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Medicine advice put patients back on track

Clinical pharmacist Tess James is proof that tackling a few simple medicine issues can greatly improve a patient's quality of life.

She supports Taranaki Pinnacle practices and their patients to optimise medication use, reduce and prevent medication-related problems and adverse events, and improve health outcomes by providing medication therapy management.

A male patient in his 80s had difficulty breathing, prompting his daughter to request a home nebuliser, a device used to administer medication in the form of a mist inhaled into the lungs. 

"The patient met the criteria for cardiovascular disease, so a referral was made for me to see him at home," said Tess. 

"I spoke to him about this medication, and it turned out he did not know how to use his asthma inhaler, so I taught him how to use it properly." 

"He had also stopped one of his heart medications, a diuretic which helps remove fluid from the body." 

"One of the side-effects is having to urinate often, which was difficult for him to manage, so we discussed a strategy on when he should take it so he did not need to worry about going to the toilet." 

"The only outings he previously made were to the general practice.  Since I have seen him, he has started getting out and about with his wife again, which he had not done in the past three or four years."

His nurse later told Tess that it was the first time he had walked through the door in four years and not been breathless.

Tess joined Midlands Health Network at the end of June. She is part of the multi-disciplinary team (MDT) being integrated into primary care to help long term condition patients with a history of diabetes and cardiovascular disease. The team consists of dieticians, social workers and podiatrists.

The former hospital and community pharmacist is now based at Midlands Health Network's Taranaki office but also spends time in the practices. She has a half-day clinic once a month in each GP practice, including South Taranaki.

"Patients can see me during these clinics, or I can organise to do a home visit if they aren't able to come in," she said.

"Coming from a hospital background, the most useful thing has been seeing how general practice works, and the issues they face such as patients not turning up to appointments or clinicians not being able to access regular laboratory results." 

"Many patients only come in once every three to six months, so we do not have an up-to-date record of what's going on daily like we do in hospital." 

"I manage medicine queries from doctors and nurses, such as a patient having side effects to medication or fasting requirements before blood tests. I also receive referrals from GPs who have tried several options for changing medications and need a fresh set of eyes to review it." 

Patients can be referred to the clinical pharmacist electronically by a nurse or GP via the Best Practice programme under Clinical Pharmacist - Long Term Conditions. 

Prior to joining Midlands Health Network, Tess was part of the Middlemore Hospital clinical pharmacy team that won the supreme national pharmacy award for implementing a clinical pharmacy service into surgical pre-admission clinics in June 2014. You can read more about the award at

For more good news stories about multidisciplinary teams, visit

Photo: "I'm loving the role. It is a new opportunity and something I was interested in doing." - Tess James, clinical pharmacist (right).

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