14 May 2015

Community Pharmacy – Back to the Future

Filed under Mark Robinson

I tried to explain at the Clinical Pharmacy Congress that Pharmacy ethos needs to change. We need to start with the person and work from there. A pharmacist asked me what I meant – so I visited their pharmacy and showed them what I was saying. I must say that there are others that think like me – it is clear with the Dispensing Health and the self-care pharmacy initiatives that some community pharmacists are on the same track.

The first prescription that I picked up was for thyroxine so I asked the question – what is this? The answer was complete and accurate as you would expect.

So what is it for? And again a perfect answer. And what are the symptoms of being hypothyroid which was also followed by an impressive list of symptoms.

Fantastic, so just as I expected this pharmacist was red hot. But the next question was the one that caused consternation. What are you going to say to the lady when she comes for her prescription?

Err – an answer of ‘ask if she has had blood tests within the last year’ may have been right or even ‘do you know how to take your tablets’, but it did not really follow after listening to a whole list of symptoms.

When the lady came in, we started from a different point. The introduction was ‘my name is’ and followed by ‘I am your pharmacist today’. I liked the personal touch and the use of the word ‘your’. The next question was slightly more leading ‘how are you getting on – are you having and problems, like tiredness, feeling cold, or dry skin’.

At first she looked a little shocked, but then started talking about her skin. She always felt cold, but she knew it was part of her condition, but the dry skin was quite a problem. She used plenty of moisturiser, but her current problems were her lips and her feet. We chatted about options and what she had been using. So she bought a lip balm with sun protection included for the day and plain Vaseline for the night. I hope that we had persuaded her to use the hydrocortisone cream a lot less often.  And a foam cream containing urea to use on her feet. We approached the subject of bowel function, but she had a diet high in fibre and constipation wasn’t an issue. She was using lots of conditioner on her hair and felt that was OK. Finally she volunteered that she had a blood test about 6 months ago and it was OK.

She left the pharmacy feeling happy. Her last comment was that she had been collecting her prescription for 12 years and nobody had asked her these questions and shown such interest.

The pharmacist asked me if I knew.  Of course not – but most people have some issues that they are managing. He understands a little bit more about what it is like living with hypothyroidism, but everybody will be different and he won’t know until he asks. Strangely, you do find these things in a text book, but you only understand when you listen to people.

The connection with people is the heart of community pharmacy. In our drive to be experts in medicines and knowledgeable about disease we may have for forgotten about the person standing in front of us. This lady may have been on a medicine (thyroxine) and may have had a medical condition (hypothyroidism), but we must always start with the person, who just happens to have a thyroid problem which is treated by thyroxine. Through engaging with the person, we were able to help.

I believe that pharmacists used these skills in the past, but we may be overlooking them now. People don’t care what we know, until they know that we care. So it is time to go back to the future. More and more people need their pharmacist for help and support.