Professor Mary Horgan:

I shall pick up on the point made about pharmacists operating in a health care setting. In the States I was trained in the area of infectious diseases where the hospital pharmacist was absolutely essential. Not only did the hospital pharmacist save about $1.5 million a year in the infectious disease service of a large university hospital, they contributed to good outcomes for patients. Pharmacy and medical students are taught safe prescribing at undergraduate level but we should do more with hospital-based pharmacists at postgraduate level. Such instruction is given for antibiotic stewardship and cancer chemotherapy.

However, it must be expanded above that. It should be a team-based approach. That is how we should be educating our trainees. We recruit very smart people into undergraduate programmes in pharmacy and medicine. The two groups can work very well together and that should continue. I can speak for a hospital where most of our trainees, members and fellows are based. Dr. Mark Murphy and Dr. John O'Brien might wish to comment on that. More integrated education at postgraduate level is essential. I frequently ring the pharmacist to ask about adverse drug effects and interactions before I send patients out.

The other thing I find helpful is that I always look at the drugs the patients are on when they come into hospital because I do general medicine. A lot of the time they do not need to be on all of the drugs. This is about working with the pharmacist to go through everything, what the patient needs, what interacts with what and what we can stop.