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Australian Journal of Pharmacy : February 2005
diabetes ESPITE increasing evidence that a case can be made to extend phar- macy’s role in the identification and refer- ral of people at-risk of diabetes, pharmacy may not yet have the capacity to deliver such new services across its national net- work of 5,000 community pharmacies. Early results from a multi-centre pro- ject investigating the capacity of commu- nity pharmacy to identify and refer peo- ple at risk of type 2 diabetes look very promising, says the Pharmacy Guild’s director of rural and professional services, Lance Emerson. He told the AJP the findings are consis- tent with overseas studies suggesting that pharmacy, potentially, has a stronger role to play in the early identification of people who may be at risk of developing diabetes. ‘The early identification process picked up a number of people with a positive diagnosis as well as a number of people with high blood glucose levels at risk of developing the disease,’ he said. ‘The pharmacist was also able to assist patients with medication and help with better control of blood-glucose monitoring. ‘The study, which was carried out in four states, tested two services. One is early detection and referral for diagnosis by a doctor and the other is medication assis- tance. The results are very encouraging, and I hope they may potentially be used to incorporate into a community health service that Government, health insurers and/or patients may be willing to pay for. ‘The Guild is constantly in discussion with the Department of Health on the implications of new data and research. We expect to take the results of this, and a number of other disease management and research projects, into the Fourth Agreement discussions.’ D Pharmacy is working with partners and building a case for extending its role in the primary care of people with diabetes. But does it have the capacity to deliver more professional services? KYMBERLY MARTIN investigates Pharmacy sweet on diabetes... But can it cope? undertakings in the Third Agreement is difficult for some pharmacists.’ The issues that need to be addressed urgently, Mr Emerson said, include: • Is business and workflow structures currently in place in community pharmacies conducive to delivery of cognitive services? But, Lance Emerson warned pharmacy must take into account the capacity of the profession to deliver these new services with the challenge to better deliver in the long term. For a start, he said, there are not enough pharmacists. ‘Accreditation for professional services such as Home Medicines Review (HMR) is declining and delivering the current • Is the average community pharmacy able to deliver HMR and professional services out of the pharmacy, given the current workflow and business management structures? • Does pharmacy need to change the way it operates—is there an increasing role for the dispensary assistant to free up pharmacist time? • Do we need to change the layout of the 96 ? THE AUSTRALIAN JOURNAL OF PHARMACY VOL.86 FEBRUARY 2005 pharmacy to include more face-to-face counselling space? • How can pharmacies deliver HMRs in a cost effective manner? • Can HMR be delivered from a pharmacy where only one pharmacist is employed? ‘These are some questions we really need to resolve, and for this reason the Guild has recently invested in a change management program to address them.’ Diabetes Australia and the National Diabetes Supply Scheme Diabetes Australia, too, is supporting a stronger role for pharmacy in diabetes programs. Mr Emerson said this follows the