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Pharmacists allowed to prescribe drugs...opinions?


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Hey Guys,

 

Forum is seeming a bit dead, or just filled with anxiety, so I though I'd add some debate in here to pass the time. I live with a Pharmacy student, and will (hopefully) be starting in September in medicine, so we've had some interesting discussions about the pharmacists newly legislated abilities in prescribing drugs (in Alberta), from our different viewpoints. I'm curious what everyone here thinks about this new legislation... seeing as we should be in a group that should have some kind of strong opinion, one way or the other, on this issue.

 

Keep it friendly!

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I think it's not a bad idea provided the guidelines and limitations are explicitly laid out - I think there is definitely a high "slippery slope" potential.

There are a few examples I've heard - e.g. continuing an already ongoing prescription - which seem okay by me...

 

Yeah, that's all I've got at the moment. Exam studying is taking its toll :P Stupid bacteria...

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What about having the pharmacists decide on what drugs to prescribe? A friend of mine told me our province is supposedly moving in that direction. Doctors will write what's the issue/disease/problem, and the pharmacists will decide the drugs and dosage and everything else.

 

Now, from the point of view of reducing the overload on the doctors and increasing accessibility to health care, I don't know what the impact would be, but if pharmacists, who are, ater all, specialists of drugs (sounds weird to say that in English... specialists of medications??) would be allowed to prescribe certain drugs, renew certain prescriptions and decide on what drugs to use according to the diagnosis of the doctors, well, wouldn't that make for a better use of those people who are very well trained?

 

I think pharmacists are under-used (and this one definitely doesn't sound good in English!!!)

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Hmm, what Eve said is a good point. I'm guessing that since pharmacists are around them all the time, they may be more familiar with the different types of prescriptions for certain ailments. Plus, if this can in any way reduce the wait times to see specialists... bonus points!

 

Will there be specialized pharmacists for drugs involving certain aspects of the body (neuro diseases, skin conditions, etc)? Or will this apply to all graduating pharmacists? (I'm not familiar at all with how pharmacy school works)

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I definitely think that pharmacists are capable of providing sound prescriptions if given the symptoms (in some situations, not all) and that they should be allowed to do so. Although I'm biased, I work in a pharmacy and I love the pharmacist there!!! :) He already collaborates with a lot of doctors in the medical building where we are and I already see him in this role on a daily basis.

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What about having the pharmacists decide on what drugs to prescribe? A friend of mine told me our province is supposedly moving in that direction. Doctors will write what's the issue/disease/problem, and the pharmacists will decide the drugs and dosage and everything else.

 

Now, from the point of view of reducing the overload on the doctors and increasing accessibility to health care, I don't know what the impact would be, but if pharmacists, who are, ater all, specialists of drugs (sounds weird to say that in English... specialists of medications??) would be allowed to prescribe certain drugs, renew certain prescriptions and decide on what drugs to use according to the diagnosis of the doctors, well, wouldn't that make for a better use of those people who are very well trained?

 

I think pharmacists are under-used (and this one definitely doesn't sound good in English!!!)

 

I think this is both dangerous and less efficient than the current system. Pharmacists are underutilized as patient educators, and there is a definite utility for giving them some prescribing power, but actual decisions about treatment are based on a knowledge of both drugs AND the disease process AND the individual patient you're dealing with. Unless Quebec has instituted some incredibly difficult new curriculum for pharmacists, they only have one of the pieces to that puzzle. Giving them the information about the other two would create a lot more work for patients, physicians, or both. If you try to set it up so that physicians only handle diagnosis and pharmacists take that and decide on the treatment, invariably you will see more inappropriate prescriptions and adverse events, because not one person in the entire team has a complete understanding of what's going on. Pharmacists have exquisite knowledge of "Drug X is used to treat Disease Y", but it's not that simple...the question requiring a physician's training is "Disease Y, in a person with factors A, B, and F, is treated with Drug X, Lifestyle change W, and sometimes Drug Z".

 

That said, I do completely support the new guidelines for pharmacists with the appropriate limitations, especially emergency prescriptions or refills, because that is actually a more efficient use of everyone's time and training.

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I definitely think that pharmacists are capable of providing sound prescriptions if given the symptoms (in some situations, not all) and that they should be allowed to do so. Although I'm biased, I work in a pharmacy and I love the pharmacist there!!! :) He already collaborates with a lot of doctors in the medical building where we are and I already see him in this role on a daily basis.

 

 

I'm also a huge fan of intra and interprofessional communication and team care. Collaboration like that is awesome, and again, helps everyone out. Connected back to the idea of pharmacists having power to make prescription decisions, I think one area this might not be a bad idea is in choosing a specific drug from a class of drugs--like, which ACEI to use--once a treatment plan has been worked out between patient and provider--assuming everyone's communicating with each other.

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