Introduction by Croakey: The highly anticipated final report from the national scope of practice review, Unleashing the Potential of our Health Workforce, has been released, with the aim of supporting health professionals to work to their full scope of practice across the primary care sector.
Croakey will cover this development in more detail in coming days, but in the meantime the article below explores emerging roles for pharmacists, and one pharmacist’s journey to an expanded scope of practice.
Dr Shania Liu is former chair of the Advanced Pharmacy Australia (AdPha) Pain Management Leadership Committee and lead author on a recently updated standard of practice in pain management services.
Liu recently received the Early Career in Pharmaceutical Practice Recognition Award at the International Pharmaceutical Federation national conference, and is currently a Postdoctoral Research Fellow at the University of Alberta.
Her team’s research will be presented at the upcoming Medicines Management 2024 conference, in Adelaide from 14-16 November. Marie McInerney will report via @WePublicHealth from the conference, using the hashtag #MM2024AdPha, for the Croakey Conference News Service.
Shania Liu writes:
When I embarked upon my career as a pharmacist, most of my colleagues imagined our futures working in roles most often associated with our profession, such as in community pharmacies, hospitals, industry, policy, or government settings.
However, my experience over the past several years reveals how the role of pharmacists is expanding and transforming.
My clinical practice has mainly taken place in the hospital setting, working alongside a multidisciplinary team to support the safe and judicious use of medications.
In recent years, the scope of my work, however, has branched out to areas that I hadn’t previously been aware of.
Pharmacists’ roles in the provision of vaccinations serve as an example in which pharmacy practice has evolved significantly in recent years.
For example, during the height of the COVID-19 pandemic, I worked alongside fellow pharmacists, nurses, and medical colleagues to lead a COVID-19 vaccination clinic at a tertiary hospital in New South Wales, on some days administering over 300 vaccine doses.
This experience demonstrated the agility with which the pharmacy profession was able to manoeuvre to meet an urgent public health need.
Another area in which my role has expanded has been in advancing pharmacy practice research.
Informed by my clinical experience, my research has served as a way to answer questions to previously unknown gaps in clinical practice, and to improve patient outcomes by showing how we can avoid repeated trends in suboptimal practice.
For instance, during my practice working as a pharmacist on hospital orthopaedic wards, I frequently saw opioid analgesics prescribed and/or used in ways that could lead to more harm than benefit.
This led me to pursue a PhD in optimising pain management practices both before and after orthopaedic procedures.
Research path
My research role has afforded the opportunity to bring together an interdisciplinary team of nurses, physiotherapists, pharmacists, surgeons, and pain specialists, to provide collective expertise and input towards a common goal; answering questions on how to better deliver health care.
Since embarking on this research path, I’ve been lucky enough to be mentored by exceptional national and international pharmacy leaders including Dr Jonathan Penm, Professor Sid Patanwala, and Professor Ross Tsuyuki, who have not only inspired steep acceleration in my professional trajectory, but have also led by example in showing genuine and generous leadership.
Quality mentorship is something that can be hard to find in clinical roles across the health system, but is something that I’ve really valued, and as such, is something I am dedicated to offering to others.
Applied more broadly, I believe quality mentorship can support pharmacists to overcome common barriers faced in practice, to then create capacity for pharmacists’ roles to evolve further.
Finally, roles within professional associations can grant pharmacists an expanded network and opportunities to contribute to work that advances the profession.
In my experience, the quantity and quality of pharmacy practice research in Australia has grown significantly over the last few years, making it an exciting time to see our profession’s latest work during the upcoming Medicines Management 2024 Conference.
My team’s work on pharmacist-partnered opioid tapering before surgery will be presented at this conference.
Speaking with conference presenters and getting involved in Advanced Pharmacy Australia (AdPha) Specialty Practice Groups are also great ways to connect and work with like-minded colleagues.
For example, my role as the Chair of the AdPha Pain Management Leadership Committee provided a national platform from which to collaborate with other pharmacy leaders around Australia.
Some of the work my team led included a national Foundation Seminar on pain management in 2021, as well as a standard of practice to guide pain management for pharmacy services in Australia, which was published in February this year.
I have since continued this work through roles in international pharmacy and pain associations to lead acute pain guidelines internationally.
Emerging pharmacy roles
In clinical practice, opportunities for emerging pharmacy roles are being created by advances in technology.
For instance, the implementation of automated medication dispensing systems in hospitals over the last few years has served to alleviate pharmacists’ dispensing roles and create more capacity in the workforce.
One example of an emerging clinical role is virtual partnered pharmacist medication charting.
Virtual partnered pharmacist medication charting is a model of care in which pharmacists work closely with doctors who may be in a remote setting, to conduct a medication review and chart medications for hospital patients.
This may be a strategy to support timely and accurate medication charting on hospital admission, improve patient flow through hospital emergency departments, and reduce the duration of hospital stay.
Since completing my PhD, I have had the opportunity to undertake a postdoctoral fellowship in Alberta, Canada, where pharmacists practise in expanded research and clinical roles.
My postdoctoral work involves working alongside multidisciplinary clinicians (including pharmacists) and academics to lead large randomised controlled trials to evaluate new standards of care such as pharmacist-led cardiovascular risk reduction and medication safety in chronic disease management.
Clinically, pharmacists in Alberta and other provinces in Canada are trained and qualified to practise at a full scope, including (but not limited to) screening and prescribing to manage acute and chronic conditions, and the administration of vaccinations.
The changing public health landscape has led to significant expansion in pharmacy roles recent years.
As a highly trained and adaptable profession, there is room for the impact and influence of pharmacy to continue to grow beyond ‘traditional’ roles, to better address gaps in practice and improve outcomes for our patients.
To achieve this, more investment in and support for the profession is crucial, such as from policymakers and governing bodies.
My experience and the experiences of numerous pharmacy colleagues have shown that embracing the advancing pharmacy landscape has facilitated a transition into fulfilling roles.
I’ve personally found that a strong support network of mentors, like-minded colleagues, and support from my professional association has been key to overcoming challenges throughout this transition.
For anyone who is considering joining the profession today, I would offer words of encouragement to consider roles outside the ‘traditional pharmacy norms’ as our professional landscape continues to evolve. If you are interested in learning more or to work with me, please be in contact.
See Croakey’s article from June: Scope of practice review is setting a strong course for wide-ranging reforms
