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Australian Journal of Pharmacy : April 2005
medication management in review Promotion of HMRs: the consultant pharmacist’s critical role Marketing professional services to consumers and health providers is something that most community pharmacists are not particularly accustomed to, but it is becoming increasingly important for the profession. PROFESSOR GREGORY PETERSON and DR SHANE JACKSON* argue that the consultant pharmacist’s role should not only be the competent performance of HMRs, but also extend to the promotion of medication reviews T HERE is relatively limited formal training in marketing within phar- macy, either for undergraduate students or in the formof postgraduate education for registered practitioners. Few phar- macists possess a full understanding of what marketing really is and many often perceive it as being an unethical activity. Marketing activity and market research within community pharmacy has tended to concentrate on pharmaceuticals and other health-related tangible products, with pricing being the dominant strategy in the marketing mix. More recently, however, the limited market research in pharmacy has consistently shown that customers want a knowledgeable, accessi- ble pharmacist who provides both advice and written information. There is now an understanding that the product that should be marketed is the pharmacist—a knowledgeable, accessible health professional who provides both advice and written information. This should become the focus of any market- ing campaign to enhance the profession’s image in the community. Marketing cognitive services Pharmacists, especially consultant phar- macists, need to actively promote the home medicines review (HMR) service and any other programs intended to improve the use of medications to help tackle the enormous unresolved issue of drug-related problems in society and to secure the future of the profession of pharmacy.1 Adverse outcomes associated with the use of pharmaceutical drugs in society represent a significant public health bur- den in Australia.2–4 ond National Report on Patient Safety3 For instance, the Sec- of the Australian Council for Safety and Quality in Health Care (‘Improving Med- ication Safety’) concluded the following: ‘Data show that between 2 and 3 per cent of hospital admissions are related to problems with medicines (approximately 140,000 per year). This is more than the combined number of admissions for asthma and heart failure. About one-half of these hospital admissions are consid- ered to be avoidable. Of the 100 million encounters recorded in general practice each year, it is estimated that around 400,000 of these are related to adverse medication events.’4 These dreadful statistics, along with the numerous (largely overseas to date) stud- ies demonstrating the benefits of phar- macist-conducted medication reviews, should form the foundation of any mar- keting programs to promote HMRs. The role of the consultant pharmacist Consultant pharmacists’ participation in the promotion of HMRs is vital to the con- 246 ? THE AUSTRALIAN JOURNAL OF PHARMACY VOL.86 APRIL 2005 tinued and future success of this program. By way of illustration, Shane Jackson was recently the recipient of a small grant from Asthma Australia that aimed to inte- grate the uptake of HMRs into the Asthma 3+ Plan. As a consultant phar- macist, he visited all three pharmacies and two medical practices in the local area of Sorell in southern Tasmania, and discussed with them the process of suc- cessful integration of HMRs into the Asthma 3+ Plan. The flowchart shown (Figure One) was used to explain to GPs and pharmacists the process of integrating HMRs into the Asthma 3+ Plan. The pharmacies used the Pharmacy Guild of Australia and National Asthma Council posters and referral pads to identify patients with asthma who would benefit from a HMR and Asthma 3+ Plan. The consultant pharmacist organised an education evening for the local GPs and community pharmacists, that included a background on asthma and what the con- sultant pharmacist would endeavour to cover as part of the HMR. After a two- month trial phase, three collaborative HMR/Asthma 3+ Plans have been con- ducted in the region. This has been a very modest result to date, but we believe that this is due more to difficulty in the organ- isation of the Asthma 3+ Plan (that is, get- ting patients to come back for three visits)