Fighting the invisible problem of medicine harm

WINNER

PAULINE MCQUOID

Severe medicine-related harm is estimated to affect around 45,000 New Zealanders each year and kills more than double the number of people claimed by road accidents and suicide combined. And yet, no one is talking about it, says clinical pharmacist Pauline McQuoid.

Preventing what she calls the “invisible harm” caused by medicines motivated Ms McQuoid, alongside clinical pharmacist Carolyn Woolerton, to establish Bay of Plenty pharmacist support service Medwise in 2008.

The year before, Ms McQuoid had returned from overseas to a job at Tauranga Hospital and became concerned about seeing the same patients bouncing in and out of hospital.

“We’d made all these changes to improve their medication, and they’d come back in and none had been enacted. I kept thinking, ‘Why is this happening?’”

At the same time, international research was showing the care transition between hospital and home was error-prone – something Ms McQuoid says comes down to a combination of factors including IT systems, patient confusion and the way GPs receive and process information.

“I recognised a need for a safety net in that system, and so I proposed a care transition service where we could bridge the gap.”

Established in 2008, Medwise is a DHB-funded service that provides clinical pharmacy support to hospitals, GP clinics and community pharmacists in the Bay of Plenty.

“We go into hospitals, talk to doctors and see what changes to medications have been made, liaise with the community pharmacists to make sure the correct medicines are being dispensed, and liaise with the GP practice to make sure they updated their system,” Ms McQuoid says.

The final step is visiting patients in their homes to ensure they understand how to take their medications correctly, which Ms McQuoid describes as a “privilege”.

“A lot of patients say, ‘No one’s ever taken the time to go through and help me understand this before.’ I’m sure people have, but in their own space the patients are more comfortable and that redresses the power imbalance quite a lot.”

Ms McQuoid’s vision for clinical pharmacists and pharmacist prescribers is for them to become a recognised and integral part of the healthcare team, “not just a ‘nice to have’”.

“At the moment, a lot of what we do is invisible because a lot of medicine harm is completely under the radar.

“The thing that gets me out of bed is trying to prevent that harm.”

Judges' comments:

A wonderful list of innovative vision statements show Pauline’s true character and determination to take the sector beyond the dispensary. Inspired and in awe. Well done

FINALIST

FIONA CORBIN

A JOURNEY with cancer led palliative-care pharmacist Fiona Corbin to reassess the way she delivers care to patients.

A prescribing pharmacist and clinical advisory pharmacist at Hospice Whanganui and at Gonville Health General Practice, Ms Corbin says being on the other side of the healthcare system made her realise “what being a good health provider meant”.

“Prior to that experience of needing to take pills every day, meeting different people, getting to appointments and taking on a huge amount of technical information, I never appreciated the burden on people. It just highlighted that there is huge inequity in the health system, and that everyone’s individual needs are different.”

Since then, Ms Corbin says she has dropped her “one-size-fits-all approach and become much more patient-centred”.

A fierce advocate for equity, she has completed a postgraduate certificate in Māori health and immersed herself in learning te reo Māori.

“In Whanganui, we have a higher proportion of Māori, and so it’s a really awesome way of being able to engage with people and help them access better healthcare,” Ms Corbin says.

Judges' comments:

Whanganui community is very lucky to have such a dedicated, pharmacist specialist who is passionate about empowering her patients, colleagues and community