Pharmacy President Prescribes Rebuke To Dispensing Doctors, UK

Main Category: Pharmacy / Pharmacist
Also Included In: Primary Care / General Practice
Article Date: 11 Feb 2008 - 4:00 PDT

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Following comment from the Dispensing Doctors' Association (DDA), in response to the Department of Health's consultation on the Responsible Pharmacist, the Royal Pharmaceutical Society (RPSGB) believes the DDA is underestimating the importance of the pharmacists' role.

RPSGB President Hemant Patel said: "The Dispensing Doctors Association suggests that dispensing can be performed safely and efficiently without the intervention of a pharmacist. We believe the DDA equates dispensing with the physical act of selecting a medicine off the shelf, printing a label and attaching the label to the box. This vastly underestimates the role of the pharmacist in ensuring patient safety.

"Pharmacists provide pharmaceutical care which is the responsible provision of drug therapy for the purpose of achieving definite outcomes that improve a patient's quality of life. These outcomes are: Cure of disease, elimination or reduction of a patient's symptoms, arresting or slowing of disease process, or preventing a disease.

"Most General Practitioners readily value the advice of a pharmacist and will recognise the times when the pharmacist has prevented a potentially serious mistake.

"Prescribing errors are inevitable. As a society, we should be making every effort to prevent errors reaching patients and causing harm. Pharmacists play a vital part in detecting prescribing errors and preventing errors causing harm to patients. A system that misses out this separate professional check is inherently less safe.

"It is of grave concern that the Dispensing Doctors Association fails to recognise these in-built risks. The service that Dispensing Doctors provide in remote and rural areas is a necessary service to patients who are truly unable to access a pharmacy to have their prescription dispensed. This must be balanced against the increased risk to patient safety from the lack of a second professional check and should never be seen as a replacement for a full pharmacy service."

Notes

Pharmacists are among the most accessible health care professionals, with branches open in the high street at convenient times - often when GPs surgeries are closed. 99% of people can reach a pharmacy within 20 minutes and many pharmacies now also have consultation rooms, which offer a similar level of privacy as at a GPs surgery.

The published error rate on prescriptions varies between 1% and 11% of all prescriptions in general practice [Neville RG, Robertson F, Livingstone S, Crombie IK. A classification of prescription errors. J R Coll Gen Pract 1989; 39: 110-112. Shulman JI, Shulman S, Haines AP. The prevention of adverse drug reactions-a potential role for pharmacists in the primary care team? J R Coll Gen Pract 1981; 31: 429-434. Hawksworth GM, Corlett AJ, Wright DJ, Christyn H. Clinical pharmacy interventions by community pharmacists during the dispensing process. Br J Clin Pharmacol 1999; 47: 695-700].

The General Medical Council is so concerned about poor prescribing that it is funding research to ascertain the prevalence and causes of prescribing errors [BMJ 2007;334:278- 279 (10 February)]. Pharmacists check every prescription before it is dispensed to detect potential prescribing errors and contact the prescriber if they are concerned [S Gray, S Woolfrey, R Copeland et al Quality in Primary Care 2004;12:47- 51; ;12;29-32; N Barber, M Rawlins and B Dean Franklin Qual. Saf. Health Care 2003;12;29-32].

Royal Pharmaceutical Society of Great Britain