The Active Pack.
The paper by Taylor and Rocchi1 published today, functions both as a descriptive review of the use of mnemonics and algorithms to facilitate consultations in pharmacy and as a distillation of the authors’ accumulated experience in teaching the use of such tools. As they discuss, the intelligent and flexible use of these structured techniques may enable pharmacists to use their professional expertise in the most efficient way in a setting that can present considerable challenges.
I was particularly struck by the authors’ description of the creative use of the medicine pack during the consultation. Although their focus was primarily on consultations for minor ailments, a similar use of the pack may be applicable in a broader range of circumstances.
In much of Europe, pharmacy medicines, and newly reclassified medicines in particular, reside firmly behind the pharmacist counter. The consumer typically has no access to the pack until the moment of purchase. However the pharmacist is expected to check the consumer’s suitability before the medicine can be supplied and this may involve a consultation including a review of presenting symptoms, previous medical history and current medications. In the past, new reclassifications have often required complex supply paradigms involving, for example, extensive checklists. Often these have presented a considerable barrier to supply in a busy pharmacy.
One recent innovation in the UK (MHRA 2017)2 has been the use of the pack as the primary tool to facilitate a pharmacy consultation for newly available medicines. To function in this way the pack must be designed to replicate the flow of a typical pharmacy consultation and to give the pharmacist the means to assemble all the critical information to judge whether supply would be appropriate for the patient concerned. Sometimes termed an ‘Active Pack’, this concept has considerable practical advantages for the busy pharmacist since the pack is always available and may be all that is needed to support the consultation in all but the most complex presentations.
Taylor and Rocchi provide a timely reminder that pharmacy consultation is a learned art, central to the front line role of the pharmacist in modern healthcare. The consumer healthcare industry and regulators of consumer medicines must work with pharmacists to ensure that the supply of new medicines recognises the nature of this pivotal interaction. The tools supplied should ensure that pharmacists’ discussions with their customers are efficient rather than burdensome. The use of ‘Active Packs’ may be a step in the right direction, aiming to work with, rather than against, the grain of the typical pharmacy consultation.
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- Taylor J. The Art and Science of Counselling Patients on Minor Ailments/OTC Medicines. SelfCare 2018 9.3.3-22
- MHRA. 2017. ‘Medicines & Healthcare Products Regulatory Agency (MHRA). Reclassification stakeholder platform –Final report https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/651905/Final-Report-Stakeholder-Platform-reclassification_041017__003___002_.pdf‘, Accessed July 2018.