the future.

[Chunder]

In my county town a large supermarket chain is upgrading their store to include a pharmacy (100 hour no doubt); advertising this on posters in and outside the store they have the tag line "Just what the Doctor ordered". This could put into the minds of the public that pharmacy is (or should be) controlled by Doctors. On the bright side there is free parking, I can hand in my script before shopping and then collect after instead of paying £1 to park my car just to have the ability to use an independent pharmacy. Which one would you use?

[Ushio78]

Hi guys,
I have just had a vision of myself in the future: I was entering in one of those hypothetic remotely supervised pharmacies where a robot welcomed me with its "hello sir/madam" robo-speech and asked for my ticket in order to collect my medicines. Do you know what I did? I went straight away to the indipendent pharmacy next door, where I could ask the pharmacist that welcomed me with my name, because he remembred me from last time when I asked to have a quite talk with him and still had a general idea of my situation..
What I mean is that many people (now more than ever) ask to have a talk with the pharmacist because they want to be reassured or educated about their conditions, they want to have the kind of chat they can't/ do not want to have with their physician (yes, even that chats that do not meet the requirements for MURs!!).
These are just my 2 cents

Matt

[sparkybw]

Hi guys,
I have just had a vision of myself in the future: I was entering in one of those hypothetic remotely supervised pharmacies where a robot welcomed me with its "hello sir/madam" robo-speech and asked for my ticket in order to collect my medicines. Do you know what I did? I went straight away to the indipendent pharmacy next door, where I could ask the pharmacist that welcomed me with my name, because he remembred me from last time when I asked to have a quite talk with him and still had a general idea of my situation..
What I mean is that many people (now more than ever) ask to have a talk with the pharmacist because they want to be reassured or educated about their conditions, they want to have the kind of chat they can't/ do not want to have with their physician (yes, even that chats that do not meet the requirements for MURs!!).
These are just my 2 cents

Matt

I think that you must be one of the few that would prefer that. You only need to look at the banking sector to see how people prefer cash machines to having to go into a bank.

I've also read articles that say that people would prefer to talk to a computer about their symptoms rather than their doctor so that doesn't bode well for someone wanting a little chat about their tablets.

[Tony Schofield]

The computer that knows the individual, their family and their medication, that can compute the history and problems with co-morbidities, explaining in language appropriate to the individual is a while from being launched so don't be too pessimistic.

[Ushio78]

I think that you must be one of the few that would prefer that. You only need to look at the banking sector to see how people prefer cash machines to having to go into a bank.

I've also read articles that say that people would prefer to talk to a computer about their symptoms rather than their doctor so that doesn't bode well for someone wanting a little chat about their tablets.

Well, when it comes down to money everybody wants to keep his own affairs secrets
Jokes apart, you can't really compare the two sectors... You could compare the use of an ATM to the GSL medicines you can freely buy from the shelves in a shopping centre (Also a bank clerk is not the main person I would look for in case I wanted to discuss "private matters" , now tell me that you have never found yourself in the situation where a grandmother comes to your pharmacy to collect her pills, then asks you about her sore throat and suddenly starts talking about her daughter's disastrous marriage O_o ).
Regarding to that article about people's preference to talk to a computer I can just say that I REALLY hope it was referring to the fact that many people use the internet for the self-diagnosis of minor-ailments (an action that I would advise against btw) otherwise it would be an index of a great lack of confidence toward the medical profession (I ve also read somewhere that a doctor has an average of 8 minutes to share with each patient... not much).

Matt

[hibernia]

I think that you must be one of the few that would prefer that. You only need to look at the banking sector to see how people prefer cash machines to having to go into a bank.

Yes but there are still a lot of banks around because if you need anything more than your own cash from your own account you still have to talk to a real person.

Once I was on a course and they asked "do you have a favourite ATM machine, one you would pass other ATMs to get to?" Everybody said "no, of course not." The next question was "Do you have a favourite petrol station and have you driven past other petrol stations to fill up there?" Most of us admitted we did, although it must be said this was before the rise of supermarket filling stations.
The difference being that when we interact with people, even if it is just handing over the money for petrol we have filled ourselves, we form preferences, we make judgements we aren't even aware of. We take in how the staff look, what the atmosphere is and how they treat us. We aren't fooled by false smiles and American style 'have a nice day.'

When people are ill or vunerable that personal touch is even more important but I fear that, like many other things, we will only appreciate it when it is gone and once it is gone there is no hope of ever getting it back.

[sparkybw]

I haven't yet met the pharmacist that knows me, my family, and health history other than those with whom I work. In fact prior to starting my work in a pharmacy I'm not sure if I had ever spoken to one!

As for the other things mentioned virtually any computer can be programmed to calculate dosages, interactions etc. Have you ever heard of knowledge based systems? There's an interesting general medical article here: Artificial Intelligence in Medicine: An Introduction

And this is more geared towards pharmacy: Involvement in medical informatics may enab... [Ann Pharmacother. 1992] - PubMed - NCBI

Here is a system that aims to bring all a patient's drug history into one place. Allscripts - Medication Management Overview

I found an interesting forum discussion on this very subject. Can't a computer do their job??? [Archive] - Physics Forums


And another with specific reference to MURs The potential for intelligent decision support systems to improve the quality and consistency of medication reviews - Bindoff - 2011 - Journal of Clinical Pharmacy and Therapeutics - Wiley Online Library

The reality is that many people are now used to using their computers for all manners of interactions and it doesn't appear impossible that the next step is to use them for information regarding their medical problems.

As for having to visit a bank to do anything other than draw money it is a very long time since that was the case. Bank loans, mortgages, insurances etc can all be done from the comfort of your own home. It's no longer necessary to go to a specific place to obtain those services.

[Pharmanaut]

I haven't yet met the pharmacist that knows me, my family, and health history other than those with whom I work. In fact prior to starting my work in a pharmacy I'm not sure if I had ever spoken to one!

As for the other things mentioned virtually any computer can be programmed to calculate dosages, interactions etc. Have you ever heard of knowledge based systems? There's an interesting general medical article here: Artificial Intelligence in Medicine: An Introduction

And this is more geared towards pharmacy: Involvement in medical informatics may enab... [Ann Pharmacother. 1992] - PubMed - NCBI

Here is a system that aims to bring all a patient's drug history into one place. Allscripts - Medication Management Overview

I found an interesting forum discussion on this very subject. Can't a computer do their job??? [Archive] - Physics Forums


And another with specific reference to MURs The potential for intelligent decision support systems to improve the quality and consistency of medication reviews - Bindoff - 2011 - Journal of Clinical Pharmacy and Therapeutics - Wiley Online Library

The reality is that many people are now used to using their computers for all manners of interactions and it doesn't appear impossible that the next step is to use them for information regarding their medical problems.

As for having to visit a bank to do anything other than draw money it is a very long time since that was the case. Bank loans, mortgages, insurances etc can all be done from the comfort of your own home. It's no longer necessary to go to a specific place to obtain those services.

All sounds great for computers in the future.
Remember a few computer maxims... GIGO.
We are a long way from a few research projects, exciting as they are to the reality of it.
Don't forget we are still waiting for the NHS standard dosage syntax.
Until then look after your "neck top" computer and update it regularly.

[LeftArm]

What I mean is that many people (now more than ever) ask to have a talk with the pharmacist because they want to be reassured or educated about their conditions, they want to have the kind of chat they can't/ do not want to have with their physician (yes, even that chats that do not meet the requirements for MURs!!).

I think it's unlikely that computers will completely remove the need or preference for a personal consultation.
There are "many" who want this but they do not make up the bulk of patients that are seen. Most of these want to collect their medicines and get out without being quizzed about them. Automated systems are ideal for these people.
Talking of dreams I had a dream where I went into the dispensary of the future. It was like a warehouse with long rows of shelves disappearing into the dark cold distance. A circuitous series of conveyor belts and chutes delivering pre packed packets of tablets down to single point at the front. They enter the end of a small cage where a hunched man in a white coat peers at each packet putting them into brown paper bags while muttering to himself. On the outside of the cage is a sign that reads "Pharmacist at work, DO NOT DISTURB".
Of course it doesn't have to be like this.

[hibernia]

There are "many" who want this but they do not make up the bulk of patients that are seen. Most of these want to collect their medicines and get out without being quizzed about them. Automated systems are ideal for these people.

These people who don't have time to talk to a pharmacist then go home, go online and spend hours looking up their medicines and every possible side effect and post messages on forums seeking advice. Some forums, like this one, offer useful advice to patients and usually recommend talking to thier own pharmacist or GP, but many others are full of silly and often downright dangerous 'advice' from a variety of sources that range from well-meaning to clearly certifiable.
This is a particular problem for medicines to treat any kind of mental illness and I do feel pharmacists could do with a lot more training in how to handle these patients who are often desperate for advice but won't ask for it or can't cope with the standard type of patient consulation.