for self care at the Royal Pharmaceutical Society, said: “Pharmacists need to have an awareness of the key factors that may impact upon shifting care from hospital to the community. This report has highlighted the need for further research into the area of shifting care. The Society, as part of its long-term conditions policy agenda, has commissioned Keele University to produce three reports on long-term conditions, which will be formally launched at the British Pharmaceutical Conference 2006.

She added that reference sources such as the “Moving patients, moving medicines, moving safely” report (PDF 1.2MB), produced by the Society with other bodies, could help multidisciplinary teams, maximise good practice and minimise risks associated with medicines when patients are transferred or discharged.