This
service is recognition that the workload in pharmacy is now so high
that providing this information and advice to all patients is not
always possible.
It will allow keen pharmacists to identify those patients who want
something extra, and to allow pharmacists to be paid for their efforts
in going that extra step.
This is something many pharmacists have tried hard to do for many
years, with the prospect of patients returning and becoming regulars
the only incentive (and we all know the many positives from patients
being regulars at one pharmacy, both professional and financial).
The
MAS service is not intended to be free to patients.
This is a major change from how we operate now.
Making the cultural change amongst pharmacy users, so we are seen
as professionals capable of charging fees for service will be
hard.
This transition will be eased somewhat with at least one private
insurer (MBF) prepared to reimburse patients for using the MAS.
This will hopefully force other insurers to follow suit.
It
is important to realise that the MAS is not intended as a substitute
for a Home Medicines Review.
A MAS consult is intended to provide counselling and information,
but not to perform complete medication reviews.
However, not all patients will require a Home Medication Review
(HMR) and will benefit from just getting more detailed one on
one counselling.
One
example is that of patients newly discharged from hospital.
Depending on the pharmacist availability in the hospital were
they were admitted they may not have received detailed information
on any new medicines.
As part of my job (in a hospital) I conduct group sessions with
patients who are undertaking cardiac rehabilitation.
Most of these patients are on five or more medications, and many
were taking no medicines two months ago. These patients could
benefit immensely from a one on one consultation with their community
pharmacist to answer all their questions in private, and to provide
advice on adjusting to the lifestyle changes that concordance
requires.
I believe these patients would certainly be prepared to pay in
some way for this service, having seen their positive response
in the group sessions.
The MAS offers some advantages over the HMR scheme as it does
not rely on government funding for its survival, and the administrative
workload should be much lower. This alone should make it attractive
to professionally minded pharmacists. This program is an extension
of the existing PSA Specialty Practice Programs and will probably
appeal to most pharmacists
Several
changes to the pharmacy layout may be required to operate this
service.
The development of a private counselling area in which to conduct
the service and take appointments will mean layout changes in
most pharmacies, as very few have space for two people to sit
quietly for up to a half-hour without interruption.
For
a pharmacist to set aside time for appointments will mean either
taking patients in slow periods with the risk of interruption,
after hours, or most likely hiring another pharmacist to cover
this period.
(One might wonder where all the pharmacists are supposed to come
from!)
More
details on taking part in this service can be obtained from the
PSA's website
( http://www.psa.org.au/practiceprograms/spp/mas.cfm
) or buy buying the MAS kit which is on sale from the PSA.
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JON
ALDOUS