There
is no better way to evaluate the contribution a pharmacist can make
to improve health than to put one into a setting where there has
not been one before.
Aboriginal health in Australia is in a distressing state with improvements
drastically needed if these dispossessed people are to be able to
maintain a lifestyle that does not threaten their life expectancy
even further.
For pharmacy, the opportunity to enter a place with a "clean" slate
does not come often, and when it does the opportunity should be
seized.
It provides the chance to see exactly what is needed to fit in with
the dynamics of a team environment.
It means the activities undertaken have to be useful, otherwise
they simply will not be funded.
So the combination of the challenge of improving Aboriginal health,
and establishing a pharmacy service is a unique duo which should
provide a base for evaluation.
Imagine the main street of a town with NO pharmacy, and all of a
sudden one is placed in the middle and tries to succeed because
of a perceived need by the community.
This is the scenario within which the Tiwi Health Board Pharmacy
Project finds itself.
The single factor that caused this to be initiated was dissatisfaction
with the "dosette box". Yes - as simple as that!
"Pharmacy" was perceived as the place where medicines come from,
and where the packaging is done.
For many years the contact with a pharmacy was through a regional
hospital where prescriptions were dispensed.
Labels were put on boxes and this was the source of supply for medicines
that could not be accessed through an "imprest" system in bulk by
monthly order.
Orders could not be placed more frequently than monthly, and prescriptions
took up to two weeks to be dispensed and delivered back to the remote
clinic.
This to the health clinic staff was "pharmacy" - a supply mechanism.
Throughout the history of health care in these situations the role
of the pharmacist had not been explored by the sponsoring organisation,
in this case a Catholic Mission.
It had not looked into a pharmacy service, nor had it been offered
by the two "supply pharmacies" which had been doing business with
the health organisation for over 20 years. The project has delineated
two functions for pharmacy and identified distinct roles for each.
The crossover is in the data collection undertaken in the supply
function.
The supply function ensures the medicine is available to the clinicians,
while the clinical function ensures it is being used in the most
safe and effective way for the patient.
Good data input at the point of supply provides the springboard
for reviews of individual patients, while good utilisation reviews
for groups of medications across the total population is possible
in a public health context.
The
pharmacy service can address in its development the following
aspects of health care: * Supply of medicines to patients
* Collection of data on supply
* Review of individual data for clinicians
* Contribution to population programs in public health.
Is this being done effectively, and the extent it is being received
will be examined in future articles.
Other
Articles by This Writer
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