The separation of prescribing and dispensing of medicines is already well established in hospitals and polyclinics in Singapore.
Benefits from this system include rational drug use to ensure appropriate use of medicines at the right dosage, counter-checking for drug allergy, drug-drug interactions and contraindications (Tap pharmacist to explain side effects; Feb 1).
In this aspect, pharmacists can indeed serve as an important resource for team-based care, where we play a vital role in medication counselling, informing patients of potential side effects and its management.
Such collaboration will facilitate a more informed decision-making process for patients while allowing doctors to focus on diagnosis and treatment.
The approach can also be extended to informed consent required for certain procedures and therapies involving pre-and post-medications or specific advice on medication management, such as perioperative anticoagulation.
While exploring greater engagement with pharmacists, especially in the private setting, can help strengthen the process of providing pertinent medication-related information to patients, it is important for the Ministry of Health (MOH) to provide clear guidance on the extent of informed consent for low-risk medications or medical procedures if the modified Montgomery Test is to be applied.
A clear directive and stand from MOH will allow for a more calibrated approach to the informed consent process; balancing information overload and the creation of unnecessary anxiety in patients who may not be equipped to appreciate the risk versus benefits of treatment and what is clinically important for patients to know.
Irene Quay (Ms)
Pharmaceutical Society of Singapore