I have come across few Medschecks completed in the community where I have felt slightly perplexed. Many Medscheck documentation would include a notification that a Medscheck has been completed but no issues have been identified but I could easily identify 3-4 potential issues just from glancing at the medication list. Some have not even included a personal medication record which, to my knowledge, is a requirement for the Medscheck Program.
I have worked as a retail pharmacist too. With all the interruptions and unexpected questions and problems, it is difficult to set aside time to conduct a comprehensive Medscheck. There may be corporate expectations to meet. But as a receiver end of this service, it is difficult to recognize the value of the Medscheck Program.
Here are some quick ways to share valuable information to primary care providers via Medscheck:
- Confirm the patient’s drug allergies. This may be an important area to explore. For patients with many documented allergies, ask them to describe their reactions. If the description does not fit the definition of a true allergy, it may be helpful to share with the prescriber so they can assess accordingly when a new treatment is required.
- Highlight the fact that you have reviewed each medication and its use / indication with the patient (and / or delegate). This is important to the prescriber that the patient has been explained (again) why he or she requires the medication(s).
- Highlight medications that may require dose adjustment in renal impairment. Although a community pharmacist may not have bloodwork results to estimate renal function, one can identify the top 3-4 medications that would require renal dosing to alert the prescribers. This may be helpful especially if the renal function continue to (or unexpectedly) deteriorate.
- Highlight the fact that the medication list has been verified for potential drug interactions. Again, this would be very helpful and reassuring to the prescribers. However if they need to be alerted to any clinically significant drug interactions , offer suggestions for management accordingly. Check here for a post on this topic.
- Identify drugs with potential to prolong QT interval and offer potential management strategies. This is an area where many prescribers may require support. Check out my post on this topic.
- Identify potential drugs to deprescribe. Again without having the full clinical picture, it may be difficult to assess if the patient can come off from the statin or taper off the proton pump inhibitor. But it never hurts to raise the question or “plant the seed” as my preceptor often would say.
- If your patient is on a opioid, calculate the MME so the prescriber may assess and determine if tapering is needed.
Pharmacists often feel left out that they are not part of the team in many health care reform initiatives. But we have not been able to consistently demonstrate our value in the forefront. While completing these Medschecks may be part of the corporate targets or deliverables, each Medscheck has the potential to increase the awareness of what a pharmacist can potentially offer and add value in patient care. Let’s capitalize on this opportunity wisely, instead of treating it as a paper shuffle exercise that is meaningless as well as not environmentally friendly.
Thank you for reading my post.