A few months ago, I saw Mrs. Tan for her uncontrolled diabetes. She was referred to my clinic by her doctor. When I reviewed her medical history and lab results, it showed that her condition had been long-standing with hint of complication. Mrs. Tan had been using five insulin injections religiously every day for years, yet she could not keep her blood sugar under control. She was losing faith in the medical treatment.

After spending some time talking with her and performing a few simple physical assessments, I recommended that her insulin therapy to be converted from five injections to two injections. Mrs. Tan looked at me in amazement and asked, “Are you sure?” A few months later, I was happy to congratulate Mrs. Tan for achieving a dramatic improvement in her blood sugar control, something which she once thought impossible. Although she thanked me for helping her, I really should be the one to thank her for making my job as a clinical pharmacist so rewarding.

Dr Joyce Lee seeing a patient.

The role of pharmacists is rapidly changing from the traditional pill dispenser to an integral member of a patient?s healthcare team. Although the evolvement has started decades ago mainly in the United States, the change is only beginning to happen in Asia with Singapore among the Asian pioneers.

Two years ago, I came from the US to join the NUS ‘pharmily’ and National Healthcare Group Polyclinics/Pharmacy with a dream to help advance the pharmacy profession and to set up clinical pharmacist services in Singapore. During my site visit for the job, I was impressed by the contributions of Singaporean pharmacists in the hospital settings. More improvement, however, was still needed in the primary care setting.

HDL-C Clinical Pharmacists. From left: Ms. Lim Mui Eng, Ms. Anna Liew, Ms. Evonne Lee, Ms. Ng Sock Mui, myself (Dr. Joyce Lee), and Ms. Esther Bek. Not in the picture: Ms. Ong Soo Im.

In October 2007, I piloted the first pharmacist-managed multi-disease clinic, also known as the?hypertension, diabetes and lipids clinic (HDL-C) in Singapore. The clinic targets the top chronic diseases in the country. It aims to work collaboratively with doctors, nurses, and other allied healthcare professionals as a team in the primary care setting to manage uncontrolled chronic conditions and to minimize complications and unnecessary hospital admissions. HDL-C was first piloted in Bukit Batok Polyclinic and the service has since expanded to Clementi and Choa Chu Kang polyclinics. I am grateful to the doctors at NHG Polyclinics, especially Dr. Sabrina Wong, Dr. Elaine Tan and Dr. Keith Tsou for supporting an idea that is new to Singapore and for giving me the guidance and resources to train primary care pharmacists and provide the HDL-C service.

This is still the beginning. Whether in the hospital setting or the primary care setting, the role of pharmacists continues to evolve. I believe Singapore will remain the trend setter in this field in Asia not only because Singapore has supportive public health managers but also because of its bright students, and high quality faculty at the NUS Department of Pharmacy who are uniquely qualified to educate pharmacists of the future. To prepare for the coming changes in pharmacy practice, the Department of Pharmacy at NUS has modernized its pharmacy curriculum, and the first post-graduate Doctor of Pharmacy (Pharm.D.) class was launched this year in order to cultivate pharmacists with a high level of clinical skills.

Mrs. Tan’s story is only one of many success stories that take place every day in Singapore due to the changing role of today’s pharmacists. With more pharmacists stepping out from their traditional place behind the pharmacy counter and applying their knowledge and skills to direct patient care, Singaporeans can look forward to a new important improvement in their healthcare service.

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If you’re interested, you may also read the articles by our other 2 faculty members from here:
By Adjunct Assoc Prof Chan Cheng Leng and
By Adjunct Assoc Prof Lam Pin Woon.

Credits to The Ministry of Health blog for the articles.

Feel free to discuss your own opinions about the posts!