Medicines Management
Issue no 5, p4
September/October 2002

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Terms need better definition

Medicines management is a poorly defined concept, according to the preliminary indications of an ongoing investigation (PDF 45K) into the nurse's role in medicines management by Leeds University (IJPP 2002:10(suppl):R14). In-depth semi-structured interviews with GPs, nurses and community pharmacists suggest that each group emphasises different aspects in their descriptions of medicines management. Practice nurses, for example, regard their work as more patient focused compared with GPs and pharmacists, who focus more on medication and professional interests.

Similarly, no defined model of pharmaceutical care exists in the United Kingdom. A separate investigation (PDF 45K) by Sarah Tulip et al (IJPP 2002:10(suppl):R93) indicates that despite general support among doctors, nurses and pharmacy staff for the implementation of a structured model of care, apart from lack of resources, there are cultural barriers to wholesale implementation. Pharmacy staff expressed fears of negativity from medical staff and deskilling of core pharmacy activities, and anxiety over their ability and training. Medical staff were concerned about continuity of service and the clear definition of the responsibilities of pharmacy staff.

There has been extensive debate about the terms “medicines management” and “pharmaceutical care”: Are they synonymous or are they convergent? Until the terms themselves are clearly defined in practice, it seems the debate is set to continue for some time. More importantly, as the Leeds group concludes, successful inter-professional work requires terms to be understood uniformly by all relevant health care professionals.