Partnering with community pharmacy

In addition to the traditional dispensing and medicine advice roles, pharmacies can offer POC testing, management of initiation and titration of allopurinol under standing orders in partnership with a practice or practices.

There are well-established models through the Community Pharmacy Gout Management Service (for example Goutbusters at Te Whatu Ora Counties Manukau, as well as Northland, Whanganui, Porirua and Levin) where community pharmacists have undertaken the initiation and titration of allopurinol, as well as related POC testing, to support patients to reach treatment goals.

The Community Pharmacy Gout Management Service has developed a suite of templates for the service.

Standing orders example

Example standing orders from Community Pharmacy Group

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CPGMS Standing Order for Allopurinol Dose Escalation FINAL 28 Aug 2019.docx

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Pharmacists undertaking this role will need to be paid a fee, so you will need to find funding to resource the role, eg, Goutbusters pharmacists are paid a fee per patient through Te Whatu Ora Counties Manukau to manage initiation and titration of allopurinol (including POC testing) to treatment goal and follow-up.

Professional development for pharmacists using the Community Pharmacy Gout Management Service is provided independently, for a fee, by the Pharmaceutical Society of New Zealand and also the Midlands Pharmacy Group.

There are benefits in partnering with community pharmacies. Community pharmacies have longer opening hours meaning whānau Māori and Pacific peoples with gout have better access to POC testing, initiation, titration and dispensing services. Before deciding to enter into a partnership with your local community pharmacy, identify which pharmacies are used by the majority of your whānau Māori or Pacific peoples with gout and partner with those pharmacies, rather than pharmacies that may be close to or co-located with your practice.

You’ll also need to work out how to share patient records between the practice and the pharmacy. The Goutbusters team at Te Whatu Ora Counties Manukau has worked with the developers of the CPAMS database, that community pharmacists currently use to report warfarin dosage to primary care practices, to extend the database to include reporting of uric acid medicine titration.

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