Medicines Management
Issue no 2, p4
March/April 2002

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GP calls for extended pharmacist role in medication reviews

A leading GP has called for pharmacists to play a much more active role in medication reviews of complex drug regimens, saying that current practices degrade the role of the pharmacist and waste GPs' time.

York GP Dr Joe Neary, chairman of the Royal College of General Practitioners' clinical network, wrote to the British Medical Journal questioning the current practice of GPs having to sign every prescription for drugs that are incrementally dispensed (Br Med J 2002; 324: 548).

Instead, he said that pharmacists could assume a more active role reviewing patient medication, leaving the GP to conduct reviews on a six-month basis.

"As a doctor I should use the time in a consultation to focus on how the patient is feeling, and how their illness is affecting them. These are the areas I can affect as a doctor," Dr Neary told Medicines Management.

He added: "But a pharmacist should have some control over how often a prescription is dispensed, and could be talking to the patient in the interim period about various things, including reminding them of their six-month review with the GP."

Dr Neary said that the current system meant that doctors were continually required to authorise increases in patients' medication, meaning they had to sign multiple pieces of paper, while pharmacists' roles were reduced to that of passive dispensers.

Although Dr Neary agreed that pharmacists could move into the role of a service provider around medication reviews, it would require a change of mentality. "The payment of pharmacists needs to be carefully reviewed because the current system encourages them to continue dispensing every 28 days."

He added that if pharmacists were to take on an extended role there would need to be some sort of quality assurance system. "It is a tribute to their professionalism that so many pharmacists have continued to keep up to date, without there being any requirement for them to do so."

He added that it was inevitable that pharmacists would eventually take on more of a role as a service provider in future. "The new generation of pharmacy graduates are a major level for change and are redefining the relationship between pharmacists and doctors," he added.