I was recently very fortunate to have the opportunity to talk to a Medicines Information Pharmacist about their role. The Medicines Information (MI) department provides unbiased, evidence-based answers to queries about the safe and effective use of medicines. Enquiries include questions about the conversion of drug doses from oral to IV, the stability of medicines in patient compliance aids and drug interactions.
I discovered that, in addition to providing advice, an MI pharmacist is involved in updating prescribing protocols and therapeutic guidelines. The Scottish Government’s Polypharmacy Guidance, Realistic Prescribing 2018 policy aims to improve patient safety and inform decisions about multiple medicine use. It was produced through collaboration with many different healthcare professionals including MI pharmacists.
The Scottish Medicines Consortium is responsible for deciding about the efficacy and cost effectiveness of new medicines within NHS Scotland. MI pharmacists form an integral part of their committees to review scientific literature and inform decisions on whether new drugs will improve the quality of life and should be routinely prescribed.
As with many aspects of pharmacy, there are ethical issues which arise when resolving medicine related enquiries. For example, if an individual wanted to know what the tablets belonging to their partner were for, an MI pharmacist would have to ensure they did not breach patient confidentiality unless it was to prevent wider patient harm.
A hot topic at the moment is the prescribing of medicinal cannabis with new questions about its use in the UK. An MI pharmacist would be involved in providing advice to healthcare professionals. Cannabis has different chemical components and Cannabidiol (CBD) is freely available from community pharmacies and health food shops. However, as with other herbal remedies, the potential for interactions must be highlighted to patients.
Every day is different for an MI pharmacist which can make the role challenging but also interesting with unusual problems to solve such as the unlikely purple colour of a patient’s urine. The cause, a metabolite of mesalazine reacting with common bleach. Mesalazine, a medicine used in the treatment of inflammatory bowel disease has a metabolite (N- acetyl-5-aminosalicylic acid) which reacts with bleach and forms a violet colour leading to purple pee!
Clearly, the queries and questions encountered by an MI pharmacist are diverse and no two days are the same. It’s an exciting and rewarding role which is crucial to ensuring safe and appropriate use of medicines and the very best care for patients.
Marie-Anne Durham is a pharmacy student.