The Role of Clinical Pharmacists in Managing Patient Care
Written on
Introduction to Clinical Pharmacists
The recent involvement of clinical pharmacists in patient care, traditionally managed by doctors, raises important questions. Are they too quick to prescribe medication without considering all aspects of a patient's health?
The Phone Call: My Experience
I was filled with anticipation as I awaited a call from a clinical pharmacist regarding my elevated blood pressure. This was a novel experience for me, as it marked the first time a non-doctor was addressing such a health concern at my GP practice.
A quick online search revealed that this shift is gaining attention, with coverage from outlets like Sky News¹ and the British Medical Association². While this approach may decrease waiting times, I have reservations about its overall benefit to patients.
A Brief Background on My Health
Last summer, I discovered my late wife's blood pressure monitor and decided to check my own levels. Noticing a high reading, I went to a pharmacy for verification, which confirmed my suspicions. They assured me they would contact my GP, but I received no follow-up.
During a flu vaccination in late 2022, I brought up my readings with the pharmacist, who appeared unconcerned. In 2023, I presented my blood pressure data to my GP. However, like the pharmacist, they did not express any worry. I also shared my struggles with anxiety, but they could not offer assistance.
In early 2024, out of the blue, my GP practice began texting me for blood pressure readings. After disposing of my old monitor, I had a pharmacy check my levels and promptly sent the information to my GP. This time, they acted quickly, scheduling a phone appointment with their clinical pharmacist, prompting me to invest in a new home monitor.
The Telephone Consultation
During my appointment, I informed the clinical pharmacist about my autism and long-standing anxiety. However, their responses were limited. When I mentioned that my anxiety had intensified due to financial concerns, they replied dismissively, "Everyone has the same problem."
Initially relieved that my recent readings were nearing normal levels, I was surprised when they insisted that anything over 120/80 is considered high. I pointed out that the leaflet I received indicated a higher threshold of 140/90, to which they explained, "That’s in a clinical setting." The fact that my home measurements mirrored those taken at the pharmacy seemed irrelevant to them.
There was some confusion, as they believed I had sought out the pharmacy for my readings without realizing my GP had prompted me for it, despite assuring me that earlier readings were acceptable in 2023. They requested a series of readings over the next four days, and I was also instructed to undergo a blood test in preparation for potential medication.
Concerns About Medication
I am apprehensive about the clinical pharmacist's eagerness to prescribe medication. Is this truly the best path forward, or is it merely their standard approach? My preference is to tackle my 17 kg (37 lb) weight gain through diet and exercise, which should ideally bring my blood pressure back into a normal range. According to the Mayo Clinic³, losing about 1 mm Hg in blood pressure can occur for each kilogram lost.
Perhaps this situation serves as a necessary wake-up call, as I recognize that I have neglected my health. It's frustrating that discussions surrounding weight loss often lead to dismissive remarks about my appearance, which can be disheartening and demotivating. (I manage to hide it well beneath my clothing.)
My initial readings are invariably higher due to anxiety. For instance, taking three consecutive readings usually results in the last one being the lowest. Listening to music has also been beneficial in lowering these numbers. (I suspect I might be experiencing a case of "white coat syndrome"! 😆)
The pharmacist advised me to take two readings a few minutes apart and then average them. However, I now find myself anxious about the pressure to start medication, especially since I don't qualify for free prescriptions despite my limited income.
Conclusion: A Call for Holistic Care
I believe clinical pharmacists can significantly assist doctors by managing routine cases. However, considering my autism, anxiety, and unhealthy lifestyle, I feel a more comprehensive approach is necessary. It's crucial to address the underlying causes of health issues before resorting to prescriptions.
References
Pharmacies to be able to prescribe medication under plans to free up GP appointments (news.sky.com)
Employing clinical pharmacists in GP practices (bma.org.uk)
10 ways to control high blood pressure without medication (mayoclinic.org)