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The role of the pharmacist in integrated healthcare


12 Oct 2011

After my own pharmacist training, I worked in a community pharmacy, but found again and again that customers were coming to me with prescriptions to address the side effects they were experiencing from the medication they were on. It meant that they were often taking a great number of tablets a day and I felt there had to be a better way than this. Lots of people were coming into the shop and asking about complementary medicines, so I studied up on this approach as I felt it was the way forward. Whilst I appreciate that not all pharmacists would be comfortable taking an entirely complementary medicine route like myself, I am seeing more and more turning to integrated health to give their customers the choice of the best that both conventional and complementary medicine have to offer. For those wanting to know more about this increasingly popular approach, this article aims to provide some advice from some of those community pharmacists pioneering integrated health.

When to consider the alternatives
Raj increasingly finds himself offering complementary healthcare as an option for helping with hay fever, as he has seen many customers have success in this area when they have already tried conventional medication. Another popular arena for complementary medicines is that of sleeplessness, with many customers preferring the more natural route as they don’t want to suffer the potential side effects of conventional medication the next morning. Older people may also prefer to take complementary medicines for sleeplessness, as they are often already taking a wide range of prescription medications.

Raj believes that people often feel comfortable using complementary medicines, as they know that they can use them safely alongside other conventional medication (under the advice of their pharmacist or GP, of course). “Mothersto- be and mothers of young children are, understandably, particularly sensitive about what they are putting in their body or their children’s bodies – morning sickness treatments being an example of this,” he states. “With the relatively recent restrictions about antihistamines in congestion remedies for children under six years old, complementary therapies have a role to play in the treatment of coughs too.” He continues: “Athletes also have to be very careful about taking any conventional medication, for example cold remedies, as this may show up negatively on their drug testing.”

Neetesh Gandhi, of KC Pharmacy in Teddington, has observed a trend of customers increasingly coming to him for advice on emotional health. “This can only increase with the growing demands on people’s lives caused by the current economic climate and this is an area where complementary healthcare can provide a huge benefit,” he says. Indeed, complementary healthcare can be used in tandem with counselling or other conventional approaches to treat the sort of stresses and strains that a lot of people are experiencing.

The need for education
Both pharmacists are also in agreement about the need for more public education on complementary therapies. They believe that if information on this option was more readily available, it would be much better for the public. Whilst they were not taught about complementary medicine as part of their pharmacist training, both have taken the time to read up and educate themselves on this topic for the benefit of their customers who frequently ask about natural alternatives. Raj puts it simply that, “we are here to serve people and they want to know about it”.

Neetesh would like to see manufacturers of complementary medicines producing more educational leaflets, but understands the tight regulatory restrictions they are under. “There are, of course, restrictions on what you can and cannot say,” he says. “I believe the public needs to be well informed about all the options available to them, so I give them the information and they read up on it themselves. They can then make their own informed decisions about how their health is treated. It should be their choice. If they then decide to try complementary medicine, I am able to offer them advice on this.”

Key considerations in integrated health
Raj believes that the biggest barrier for the pharmacist is that, “you have spent four years training to think in a particular way and it’s hard to then get your head around the difficult concept of extreme dilution in homeopathy, for example, as it appears to go against everything you have learnt”. He continues: “in our pharmacy, we have private prescription books dating back to 1876 and it is interesting to see how much homeopathic medicine has been prescribed over the years. It has been around for a long time, so we shouldn’t dismiss it.”

Neetesh’s approach is about helping the person, using whichever approach is right for them, rather than selling a particular product. His advice to other pharmacists is that their role and responsibility should be first and foremost in line with their pharmacist training. “You need to know what you are allowed to recommend and stick to the guidelines about this. Whilst I have personally seen some amazing benefits with a number of complementary medicines, I will always be careful to offer choice to my customers and to explain about the licensing or status of a product.”

Raj’s advice for pharmacists looking to introduce an integrated health approach and offer complementary medicine as a choice alongside conventional medication is to start small and build up. He also suggests relying on your rep to give you say half a metre of the most popular complementary medicines and to get them to use their knowledge and expertise to help make it work for you. “I’m fairly confident that you will want a metre or more after a while,” he adds. Neetesh agrees that it is a long-term investment, but a worthwhile one, with 15-20 per cent of his OTC sales coming from complementary medicines.

The future
Neetesh sees the traditional pharmacy model changing, with increasing demand for a ‘one-stop-shop’. “It’s no longer just about medicines, be they conventional or complementary, it is also about offering treatment rooms for a range of therapies, such as nutrition, homeopathy, reflexology and acupuncture,” he explains. “We launched our Orange Tree Clinic in July this year in response to consumer demand. It is something I had envisaged over 13 years ago, but it has taken a while to accomplish”. He adds: “I can see the future being more and more about integrated health – a balance between conventional and complementary medicine. The community pharmacist is in the ideal position to play a key role in this development and offer a range of different options for their customers. I firmly believe that an integrated health approach gives people the best of both worlds.”

We have certainly found this also to be true at our pharmacy, where complementary practitioners and therapists meet clients face to face for consultations and treatments as well as advice about integrated health. This level of interaction with the public together with the broad in-depth advice means that customers feel satisfied with the service we provide and more in control of their healthcare.

Susanne Haar
Pharmacy manager,
Nelsons Homeopathic Pharmacy

References 1. Complementary medicines – UK – December 2009. Mintel. http://oxygen.mintel.com/sinatra/oxygen/new_ reports/&list=latest_items/display/id=394670


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