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Why more people are taking their health problems to the pharmacist

Instead of waiting in line to see a doctor, more of us are heading to the pharmacy, a move that could be a solution to the growing shortage of medical workers.

If you’re one of the 75,000 New Zealanders who had a flu shot at a pharmacy this year, you already know how convenient it is. If you’re busy – or just a bit disorganised – there’s a lot to be said for being able to pop into a chemist shop for a shot when you have a bit of spare time, rather than having to schlep to your doctor’s office, or remembering to turn up for a workplace flu vaccination.

As is the case after any vaccination, you won’t be able to leave immediately. You’ll have to stay in the pharmacy for another 20 minutes to make sure you don’t have a serious reaction, such as anaphylactic shock.

“The chances of that happening are about one in a million – though I have had about four significant faints where I had to make people comfortable afterwards,” says Ian McMichael, president of the Pharmaceutical Society, whose Hamilton pharmacy first started providing flu shots in a pilot programme in 2009.

In 2012, Medsafe reclassified the flu vaccine as a restricted, rather than a prescription medicine. That means it can be given by registered pharmacists who have completed an approved vaccinator training course. About a third of community pharmacies now offer flu vaccinations and the number of people having them is increasing. “The percentages are going up, from about 3% of all flu vaccinations a couple of years ago to about 10% this year,” says McMichael.

Pharmacist Ian McMichael. Photo/Supplied

Most people pay about $30 but, since 2017, flu vaccinations in pharmacies have been free for pregnant women and people aged 65 and older.

Pharmacies that offer flu shots must have a “vaccinating space” to carry out the procedure as well as somewhere for people to wait afterwards. In many cases, the space is very similar to a doctor’s consulting room, which is not surprising given that flu vaccinations are just one of a growing number of previously doctor-only services and medications now available at pharmacies.

Others include vaccinations for shingles, whooping cough and meningitis as well as medications such as the morning-after pill, selected oral contraceptives, antibiotics for cystitis and a drug to treat erectile dysfunction.

The most recent drug reclassified by Medsafe is Circadin, a melatonin tablet used to treat insomnia. Previously only available with a doctor’s prescription, it can now be prescribed for up to 13 weeks to people aged 55 and older by pharmacists who have completed an approved training course.

As well as the cost of the medication (which is not funded for that age group by Pharmac), you’ll also be charged a consultation fee to cover the cost of the assessment the pharmacist must carry out. This may help uncover underlying medical issues such as sleep apnoea.

Natalie Gauld. Photo/Supplied

McMichael describes the move towards pharmacists becoming increasingly more involved in primary health care as a paradigm shift for the profession. “It’s a huge leap forward and most pharmacists are loving it. For consumers, it provides greater accessibility – they can go after-hours or at the weekend, the location is often more convenient and they don’t have to have an appointment.”

It’s also a solution to the growing shortage of medical workers, particularly in rural localities. “In some areas you can wait up to six weeks to see a GP.”

In the case of vaccinations, the Pharmaceutical Society has set an ambitious goal. It wants all the vaccines used in New Zealand – including the MMR and HPV vaccines – to be available in community pharmacies by 2025, with pharmacists getting the same government funding for them as other health providers. “It would be the patient’s choice where they got their vaccination services from,” McMichael says.

Auckland pharmacist Natalie Gauld is a key advocate of many of the recent changes. She’s worked with several drug companies and pharmacy chains on the reclassification process – including the reclassification of Circadin. She says it’s part of an international trend that is helping to break down the stereotype of pharmacists as little more than pill-counters.

“Pharmacists have a lot of medical training and it’s nice for them to use their skills in the best way possible and contribute to the health of their community.”

This article was first published in the November 2, 2019 issue of the New Zealand Listener.