Role of Pharmacist

1
Role of Pharmacist

• Kay Roberts
• Lead Pharmacist

2
Qualifications

• Degree course -gt MPharm
• Pre-registration year
• Pre-registration examination
• Postgraduate diploma/degree
• Mandatory Continuous Professional Development

3
Pharmacists and Substance Misuse

• Prevention of Misuse of Prescription and OTC
  products
• Needle Exchange
• Health promotion advice/information
• Methadone and Subutex supply and supervised
  consumption

4
Issues that can cause problems

• Environment e.g. privacy/confidentiality
• Lack of information even in Shared Care schemes
• Misuse of Drugs Regulations
• Incomplete prescriptions
• Own handwriting exemptions
• Query doses
• Drug/drug Interactions
• Adverse drug reactions

5
Harm Reduction 1

• Dispensing of Controlled Drugs
• Monitoring prescriptions
• Concordance/compliance
• supervised consumption
• withholding doses
• Provision of advice
• Referral to other services
• Ongoing assessment

6
Dispensing/supply issues

• Interactions drug/drug alcohol CYP2D6
• Supervision Why? How? When?
• Intoxication drugs/alcohol
• Missed doses loss of tolerance
• Conflict - Methadone Needle Exchange
• Prevention of accidental overdose
• Methadone and oral health

7
Harm Reduction 2

• Needle Exchange
• Provision of advice - safe injecting/disposal
• referral to other services
• advocate for patient/client
• Responding to symptoms
• self-limiting conditions
• under/overdosing (Supplementary prescribing?)

8
Health Promotion

• Advice on oral health and hygiene
• Constipation
• Safe storage of medicines
• Vaccination programme Heps A B
• Passive or proactive?
• Avoiding overdose/ safe storage of medicines
• Naloxone supply alongside methadone with advice?

9
Other issues to consider

• Security staff and goods
• Communitys perceptions of drug misuse services
  from pharmacies
• Other customers perceptions of provision of
  services to drug misusers from pharmacies
• Personal and professional liability

10
Emerging Roles

• Pharmacists as supplementary prescribers (as
  part of agreed treatment plan)
• Non-CD medications (possible now)
• CD medications (SI 2005 No. 271)
• The Misuse of Drugs Regulations must be obeyed
• Pharmacists are experts on medicines use their
  expertise

11
Conclusion

• Community pharmacists are part of the treatment
  and care team
• Role greater than may appear
• Daily contact with clients - early assessment of
  changes
• Pharmacists have an ethical and legal
  responsibility to ensure patient safety
• Use them, they are your allies and fellow
  healthcare professionals!