The use of insulin, considered a high-risk medication with APINCHs classification,5 Ms Barwick notes, provides justification for a Home Medicines Review (HMR). ‘There’s an advantage to going into the home to observe the patient’s diet, consider potential interactions, and educate patients on the best effects and outcomes,’ she says.
Advice around cleaning blood glucose level (BGL) monitors to ensure accuracy can also be provided. ‘Pharmacists can explain how to put test drops through and clean blood spills on the monitor, common in pregnancy due to higher blood volume,’ says Ms Barwick.
With only 50% of women diagnosed with GDM receiving tests for heart disease and type 2 diabetes post-pregnancy,6 HMRs can be beneficial at this stage of the journey, too.
‘Along with conversations around diet choices, exercise regimes and sleep, I also explain how often testing is required over the next 5–10 years, and how to monitor for signs of the development of diabetes,’ Ms Barwick advises.
Nausea and vomiting in pregnancy
The presence of iron in pregnancy multivitamins may exacerbate symptoms of nausea and vomiting in some pregnancies, according to Ms Barwick.
‘Pharmacists can recommend a trial cessation of the iron component of pregnancy vitamins, often unnecessary in pregnancy,’ she says.
In 2020, photographer Bobbi Lockyer created a Birthing on Country project to highlight and create awareness around birthing issues and outcomes in Aboriginal women. For more, see 
Suzanne Nielsen MPS[/caption]
Gunnedah-based Karen Carter FPS loves making a difference to patients’ health and wellbeing. She always knew she wanted to own a pharmacy. Now she has two – and her children Justin and Wendy have followed her into the profession.
What led you to pharmacy?
I enjoyed chemistry and biology at school which led to me choosing pharmacy over optometry. Wanting to help people and work in the health area, pharmacy allowed me to combine my passion for science and to make a difference to patients.
Can you describe your initial years?
After 3 years of pharmacy study at the University of Sydney I added the Diploma of Hospital Pharmacy. During university holidays I worked at Colless’ Pharmacy in Narrabri and enjoyed working in a community pharmacy where the pharmacist knew the patients and offered lots of advice. This experience was invaluable.
During my diploma year I enjoyed working at different hospitals, then worked in the intensive care and renal units at Prince Henry Hospital – an opportunity to work in a team environment, educate nursing staff and be involved in antibiotic and patient-controlled analgesia policies.
Where else have you worked? How did you wind up with two pharmacies?
I also worked in community pharmacies in Marrickville, Baulkham Hills, Glebe and Bondi Junction in Sydney while working at the hospital gaining as much experience as I could because I wanted to own my own pharmacy and provide the best healthcare to patients. I left Sydney for country locums in Forbes, Wee Waa and Quirindi before joining a partnership in Gunnedah. I eventually bought the pharmacy and after a few years merged two pharmacies in 2001. In 2009 with my husband David, who has a banking background, an opportunity arose so we bought Narrabri Pharmacy.
What led to accreditation?
I have always enjoyed lifelong learning and became an accredited pharmacist in 2003 while juggling work and raising two children. The review process allowed me to have closer contact with patients and make suggestions to improve their health. I now travel to Bourke, Walgett, Wee Waa and Boggabri to perform Home Medicines Reviews (HMRs) and Residential Medication Management Reviews (RMMRs). I travel in a two-seater plane to Bourke and Walgett with the physiotherapist from Narrabri who is the pilot!
Tell us about other areas of operation.
We have been involved in research projects such as diabetes screening using HbA1c testing, asthma and sleep studies with the University of Sydney. In Gunnedah we were involved with the Indigenous Medication Review Service (IMeRSe) study allowing a closer relationship with our Aboriginal and Torres Strait Islander patients. This took me to Brewarrina and Skype interviews at Cooktown. I am studying a Graduate Diploma in Wound Care at Monash University and incorporating wound care services in both pharmacies.
How are the services offered in a regional town pharmacy different to those in other pharmacies?
A one-stop service store with most of our pharmacists accredited for vaccinations. We do HMRs, RMMRs and in-store medication reviews, provide equipment and screening for sleep apnoea and aids for daily living. Six pharmacists are trained in mental health first aid. We have an extensive patient delivery service to Gunnedah and Narrabri for personal medication packs or medicines. We have a beauty therapist in both stores, and cosmetics and giftware offer a department-style store in these country towns. We have attended AgQuip with sleep apnoea equipment and advised on sleep apnoea screening. We sponsor local events and sporting teams. A dispensing robot and Webster robot in Gunnedah have allowed more pharmacist time.
And the next generation?
Our son Justin interned with us in 2019 and is now one of our registered pharmacists while our daughter Wendy is currently in the 4th year of her pharmacy degree. Pharmacy is a fantastic career and the future is bright with opportunity.
A DAY IN THE LIFE of Karen Carter FPS, an accredited, rural community pharmacist owner in Gunnedah and Narrabri, NSW.7.30 am – A quick trip Drive 132 kilometres to a Wee Waa residential aged care facility (RACF). 9.00 am – On the ground in an RACF Deliver education and interview patients/care staff for RMMRs. Notice a new patient is taking amitriptyline (anticholinergic) and donepezil (cholinesterase inhibitor). Family agrees to an RMMR. Discover patient has been chewing Panadol Osteo and Duodart. Ring GP to discuss ceasing amitriptyline, change formula of paracetamol and organise RMMR referral as patient has swallowing issues. Duodart changed to prazosin after review. 11.00 am – Drop into Narrabri Pit stop at my pharmacy to check on team, referrals for HMRs, collect reports and roster and drive the hour home, making phone calls (hands free) to accountant or remembering to change our ad for the radio station. 12.00 pm – Back in Gunnedah At Karen Carter Chemist in Gunnedah, check latest sleep apnoea clinic patient results after setting up a CPAP trial on previous day. Patient has improved from 64 on apnoea/hypopnea index (severe sleep apnoea) to 4. She slept 7 hours (husband also slept well); feels better. 2.00 pm – Afternoon variety Dispensing, vaccination service and checking dose administration aids, dress a wound, discuss using a spacer and demonstrate use. Noticed a patient taking Galvumet only once daily rather than twice daily prescribed dose. Spoke to him about bringing in medicines for a MedsCheck. 4.00 pm – Report writing Write up RMMR report from the morning and fax to Wee Waa RACF and doctor. 6.00 pm – Home work Closing time and head home to family. After dinner write up RMMR/HMR reports, tackle an essay for my Graduate Diploma in Wound Care or attend a webinar on e-scripts. |
Explore new paths at www.psa.org.au/careerpathways
