The Editorial Executive Committee welcomes letters, which should be less than 250 words. Before a decision to publish is made, letters which refer to a published article may be sent to the author for a response. Any letter may be sent to an expert for comment. When letters are published, they are usually accompanied in the same issue by their responses or comments. The Committee screens out discourteous, inaccurate or libellous statements. The letters are sub-edited before publication. Authors are required to declare any conflicts of interest. The Committee's decision on publication is final.
Letter to the Editor
Editor, – In her recent article (Aust Prescr 2010;33:191-3) Ms Rigby provides a timely, succinct analysis of the issues confronting the medical and pharmacy professions striving for better medication management in an era of increasingly complex health care. The necessity for a team approach in this environment is obvious. The challenge is defining relationships and boundaries for each of these health professionals and the patient. Trust is the touchstone upon which effective primary care operates. Any system promoting collaboration develops trust, not only with patients but between health professionals.
The Home Medicines Review system is challenged by administrative issues and poor reimbursement for quality reports. Current business rules restrict access. Where patients have no relationship with a pharmacy, the system breaks down, placing a barrier between general practitioner and accredited pharmacist. The referral process also takes no account of the skills and expertise of an accredited pharmacist (for example palliative care, geriatrics, de-prescribing, post-discharge and cultural issues).
In the face of an ageing population and overburdened hospitals discharging patients early, accredited pharmacists could develop expertise in areas where there are gaps in medication management. Allowing direct referral from general practitioners and giving consideration to co-location of pharmacists within a general practice will allow the growth and development of this role for pharmacists. Any system is only as good as the people who participate in it. Trust and collaboration can only be achieved through patience, time and understanding while, above all, maintaining the interests of the patient.