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Letter to the editor

Editor, – The excellent article by Dr Glyn Brokensha, 'Strategies to assist patient compliance with lifestyle changes' (Aust Prescr 1998;21:92-4), reflected many of the practices and problems of pharmacists as well as doctors. At the University of Sydney, we teach communication courses to pharmacy students, and many of us carry this over into our continuing education teaching, all with the aim of optimising patient care. One of the things we do is teach the practice of asking open-ended questions of the patient with the aim of filling in information gaps. The answer to a favourite question in my practice, namely, `What else did the doctor tell you to do besides take this medication?', is usually very little if anything. This might be because the patient has forgotten. It is certainly very rare to see any kind of written treatment or lifestyle plan. Pharmacists also experience big problems when we uncover doubts about the doctor's 'clear and specific intention' via the prescription, based on our information gathering and the counselling advice we give to the patient. Often these doubts are based on information about the patient's treatment that may have been overlooked by the doctor and not asked by the patient.

It seems to me that society and/or the academic medical community expect superhuman feats of patient care from general practitioners, all to be accomplished in a limited time and also involving (essential) detailed and specific lifestyle prescription plans. However, there are many pharmacists who would like to help. Many pharmacists have installed computer databases in their pharmacies that are capable of providing lifestyle advice in addition to detailed drug information. The lifestyle advice and fact cards on a huge variety of different disease states are often supplied at no cost to the patient. Many of us are out here contributing to patient care and also eager to assist doctors who search us out to help their patients.

Ben Basger
Practitioner/Teacher in Pharmacy Practice
University of Sydney
Sydney, N.S.W.