Pharmacy testing debate
July 27, 2012
AUSTRALIA needs to cast the net
wider beyond the GPs office to
reach patients with undiagnosed
modifiable health risk factors,
according to the Director of the
Baker IDI Diabetes and Heart
Institute, Professor Garry Jennings.
The comments come as part of an
article written by Jennings in MJA
Insight, where he argues the case
for and against pharmacy screening.
In the plus column, Jennings cited
a blood-pressure and cholesterol
campaign run in Portuguese
pharmacies, which found that
nearly half of all people who got
their blood pressure and
cholesterol checked in pharmacies
were at risk of having a fatal
cardiovascular event.
Other positives include the fact
that pharmacists are trusted by the
Australian public and their
presence is widespread.
“Pharmacists are trusted as a
reliable source of health
information,” Jennings wrote.
“They are trained in health and
disease, arguably underutilised and
capable of doing far more than
labelling medication boxes,” he
added.
On the flip side, Jennings said
blood pressure testing requires a
“quiet and familiar environment”,
and that public screening often
attracts the “worried well” who
may clog up the queue, slowing the
system from identifying those who
are actually at risk.
In addition Jennings said that
because pharmacy screening does
not offer an immediate solution for
those identified as at risk, and
instead refers them on to their
doctor, it may be virtually useless.
“Risk screening without risk
reduction can be worse than none
at all,” he wrote.
Finally Jennings said pharmacists
would need to also avoid
recommending remedies that have
no evidence base.
Despite the negatives, Jennings
did conclude that pharmacy testing
is worth a trial.
MEANWHILE the article has been
labelled as a “well balanced
assessment of the value of
pharmacies as places for well
person screening for hidden
chronic disease states” by
pharmacy consultant Rollo Manning.
A trial, according to Manning
“would be the opportunity to
leverage a change in the way
pharmacies are utilized by
government to deliver health
services through the establishment
of a PharmaCare Agency that is
accredited to provide such services
and receives a fee for doing it”.
Rollo goes further, arguing that
“the present process of granting an
Approval Number to every
pharmacy that was in business in
1990 with no follow up on
efficiency, effectiveness or intent to
improve health outcomes has made
a mockery of the ‘approval’
process”.
All pharmacies, according to
Rollo, should have to apply for an
‘Approval’ that would require
them to provide a certain range of
services for which they would be
paid an amount determined by an
independent agency such as
PharmaCare.
“The holder of the approved
Agency would be required to have
studied an additional range of
subjects and have obtained some
post graduate qualification in order
to safely carry out the new
responsibilities that are on offer
with a PharmaCare Approval,” he
said.
“The days of dispensing PBS as a
right must go and responsibility to
carry out health promoting
functions put in its place,” he
added.
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