Pharmacists

[l_i_j]

Hi everyone.

I am a pharmacist undergraduate student, writing an essay on Crohn's disease and the pharmacist at the moment. It is due in on Friday (!) and I am a little short of ideas to write about.

Really what I need is how the pharmacist gets involved with Crohn's. There are a few areas I would really appreciate any feedback in:

If you have been on infliximab, what was the pharmacist's involvement in the treatment? What did they say to you? What did they do?

Did the pharmacist get involved at all in diagnosis?

What sort of advice have pharmacists given you? (in hospital or your community pharmacy).

What sort of services are you aware your pharmacy runs to help, or what do you think would be good for them to do?

Any other info relating to the pharmacist will be good.

Thanks for any info. You might just be helping me apply some patient experiences to the journal stuff I have researched.

 

[Jeff D.]

What country are you from?

In the US the pharmacist has done nothing but fill my prescriptions. I'm not 100% sure but I think in the US pharmacists do not diagnose and instead they fill prescriptions the doctors prescribe.

I don't think my pharmacy does very much in terms of services.

If you have other questions just ask.

 

[l_i_j]

I am in England. So things may well be slightly different here.

I don't think pharmacists really do all that much here, but they are supposed to be able to offer all sorts of advice I think.

Thanks

 

[soupdragon69]

There is a pharmacist that works as part of my gastro team and she is expanding her role.

She was involved in getting me set up on Azathioprine/Imuran during Spring 07. She had a crib sheet with all the major points she needed to cover on it. Basically went through all the main side effects, plan for dosage increase, blood tests required and how often and was to see me in clinic again to see how I was getting on.

The aim was to take some of the time away from the specialist nurses so they could focus more on support aspects and troubleshooting other problems for patients.

Also from the consultant perspective it freed up more time for him too by having her professional input on the above aspects.

In the end I only saw her the once as I deteriorated and ended up in hospital with further appointments with my Gastro cons. The principle itself was a good thing and I think she was enjoying doing it but dont know whether she continued or it was a trial only.

Also from the community perspective I have had some appalling times trying to get hold of my elemental drinks. Basically it comes down to the suppliers AAH who run the monopoly on most pharmacies like Tesco and Boots and they never ever have the flavours you request!! On one occasion I did 30miles (3 individual trips) just to get one script of elemental filled out. Emotionally it is draining having to fight your corner constantly. In the end I phoned the manufacturer and they said all AAH had to do was contact them and it would be supplied.

I also had another pharmacist at a different Tesco store tell me I should be grateful for what he gave me (erm 9 cartons and 11 sachets instead of 84 cartons and 60 sachets does not make me grateful when I need either 12 cartons a day or 6 sachets a day to survive without food and only hot or cold water to drink!).

Thankfully I finally found a superintendent pharmacist who is worth her weight in gold multiple times over. Even when there has been a problem with my elemental and I have gone over the whole thing yet again she sorted it! She keeps track of how I am too in relation to my crohns and other health issues (hypothyroid, brittle asthma, 5 skin diseases, inflammatory arthritis) and the meds I am on and how they interact. Some of which are infliximab, methotrexate, domperidone, mebevrine, tramadol, paracetamol, fenfexodine, inhalers etc etc.

A knowledgeable supportive pharmacist who communicates very well and has an interest in those she cares for makes a huge difference to those of us relying on polypharmacy. She has lightened my burden phenomenally and I know I can approach her about anything.

Recently I asked her about a laxative I could take to prevent severe constipation post barium follow through test. She went through the different types with me then said " to be honest I wouldnt be happy for you to have any of these, I suggest you try something more gentle like apple juice!" IT WORKED!

Hope this helps..

 

[My Butt Hurts]

My pharmacist had nothing to do with diagnosis, and will answer almost no questions unless it pertains directly to how to take my meds. They don't make judgements, just give the facts. My Humira was mail order, so the pharmacist had nothing to do with that. My Remicade is at the hospital, so that goes right from the hospital pharmacy to the nurse, and I have nothing to do with it. My pharmacist can answer questions about drug interactions, with other medications and breastfeeding and pregnancy. They seem to view taking drugs more cautiously than my doctors do. Usually if I have a question the answer is "ask your doctor".
I hope that helped you in some way. Good luck in your studies!

 

[l_i_j]

Thanks everyone.

I think what has just been said pretty much sums it up really. The sad thing is many pharmacists just don't so anything other than directly relating to dispensing meds. But a really good pharmacist will try their best to provide patient care however they can.

In regards to soupdragon: I think what you are describing is increasing in occurence. In many places pharmacists are getting more involved in clinics. After all, to be honest they will be just as good, if not better to discuss changes to therapy as well as the normal drug interactions etc.

Also to pen: if you have a good community pharmacist, then being able to talk to them any time, and for them to recognise you is of a huge advantage.

Like I said I think one of the main problems facing pharmacy really comes down to the individual. If a pharmacist is keen to show interest in patients, then the patients will get an infinitely superior service. If they are only interested in dispensing until it is time to go home, then the patients suffer because of it. Hardly seems fair.

Thanks again. It's really useful to get some experience from a few people.