• 14 Jul 2020
  • 09 min 55
  • 14 Jul 2020
  • 09 min 55

In this episode, Steve Morris speaks with Chris Freeman, National President of the Pharmaceutical Society of Australia (PSA) about how pharmacists have responded and adapted to the COVID-19 pandemic, navigated medicines access challenges and enabled continuity of care, and the importance of taking care of their own health and wellbeing.

Further reading

Coronavirus disease (COVID-19) information for pharmacists: www.psa.org.au/coronavirus/

NPS MedicineWise COVID-19 information hub: www.nps.org.au/coronavirus

Transcript

Voiceover:

Welcome to the NPS MedicineWise podcast, helping health professionals stay up to date with the latest news and evidence about medicine and medical tests.

Steve Morris:

Hi, I'm Steve Morris, CEO of NPS MedicineWise, and welcome to another podcast in our series related to COVID-19 issues. Today, I'm really pleased I'm joined by associate professor Chris Freeman, president of the PSA [Pharmaceutical Society of Australia]. Welcome, Chris.

Chris Freeman:

Thanks, Steve. Thanks for having me.

Steve Morris:

Yeah, thanks for joining. Look, pharmacists have been on the frontline of our health services, facing down COVID-19 pandemic. I'm really interested to explore your thoughts on challenges pharmacies are faced and how services have adapted and evolved over the last few months. In particular, just to get your understanding, what do you think have been some of the ways pharmacists and pharmacies have had to adapt during this period?

Chris Freeman:

Yeah. Thanks, Steve. Can I say, from the outset, I'm extremely proud of my colleagues in the pharmacy profession, both inside and outside of Community Pharmacy. They've really stepped up to the challenge of not just COVID, but the previous bushfires before that, and have maintained the continuity of service for many of the consumers using their pharmacies.

I think in terms of the way that they've adapted, one of the critical elements was the introduction of the telehealth consultations with GPs. And one of the flow-down effects was how prescriptions were then communicated to patients and then to, obviously, the pharmacies. And we had the advent of digital image prescriptions, which caused a lot of, I suppose, anxiety in the profession on how to manage that. And of course, each state and territory, based on their legislations, had implemented slightly differently. So, that was a real challenge for the profession, but I think we've gotten through the hump of that. And obviously, there's a move to electronic prescribing in the future.

I think there was some challenges for pharmacies around how they rostered their staff, so making sure, if they had a capacity, had split teams to ensure that if unfortunately one of them did contract COVID-19 virus, that they were still able to operate. Many of them changed their physical layout, so that we reduced the number of people, say, in the pharmacy space at any one given time, maintaining that physical distancing measures.

And then obviously implemented many new services. So, some pharmacies started some telehealth services of their own, but also took up the call to increasing things like home delivery services for medicines. And I think the pharmacy sector has done a fantastic job, as I said at the beginning, maintaining that continuity of service for consumers during the pandemic.

Steve Morris:

Yeah. Look, thanks Chris. You've rightly highlighted fantastic job pharmacists have done in stepping up to the challenge. But of all the challenges, I suppose, you refer to, what do you think has been the biggest single challenge? Are you able to just name the biggest challenge of all in this process?

Chris Freeman:

I probably can't give you just one, Steve, maybe a couple. I think, early on, some of the inconsistent messaging around PPE and access to PPE for pharmacy staff was a challenge, and we worked our way through that, although there was a continued shortage of PPE for a period of time.

I think one of the biggest challenges, and has been a challenge prior to the COVID-19 pandemic, but was emphasised during it, was the differences in state and territory legislations as it relates to medicines. So, when we had changes, say, to digital image prescribing, changes to restrictions on supply of medicines, we had to then navigate each state and territory differently as well as then also trying to coordinate it at a federal level. So, that was a huge challenge from a policy point of view. And then from an implementation on the ground point of view, making sure that pharmacists understood what their requirements both legally and professionally were to their patients based on where they were practicing.

I think, thirdly, one of the biggest challenges, and I think everyone appreciates, just was the shortages of medicines that were occurring. And I worked with everyday items, such as paracetamol and ibuprofen for children, but also some medicines that were heralded as a novel treatment or prevention for COVID-19 infections, such as hydroxychloroquine, where we saw a dramatic increase of prescriptions in a short period of time, which created access issues for people using those sorts of medicines for other medical conditions.

Steve Morris:

Chris, and often, positive things can come out of difficult situations. What do you think are the positive things that come out the pandemic period in terms of pharmacists' role that you'd hope will be sustained going forward?

Chris Freeman:

Yeah. So, there are silver linings, I think, to this situation. Not that there are many, but there are some. And I think the acceleration of moving towards electronic prescribing will be of benefit in the long run, so that consumers will be able to access their medicines through electronic prescriptions. Moving forward in that work has obviously accelerated during the COVID-19 pandemic.

I think the other positive things that have come out is it's exemplified the real positive work that Community Pharmacy has done in the community in providing central services, and I think that has come to the forefront as well, working with other health practitioners to make sure that there is that continuity of medicine supply and healthcare more broadly.

And I think other positive thing was acknowledgement that legislation at a state and tertiary level continues to be problematic, and we need to now focus on making sure that there is better harmonisation so that when there is acute health policy change occurring in response to a pandemic like COVID, that we can implement these things quickly and easily.

Steve Morris:

Yeah. The next question. Do you think the pandemic has changed pharmacists' relationship with other stakeholders in the health system?

Chris Freeman:

Yeah, Steve, I think it's actually forced the issue in many ways. So, we've heard anecdotes and stories of pharmacists working very closely with their local general practice or other allied health providers to make sure that there was continuity of care. So, for example, we had some general practices primarily using telehealth consults and so required the person to come into the Community Pharmacy to get routine checking done. For example, having their blood pressure measured, making sure that they had continuity of supply. So, I think it forced that collaborative environment.

And of course, many pharmacies provide vaccinations for people in primary care, and where we had many GPs who were using telehealth, that required collaboration with the local Community Pharmacies to make sure that there was a continued access to vaccinations at a really critical time where we didn't want to, not only a coronavirus pandemic, but an influenza pandemic at the same time.

Steve Morris:

Yeah. Maybe just to change tack a little bit. So, at the beginning, obviously pharmacists have been the frontline of COVID-19 and providing services. Do you have any insights in how pharmacists have looked after themselves, particularly their own health and their own mental health in dealing with the many issues that we'll be facing?

Chris Freeman:

Yeah, Steve, this was a really important issue, and one that I was quite anxious about even early on when the pandemic was really kicking off. Was making sure that there wasn't going to be profession-wide burnout within the pharmacy profession, given the stress and continued anxiety that the profession was under, coming out of significant bushfires and then into the pandemic. And we were regularly in contact with many pharmacists, making sure that they were taking breaks when they could, referring them to some of the support lines that we've got available to the profession, and sending general messages out to the broader profession to make sure that they're looking after their own health and not just the health of their patients. It's really critical and we're continuing with those messages because, even though we've seen a softening of the pandemic here in Australia compared to other places, that the continued stress and anxiety is still an issue. What don't want to see is, in the aftermath of the pandemic, profession-wide burnout amongst pharmacists.

Steve Morris:

Yeah. That's absolutely fundamentally important, Chris, as you say. And thanks for giving us a broad overview of what pharmacists will be able to do and support in the pandemic. Are there any final thoughts you'd like to leave with our listeners?

Chris Freeman:

Really just to, again, thank the pharmacy profession for really stepping up and working through the pandemic. We still got a way to go, and I'm sure that the profession will be called on once again to manage another situation as it arises, whatever that will be. So, I thank and honor the pharmacy profession for their incredible work through a really difficult time.

Steve Morris:

Yep. Thanks, Chris, and thanks for taking the time to be part of this podcast.

Chris Freeman:

Thanks, Steve.

Steve Morris:

And as always, just a reminder to our listeners, further information on COVID-19 quality use of medicines issues can be found at our website at nps.org.au. Thank you for listening.

Voiceover:

For more information about the safe and wise use of medicines visit the NPS MedicineWise website at nps.org.au.