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Clinical Pharmacist

We have a qualified clinical pharmacist who can work closely with you, your doctor and any other health professionals involved in your care to help ensure that you are obtaining the maximum benefit from your medicines. We focus on providing quality education, information, reviewing and managing medications with best practice prescribing.

How We Can Help

Medication Review (MUR) will help you by...

  • Discussing how the medications are working for you

  • Checking your blood checks are up to date

  • Checking you are on the right medicines for your conditions and if you are tolerating them well

  • Checking for any changes in medications and discuss why these changes have occurred and discuss how they are working for you

  • Also helping with lifestyle changes to help manage your condition(s)

  • Answering all your medicines-related questions

Medicines Reconciliation is when the pharmacist...

  • provides the most accurate list of medications and updates this with your GP/Nurse

  • Compares your prescribed medications, records of allergies and adverse reactions, discusses this with you and updates your records.

  • Takes into account herbal medicines, complementary and alternatives medicines, any other medications bought over the counter and online.

  • Any discrepancies are documented in health records with the GP

Deprescribing – managing polypharmacy (when you are taking more ten (10) or more medications. Pharmacist:

  • Works proactively with your GP to identify and discontinue or reduce medicines where harms caused by the prescribed medicine outweighs its benefits.

  • You as a patient are involved in this decision-making process.

“A service that allows you to sit down with a pharmacist and talk about your medicines and make sure you are getting maximum benefit from them”.

“Together you can discuss any problems, questions or concerns you may have regarding your medicines and put together an action plan to address these”. (PSNZ)

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People are usually referred to the pharmacist by their GP, practice nurse or other health care professionals. When the referral is received, the Pharmacist will contact you directly to make an appointment for a phone or video consultation.  

Referrals can be made by a whānau member and you can make a self-referral. Just call Whanganui Regional Health Network on 06 348 0109.

For Clinicians

Medicines Reconciliation. (Note this involves a clinical review for appropriateness and is not just a technical task)

  • Reconcile medicines following hospital discharge.

  • Resolve any discrepancies, discussing changes with patients to clarify any misunderstandings, updating the records, provide medicines education and ensure an appropriate follow up plan is in place for monitoring including blood tests, adverse effects , clinical review, and dose titration.

  • Requires collaboration with General Practitioners, Community Pharmacists, and secondary care colleagues. May include inviting in for a consultation (or a home visit depending on the service provision)

  • Reconcile medicines following outpatient clinic visits- as above, includes updating the patient records, confirming the patients have understood the instructions, checking the outpatient clinic are aware of the patients’ current medications.

  • Reconcile medicines on transfer between care providers - as above, including new patients.

  • Ensure the patient management system medication records are updated, and any changes made are fully documented with reasons for stop, start or change of dose documented as well as usual documentation in the patients notes.

  • Update patients medicine allergies and adverse drug reactions to ensure safety with prescribing.


Clinical audits

▪ Undertake in-depth clinical audits to identify patients in whom pharmacotherapy can be improved including:

  • High risk medicine or combinations of medicines e.g. warfarin, Direct Acting Oral Anticoagulants (DOACs) dual antiplatelets, non-steroidal anti-inflammatory drugs (NSAIDs) Triple Whammy, disease modifying anti-rheumatic drugs (DMARDs), anti-epileptic drugs.

  • At risk populations e.g. frail and elderly, Māori and Pacific Island people

  • Targeted medical conditions e.g. diabetes, gout, COPD

  • Targeted indicators e.g. blood pressure, HbA1c, uric acid, creatinine clearance

  • Feedback this information in a useful, practical manner with further review of individuals as agreed so that recommendations are individualised and not merely guideline driven- this may result in clinic appointments with the clinical pharmacist or GP

  • Increase quality and safety of prescribing through mechanisms such as audit and Plan-Do-Study-Act (PDSA) cycles which contributes to continuous quality improvement.


Medicines Education and Information For Clinicians

  • Medicines information resource – readily accessible in clinic for day-to-day medicine related queries

  • Respond to requests for complex medicine information queries. This may include quantification of risk / benefit for an individual.

  • Providing up-dates on changes/ trends in medicines therapy – providing independent critical appraisal of the literature. This is especially useful in rapidly changing therapies.

  • Developing medicine information bulletins, that could be shared locally and/ or nationally.

  • Improve prescribing practice through educational support for prescribers within the practice.

  • Lead where changes in evidence require changes in prescribing across patient population e.g., where a drug is withdrawn, or indications or evidence changes.

  • Participation in peer group discussions or continuing professional development sessions.

  • Present on topical medicine related issues, significant events and issues that cross primary and secondary care

  • Present at conferences nationally and internationally, promoting the role of general practice based-Clinical Pharmacists


Quality use of medicines/ Quality improvement

▪ Work with primary care professionals and patients to implement evidence-based guidelines within local or NZ context

▪ Participant in inter-disciplinary teams

▪ Report on the result of audits and discuss actions arising from them

▪ Contribution to quality improvement of the practice

▪ Development and review of practice medicines related policies and standing orders

▪ Centre of Adverse Reaction Monitoring (CARM) reporting

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