Pharmacist role in

healthcare system

Experience as a community pharmacist in new

Zealand

Destari Pratiwi Clark Pg.Dip. Pharm., M Pharm.

In accordance to the Pharmacy Council New Zealand Guidelines,
the role of pharmacist are:
❖ Could work in a variety of settings (e.g. hospital pharmacy, community
pharmacy, primary health organizations, general practice, pharmaceutical
manufacturing, education, government).

❖ Supply scheduled medicines classified as ‘pharmacy-only’ and ‘restricted’.

❖ Can have additional training and accreditation to provide health-screening

activities, certain prescription medicines without a prescription, and
administering medicines, including injectables.

❖ Researching and evaluating information to provide evidence-based advice and

recommendations on medicine-related health issues.
Organisations
 Pharmacy Council of NZ : APC (Annual Practicing Certificate) &
Regulations. The primary role is to protect the health, safety and
wellbeing of the public by ensuring pharmacists are competent and fit to
practise

 Pharmacy Defense Association : a non-profit, pharmacist support

organisation. PDA is designed specifically to provide assistance to
pharmacists in the event of professional indemnity, public liability and
statutory liability claims.

 Pharmaceutical Management Agency (Pharmac) : NZ government

agency that decides which medicines and related product are funded in
New Zealand

 To continue …
➢ Pharmaceutical Society of New Zealand
 Enhance: The society’s professional development programme
approved by the Pharmacy Council of NZ, provides the mechanism for
pharmacists to demonstrate that they are maintaining an ongoing
competence to practice and enable them to meet their APC
requirement, in whatever area of pharmacy they work in.
 Structure of CPD: Group 1,2 & 3
 20 points of CPD every year (maximum of 10 pts of Group 1), plus 10
points Group 3 every 3 years

 College of Education and Training : to help achieving

professional excellence

 Practice: helping pharmacies deliver the best in pharmacy practice

and professional services
Become a registered Pharmacist

 Health Science (1 year)

 School of Pharmacy : Bachelor of Pharmacy (3 years)
 Internship (1 year): Hospital, Community pharmacy
 Overseas Pharmacists : depend on country of origin
 Trans-Tasman reciprocate agreement
What I did to be registered in NZ
 Submitted all grades from University in Indonesia + certificates and
references
 IELTs overall band 7.5 with Speaking & Listening scores minimum
of 8 out of 9 points (it’s not easy)
 The last 3 semester of Bachelor Degree programme at University of
Otago, in two compulsory subjects: Law & Ethics A,B,C and QUM
(Quality Use of Medicines) A,B,C
 Optionally: 8 weeks workshop + online learning & exams
 6 months part time internship in a community pharmacy
 Final exam (theory & role play) in Wellington (held twice a year by
PSNZ for the whole interns in NZ)
About Healthcare Services
 Pharmacists support and guide New Zealanders about healthcare choices through
thousands of consultations every day. They are the health professional who are
seen most often.

 Pharmacist can be seen for the following :

❖ Emergency Contraceptive Pill
❖ Erectile Dysfunction Treatment
❖ Medicines Use Review
❖ Quit Smoking
❖ Selected Oral Contraceptives
❖ Urinary Tract Infections
❖ Vaccinations
Community Pharmacist

 Hold valid APC (renew yearly)

 Has to be on premises at all time
 Most accessible health professional
 No appointment needed
 Free advise
 A rewarding profession
Consultation Room : provide privacy
Selective oral contraceptives
 In March 2017 the Medicines Classification Committee reclassified selected
oral contraceptives allowing supply by pharmacists who have successfully
completed the oral contraceptive training programme.
 Have to see GP every 3 year, full assessment every year, resupply every 3
months
 The reclassification enables accredited pharmacists to supply the following
selected oral contraceptives (SOCs) under strict criteria:
❖ Ethinylestradiol (35mcg or less) combined with Levonorgestrel or
Norethisterone (Combination Oral Contraceptives)
❖ Levonorgestrel, Norethisterone or Desogestrel alone (Progestogen Only/
Mini Pills)
Erectile Dysfunction Treatment
 Many men are able to be supplied treatment for erectile
dysfunction in a tablet form, via consultation with a pharmacist.
Most pharmacies now offer this service.
 The consultation process ensures there are no underlying health
conditions that might affect the safety of the treatment.
 This service is provided discreetly and confidentially by your
pharmacist.
 Sildenafil; Full assessment every year
Quit Smoking Programme
 Using nicotine replacement therapy (NRT) can double the chance of
staying smoke-free in the long-term. Pharmacist can help with
advice and therapies to help quit smoking including subsidised
nicotine patches, gum and lozenges.

 Step 1, 2 , 3 depends on how many cigarette they smoke per day

 Initial consultation + 2 repeats (minimum dispensing for 4 weeks )

 Consultation fee : varies amongst pharmacies (normally $5 to $10) ,

no charge at Dunedin City Pharmacy
Urinary Tract Infections

 Accredited pharmacists can supply an

antibiotic, Trimethoprim, without a
prescription but only under specific
circumstances and in limited quantities
3 day supply
 Refer
Hepatitis C
➢ Review Hepatitis C infection, and the consequences if left untreated
➢ Identify risk factors for infection and screening protocols in HCV patients in
New Zealand
➢ Describe the following for MAVIRET (Glecaprevir/pibrentasvir : a direct anti-
viral agents) :
➢ Recommended dosing regimen for different genotypes
➢ Safety profile and common adverse events
➢ Contraindications, warnings & precautions
➢ Use in pregnancy and breastfeeding
➢ Mechanism and management of drug-drug interactions
➢ Explain how and where to report any adverse events.
➢ Eligible patients: Maviret 8 weeks or 12 weeks supply
➢ No charge to patients, pharmacy get reimbursement from govt.
Working together with other health
professionals (GPs, Dentists, Nurses)

 Confirm Rx, advises, suggestions

 Medical history
 Dose/Medicines changes
 Good communication is the key
 Clinical knowledge
 Ready for solutions/alternatives
 Health One
 HealthOne (Shared Care Record View) is a secure record that
stores health information including GP records, prescribed
medications and test results

 Currently HealthOne is rolled out across the South Island, and our
user base covers General Practitioners, Nurses, Pharmacists,
Pharmacist Technicians, and Nurse Maude Clinicians. It also
includes clinicians from Laura Ferguson Trust and Insight who
provide a rehabilitation service for patients with traumatic brain
injury. Authorised hospital employees also have access to the
information held in HealthOne across these districts

 Great tool to check medical/dispensing history & prevent forgery

General Advices on daily basis
➢ Pain/fever
➢ Allergies
➢ Skin conditions
➢ Strains & sprains
➢ Eyes
➢ Thrush
➢ Medications/Interaction
➢ Pregnancy & Breastfeeding
➢ etc.
Selfcare Cards
Pharmacist Only Medicines
 Non-self selective (behind the counter)
 Has to be sold by pharmacist : ID
 Make sure it is appropriate to sell to the
customer (check other medications, medical
conditions, etc.)
 Record sales
NZ Formulary: A very good website for checking
medicine interactions
Medicine compliance
 VACCINATIONS
 Influenza vaccinations
 Pharmacies provide FREE influenza vaccinations for eligible
patients aged 13 and over. Eligible patients include people aged 65
and over, pregnant women and people with certain chronic
conditions (such as heart disease, diabetes, asthma, etc). Pharmacies
are also able to provide privately funded influenza vaccinations to
all adults over 13 years of age.
 The flu spreads easily. Ideally, people should be vaccinated before
the main influenza season in May to September.
 Infection with the influenza virus can lead to a stay in hospital for
any age group but particularly for the elderly or people with
ongoing medical condition.
Other vaccinations
Pharmacists are also able to provide privately funded vaccinations, including:
❖ Meningococcal (meningitis): Available to anyone 16 years of age or over.
❖ Diphtheria, tetanus and pertussis (whooping cough): Available to anyone 18
years of age or over or pregnant women.
❖ Cholera – This can be purchased as an oral liquid from your pharmacy.
❖ Zoster (shingles): Available to anyone 50 years of age or over.
❖ Measles, mumps, rubella (MMR): Available to anyone aged 16 years or over
(until 28 October 2020).

❖ Future: Gardasil, Covid 19

Opioid Substitution Treatment
 SAS (Specialist Addiction Services) / GP
 Methadone/Buprenorphine+Naloxone
 COP/TA
 Aim: to reduce the risk of drug-related harm, as much as
circumstances allow, for each person and for the
community, by minimising withdrawal symptoms,
reducing opioid drug craving and blocking the euphoric
effects of injected opioids.
NZ ePrescription Service

 Provides a secure messaging channel for prescribing and

dispensing systems to exchange prescription information
electronically. It enables a prescription to be generated by the
prescriber, transmitted to the NZePS health information exchange
broker, and downloaded electronically at a community pharmacy.

 The prescriber can note the reason for prescribing and make other
comments at the time of prescribing. This will be sent as part of
the prescription information passed electronically to the
pharmacy. Prescribers can request a notification when a patient’s
medication has not been dispensed, and pharmacists can send
dispensing comments back to the prescriber.
E-Rx
sample
Domba our pet/farm dog
Prescription medicines in NZ:
 Mostly fully funded
 Some have part charge
 A few are non-subsidised at all
 No charge for children under 14 year old for fully funded meds.
 Over 14 & adults: co-payment $5 / Rx for fully funded meds.
 Dentist/specialist Rx: $15 co-payment or $5 for Community
Services Card holder (for low income people)
 Free after 20 paid Rx every year (ends 31 Jan per year) for the
whole family including children under 18 yrs.
WellSouth : primary health organisation for Otago and Southland
which organise and support primary health care services (general practices)
for the district.

 The WellSouth Voucher programme targets Maori, Pacific and other high risk populations.
It is strictly for patients who are unable to pay, and without the voucher, would not visit
their GP/Practice Nurse or pharmacy.
 Vouchers are for people who have an immediate acute health need or risk which needs to
be addressed in general practice, but do not have the means to pay. The issuer must
consider solutions to the ongoing and long term health needs of the patient to ensure that
the voucher system is not relied on for ongoing health needs or for managing chronic
conditions – such as enrolment in care plus and/or other clinical programmes.
 Generally, patients are entitled to one voucher every six months.
 Patients will be issued with a GP Voucher to the value of $40 and Pharmacy Voucher to the
value of $20. Patients must cover any costs above this.
Resources
 Pharmacy Council New Zealand : www.pharmacycouncil.org.nz
 Pharmaceutical Society of New Zealand : www.psnz.org.nz
 The New Zealand Formulary : www.nzf.org.nz
 HealthOne: www.healthone.org.nz
 Pharmacy Defense Association : www.pda.org.nz
 Pharmac : www.pharmac.govt.nz
 WellSouth : www.wellsouth.nz
Young farmer in the making
Something never changed …… his love to animals ☺
Bye from Taieri Beach Farm

Ka kite ano