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Insight: Reasons to be cheerful

By Alexander Humphries*

I am refreshed and raring to go after the summer holidays. Apart from the next six months being hellish regarding the comings and goings of staff as they continue their personal journeys of maternity leave, promotion, leavers and new starters, there is plenty to be optimistic about.

For a start, we apparently have a Secretary of State who wants to invest in pharmacy – at least until his civil servants get their hooks into him. This is something we haven’t had in a very long time. I feel optimistic, as I always have been, that Government and NHS England are running out of time and options for getting a grip on the health service.

Sooner or later ministers will have to look again at community pharmacy, and as a solution rather than a problem. With the judicial review process having run its course, there is one less excuse for the anti-pharmacy lobby to not engage with us. PSNC even has “dates in the diary” to begin the next round of face-to-face negotiations with the Government – surely a positive, constructive development.

Convenient excuse

But there is nothing like the general public to dampen even the cheeriest of dispositions. A customer told me recently that a celebrity medic was coming to town, and perhaps I ought to go and listen to him because he is against “people taking loads of medicines”. I explained that as a pharmacist I am not a believer in taking medicines for everything, but that I respect medicines as tools, using the right one for the job, and only when needed.

As an ex-nurse, she said that she agreed, but insisted that I should go and listen to the medic pontificate anyway. At this point I had to say that while I did sympathise with the general message about over-prescribing, I was worried about what this sends out to patients who are either non-compliant or reluctantly compliant. It almost becomes a convenient excuse for people who don’t want to take their medicines.

While there are definitely plenty of cases where medicines can be stopped because the balance of risk is no longer in favour of using a particular treatment, the oft trotted out figure of 50 per cent of medicines not being taken as prescribed is not going to be helped by people who haven’t seen a patient in years, preaching from their soapboxes about the evils of medicines.

While it is important to have a rational conversation with patients about deprescribing, we need to be careful about the language that is used. When the old PCTs ran waste medicine campaigns, it was always the very people who we wanted to keep taking their tablets who would stop something like their anticonvulsant because they thought they were “saving the NHS money”.

Doctors and pharmacists making bland statements about over-prescribing may not be delivering the most helpful message in the world, because patients will often choose to overlay their own beliefs onto these generalised statements.

The originators of such statements do not know the specifics of the person reading the message, while the person reading the message may not be equipped to make a decision about the risk:benefit of their medication without seeking more appropriate, tailored advice from their regular, expert caregivers.

I would really caution colleagues to be careful about how they frame conversations around the deprescribing of medicines. The power of words in reinforcing beliefs to patients is amazing. If only this was used to give helpful messages like “don’t stop taking these” and “they may make you feel worse before you feel better”...

Unbeatable

So back to reasons to be cheerful. Vinyl record sales are up. In the age of the instantaneous digital download, this is big news. The techno-bandwagonists had been boldly predicting this particular medium going the way of the C90 cassette, but no, sales have shot up. As have sales of physical books, which were supposedly on the way out, to be replaced by e-books.

What has this got to do with pharmacy? Well, the same people boldly predict that online pharmacy is the way to go, yet the numbers who use this method to obtain their medicines are still insignificant compared to those who choose to walk through the doors of a bricks-and-mortar pharmacy every day.

You cannot beat the personal care and prompt service that you get in most community pharmacies. Keep the faith. Our sector has plenty to be cheerful about.

* Pen name of a practising community pharmacist. Alexander Humphries’ views are not necessarily those of Pharmacy Magazine. How cheerful do you feel about pharmacy? Email pm@1530.com

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