Pharmacists helping physicians
==============================

* Denise Bowes

The report by Catherine Lemière and colleagues1 raising concerns about Health Canada's approval of a new indication for Advair (a combination of fluticasone propionate and salmeterol) contains the following important sentence: “In a health care system that is already struggling with the increasing cost of medication, it is our responsibility to avoid prescribing expensive drugs without evidence of their superiority over the standard treatment.” If every physician hung that sentence on his or her wall and looked at it before pulling out a prescription pad, would prescribing behaviour necessarily change? 

I believe that doctors in practice should not be getting all or most of their information from drug manufacturers and their representatives. There is an opportunity for community pharmacists to take a much greater role in training groups of physicians about the appropriate use of new drugs and in discussing issues such as determining when old drugs should be “retired.” Most physicians have poor knowledge of the costs of the drugs they prescribe, and pharmacists could be a valuable resource for more information in this area as well. This enhanced role for community pharmacists has already been suggested in some models of primary care reform.2

**Denise Bowes** Family Physician (Retired) Athens, Ont.

## References

1.  1. Lemière C, Becker A, Boulet LP, Bowie D, Cartier A, Cockroft D, et al, for the Asthma Committee of the Canadian Thoracic Society. Should combination therapy with inhaled corticosteroids and long-acting β2-agoists be prescribed as initial maintenance treatment for asthma? [editoria] CMAJ 2002;167(9):1008-9.
    
    [FREE Full Text](http://www.cmaj.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiRlVMTCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiY21haiI7czo1OiJyZXNpZCI7czoxMDoiMTY3LzkvMTAwOCI7czo0OiJhdG9tIjtzOjIyOiIvY21hai8xNjgvMi8xNTEuMS5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=) 

2.  2. Rachlis M, Kushner C. *Strong medicine: how to save Canada's health care system*. Toronto: Harper Collins Canada; 1995.