Finding a purpose in community pharmacy

In this article, Mr Choo Yan Cheng (Class of ’15) shares with us his experience as an Intermediate and Long-Term Care (ILTC) pharmacist at Watson’s Personal Care Stores Pte Ltd.

Could you share with us about your background before becoming a community pharmacist?

I graduated in 2015 and completed my pre-registration training at Khoo Teck Puat Hospital.

While I was in KTPH, I was exposed to the myriad of roles a pharmacist can perform on top of the usual dispensing: Pharmacist-led Clinics, Home Outreach, Nursing Home Reviews. It was to say the least, awe-inspiring and at the same time, intimidating. While the pharmacists I observed were stellar at each of their jobs, I felt that there was a huge gap in skills and knowledge which needed to be bridged before I could aspire to perform a role like theirs. After I completed pre-registration training, I looked for opportunities where I could continue to contribute to patient care and found that calling answered in Watson’s Personal Care Stores Pte Ltd.

How has your experience as a community pharmacist been so far?

As a community pharmacist I faced a steep learning curve as I had to juggle various responsibilities such as inventory and business management to ensure availability and relevance of stocks to meet my customers’ needs, on top of my primary role in dispensing and customer service.

Being stationed in the heartlands of Toa Payoh, the elderly people form most of my customer base. I had to recommend drugs to them appropriately whilst evaluating their increased susceptibility to adverse side effects and current medications. As a point-of-care in the community, we also have a role in helping manage fall risk and driving health literacy. For example, I would educate elderly patients on safer drug alternatives if I see someone with unsteady gait making an inquiry for a drug with anticholinergic side effects like chlorpheniramine. Rehabilitative equipment like walking aids could also be recommended to help them get around more safely while allowing them to maintain independence. Through the time spent with the elderly folk, I also learned how to motivate them to take better care of themselves by seeking to understand their values before making recommendations. I believe this helped cement their impression of the community pharmacists’ role in being an accessible resource for health knowledge.

Recently, I have joined the ILTC portfolio and taken up a role as a Preceptor.

Could you describe more about being an ILTC pharmacist, how has it been so far, and what is the most meaningful part about your work?

I have found a second home in my company’s ILTC portfolio where I had the opportunity to audit a nursing home on medication management and perform drug therapy reviews for residents. I felt that the portfolio offered exposure beyond the typical dispensing at the shop floor. Being able to review medications from their case notes and using the opportunity to help a patient optimise their drugs was a stimulating process.

The ILTC sector extends beyond nursing homes and includes welfare homes and community care centres. I have had the chance to work with them on medication audits and Pharmaceutical Care Services (PCS), respectively.

In the PCS pre-pilot which started in late 2018, it felt like a step-up in the skills demanded from the nursing home as we had to interview residents of Community Care Centres and assess them on their adherence, on top of optimizing their drug regimens. It was a good training exercise in motivational interviewing and clinical skills.

Looking back, I feel that it was also a period of personal growth in terms of resilience and interpersonal skills as I had to work with other professionals as part of a team to oversee the care of the residents. I look forward to the pilot phase of PCS where I will be able to help patients in the same capacity again.

I find a great deal of meaning from my involvement with PCS as I think it could be a model for how healthcare in the future will look like – a world where the elderly are provided with services to help them age in the community with dignity.

What are your thoughts about this career path, given how the healthcare landscape is progressing?

The role of the community pharmacist is likely to grow and diversify as healthcare grows towards engaging the community and adopt preventive strategies such as emphasis on preventive health. In 2017, MOH shared its strategies, the 3 Beyonds: Beyond Healthcare to Health, Beyond Hospital to Community and Beyond Quality to Value. I see potential roles for the community pharmacist to play in each of these thrusts. In my experience with PCS, I am confident that our healthcare landscape is progressing in line with these goals.

As our educated population ages, I personally envision a future where we will shift away from the clichéd model of paternalistic prescribing to one where healthcare professionals will perform a more proactive role in empowering patients to reach their individual health goals. In this future, I certainly see areas where pharmacists can add value to helping patients understand how their medication regimes work and craft a care plan which is in line with a patient’s wishes.

As community pharmacists, we can certainly contribute to the healthcare needs of the nation via patient-centred care using our specialised knowledge and skills. As part of right-siting of care, by virtue of our location in the community, we can promote primary care, along with minor ailments and chronic disease management.

What advice do you have for students or alumni who may be considering becoming an ILTC or community pharmacist?

Make your every decision in patient care an embodiment of your personal values. If you feel uncertain in your choices, let your obligation to the patient’s safety and care be your compass.

#PassionPridePurpose

Article by Mr Choo Yan Cheng (Class of ’15) and Ms Chung Wing Lam (Class of ’09)