The RESPECT trial of pharmaceutical care researchers wondered if a detailed medical history would help community pharmacists be more active in patient medication delivery, for example by suggesting alternative drugs.1 At my practice we have been providing clear reasons for the drug prescribed on our prescriptions for over 5 years now. The Clinical Indications2 process provides detailed GPs' clinical prescribing decisions for the unattached community pharmacist. For the pharmacist it makes the medicine use review easy to perform with the addition of allergies and adverse drug reactions on the attached prescription slip enhancing this process. Nevertheless, it has been rare for an alternative drug to be suggested as this still requires much more detailed knowledge of the patient.
As many older patients are on numerous drugs (an average of seven in the RESPECT study) and many have failing cognition, it can be even more important in team care to indicate the necessity for medication and be able to confidently reinforce its importance. One area of communication that has worked well has been the use of stop dates on older peoples' warfarin prescriptions, for example for DVT.
If you are not already using this process, I encourage you to get up to speed on modern medication delivery.
- © British Journal of General Practice, 2010.
