New pharmacist role benefits patients

A demonstration project where pharmacists have taken on a greater role in managing patients on the traditional blood thinning drug Warfarin, has resulted in excellent outcomes for patients and high levels of satisfaction.

An independent evaluation of the project, which has been running in 15 community pharmacies across New Zealand, confirmed that management of Warfarin treatment by pharmacists is safe and convenient for patients with heart disease, and could save millions of dollars.

The evaluation by the University of Auckland recommends that the pharmacy model of Warfarin management should be rolled out to all eligible patients across the country.

Health Minister Tony Ryall said: ‘This model of care where pharmacists take the lead in managing Warfarin treatment alongside GPs shows real value with selected patients.

‘Over the next few months we will be considering the findings further and working with DHBs to look at the potential to extend the pharmacy model of Warfarin management.'

The project, overseen by Health Workforce New Zealand (HWNZ) in conjunction with the New Zealand Pharmaceutical Society, included pharmacists conducting finger prick blood tests in the pharmacy, advising patients on the management of their medication and modifying their dose if required, working in collaboration with the patient’s GP.

Participating pharmacists underwent specific training and assessment before taking on the extended role.

Anticoagulant control blood test results improved significantly for those patients selected to take part in the six-month project, meaning less likelihood of health problems such as stroke or bleeding. Patients reported that they were very satisfied with this new model of care which means fewer general practice and laboratory visits.

Pharmacists welcomed the opportunity to make better use of their skills, while GPs and practice nurses reported that the pharmacy management model saved valuable practice time – up to five hours per week.

Pharmaceutical Society President Elizabeth Plant said: ‘This project confirmed that pharmacists can take on a greater role in medicines management working within an integrated team. The pharmacist can spend time with the patient discussing their treatment at a time that’s convenient which helps with compliance as well as freeing up nurses and GPs to do what only they can do.’

Conducting Warfarin blood testing in pharmacies would save approximately $10m a year and the evaluation report concludes that if 50% of current Warfarin patients are moved to the pharmacy management model, savings could amount to $111m over five years.

Chair of HWNZ, Professor Des Gorman said: ‘The project demonstrated a model of integrated care with closer working relationships between health professionals that means better, sooner more convenient services for patients.

‘This project could pave the way for similar initiatives that better utilise community pharmacist skills, particularly in managing medicines in stable patients with long term health conditions.’