Pharmacists are on the verge of a major acceleration in their scope of practice, but a shift in perspective is needed first, delegates heard at a panel discussion held on day two of PSA26.
Kate Gunthorpe MPS, Deputy Chief Pharmacist for TerryWhite Chemmart, who was among the first cohort of pharmacist graduates to expand their scope into prescribing medicines, believes prescribing pharmacists should consider themselves as ‘pharmacist practitioners’ – a shift in language she considers to be critical to capturing their broader role.
‘There is so much more to expanding your scope of practice than just being able to prescribe,’ she said.
‘I have dedicated my career to advocacy on scope of practice and ensuring that we can successfully and safely implement scope of practice into all of our pharmacies across Australia, and I think it is the future of pharmacy.’
Using the language of ‘pharmacist practitioner’ reduces the risk of antagonising medical colleges, Gunthorpe said, and is a natural step that aligns pharmacists with other health workers, such as nurse practitioners and medical practitioners.
Not just prescribing
According to Professor Lisa Nissen FPS, Director and Taylor Family Chair at the University of Queensland’s Centre for Business and Economics of Health, taking on the responsibility of vaccination was the best thing pharmacists did in terms of accelerating opportunities to expand their scope of practice.
‘I think we’ve unleashed the potential for pharmacy,’ she told delegates attending the Saturday plenary session. ‘We’ve shown that it’s safe, pharmacists can contribute, and patients really value our contributions.’
The idea that pharmacists have no role in prescribing is a myth, Prof Nissen said, describing that making decisions about medicines was a ‘core capability’ in which pharmacists are trained.
‘We can think of it as one of the tools on a belt of tools that we have in our practice,’ she said.
‘The ability to use it in an enhanced way – which is really what the endorsement for scheduled medicines is talking about at a national level – is about being able to uplift that tool in a different way in the community. And we already prescribe our [non-prescription] medicines, UTI, and contraceptive medicines.’
Fitting into the system
Associate Professor Fei Sim, former PSA National President and a PSA Board Director who is currently enrolled in the Pharmacist Prescribing Scope of Practice Training Program, added that shifting language use was an indication of the way pharmacists complemented the work of other healthcare professionals.
‘If people ask me how I am now – and if I feel normal that day – I would say I am “unremarkable”,’ she said, using a term standard in clinical documentation.
‘One of the things that we do is writing clinical reports for our medical colleagues – for other healthcare professionals – and that’s something that, traditionally for pharmacists, we don’t always do.’
Prof Nissen and Ms Gunthorpe agreed that education was an important part of expanding the visibility of pharmacists’ scope of practice, particularly among the general public.
‘A lot of people don’t know what pharmacists actually do,’ Prof Nissen said.
‘The magic behind the curtain or the special sauce of what pharmacists are doing to prepare the prescription that people actually see as their product – people don’t understand all of that.
‘I think the marketing that we do around the medicines expertise, the medicine safety, the systems work that pharmacists do – we haven’t really exposed that to the public or a lot of our other health practitioners.’
Patients are pharmacists’ best advocates, the panel agreed – pharmacists just need to do a better job of marketing their services.
Taking on a new role
Today, according to Ms Gunthorpe, pharmacists provide more vaccinations than any of their healthcare colleagues, which is, over time, changing how consumers see them.
‘It’s a change in our responsibilities within the healthcare system, and it’s going to take some time, but patient education and patient awareness is really how we want to make that change,’ she said.
While pharmacists’ expanded scope of practice has resulted in some misinformation about their role in prescribing – that it’s unreliable or outside their proper role, for instance – Ms Gunthorpe said it was also important to manage patient expectations.
‘We provide patient-centred care and not patient-led care,’ she said. ‘I make it very clear, from the minute that a patient comes in to see me what’s within my scope of practice. As part of the consent process, there are disclaimers that I can’t provide any Schedule 8 or medicines.’
Ultimately, Ms Gunthorpe said, even though expanded scope isn’t for every pharmacist, it should be for every pharmacy.
‘We have pharmacists that just aren’t interested, and that’s okay,’ she said.
‘[Between] when you open the doors in the morning and when you close the doors at nighttime, you need to be able to offer this service so that patients can get that timely and accessible care that we’ve all spoken about.’
