In a strategic move to bolster primary healthcare, community pharmacies in the Hong Kong Special Administrative Region are set to play a more integral role in looking after the public’s health, evolving from being mere medication dispensers to first-line advocates in disease management and health promotion.

The Hong Kong Jockey Club has decided to allocate HK$415 million ($53.14 million) for building a comprehensive community medication service network over the next five years to help eight community pharmacies across the city expand their services.

Besides dispensing medication, the pharmacies, run by nongovernmental organizations, will provide medication management guidance to patients and caregivers, offer advice on health and minor ailments, and promote health literacy on proper medication use, as well as managing chronic diseases.

The SAR government’s Primary Healthcare Blueprint, published in December 2022, sees an increasing role for community pharmacists in caring for patients. Pharmacists are expected to play a strengthened role in offering drug advice and counseling, smoking cessation programs, disease prevention services, and dispensing medicines to patients in public hospitals

The project also plans to set operational guidelines for community pharmacies and collaborate in training healthcare professionals with prestigious academic institutions like the University of Hong Kong and the Chinese University of Hong Kong. About 110,000 residents in need of medical care are expected to benefit from the services, and specialized training will be provided to more than 5,400 professionals.

At present, there are over 600 community pharmacies and 3,000 registered pharmacists in the SAR.

The program is in sync with the evolving role of local pharmacists who have been traditionally seen as playing second fiddle to doctors. But, in recent years, their expertise has been increasingly recognized, as shown by their involvement in prescription reviews and offering medication advice in hospitals. Some public hospitals have even allowed pharmacists to modify medication for certain patients directly and arrange medical examinations.

The SAR government’s Primary Healthcare Blueprint, published in December 2022, sees an increasing role for community pharmacists in caring for patients. Pharmacists are expected to play a strengthened role in offering drug advice and counseling, smoking cessation programs, disease prevention services, and dispensing medicines to patients in public hospitals.

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Leo Lo Kin-yip, a pharmacist at the St. James’ Settlement Community Pharmacy in North Point — one of the eight pharmacies to be subsidized under the project — admitted there has been confusion among patients in seeking drug therapy, particularly those with chronic diseases. Misunderstanding the application of their medication regimens or misusing them is not uncommon.

Leo Lo Kin-yip, a pharmacist at the St. James’ Settlement Community Pharmacy in North Point — one of the eight pharmacies to be subsidized under the project — admitted there has been confusion among patients in seeking drug therapy, particularly those with chronic diseases. Misunderstanding the application of their medication regimens or misusing them is not uncommon

He recalled an incident in which a resident with nasal allergies who had been over-relying on over-the-counter medicines, experienced worsening symptoms. After consulting with Lo, the patient modified his medication regimen, took nasal saline irrigation at home, and soon recovered.

Kwan Shuk-yi, a 60-year-old with diabetes, hypertension, and high cholesterol, said the time she had to spend collecting medicine at public hospitals was daunting, sometimes stretching up to two hours. The problem forced her to turn to local community pharmacies regularly.

She said pharmacists can provide her with good guidance, such as the best time for taking medicines, and advice on the potential side effects of drugs.

Broader impact

Ian Wong Chi-kei, a principal investigator with the Jockey Club Pharm+ Community Medication Service Network and head of the Department of Pharmacology and Pharmacy at the University of Hong Kong, said he hopes the eight subsidized pharmacies can set a benchmark for service quality that could be adopted by more than 600 community pharmacies in the city.

He said the standardized practice guidance can strengthen pharmacies’ performance in primary healthcare, offering residents, patients, the elderly, and caregivers access to more comprehensive services. By unlocking the potential of professional community pharmacists, the project will alleviate the public’s reliance on public hospitals, leading to more efficient utilization of medical resources.

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In addition, in-house pharmacists will provide referrals to other healthcare resources when needed. Wong compared pharmacists’ assessments to “traffic lights” by directing residents to appropriate healthcare resources. They would recommend those with severe symptoms to seek emergency services in hospitals, dispense medicine, and offer guidance to patients with milder conditions to enable them to monitor the symptoms themselves.

However, Wong said a gap remains in making residents more aware of the role of community pharmacies and the services they provide. Many residents still prefer hospital services to community-based options. He said the transition to using and trusting these new pharmacy services would take time.

Ian Wong Chi-kei, a principal investigator with the Jockey Club Pharm+ Community Medication Service Network and head of the Department of Pharmacology and Pharmacy at the University of Hong Kong, said a gap remains in making residents more aware of the role of community pharmacies and the services they provide. Many residents still prefer hospital services to community-based options

To increase public understanding of and confidence in community pharmacies, Wong said he will step up collaboration with the government, the Hong Kong General Chamber of Pharmacy, and other social organizations to increase public understanding in this field. He believes that the standardized community pharmacy practices will bolster public confidence in their services.

David Lam Tzit-yuen, who represents the medical sector in the Legislative Council, said community pharmacies can set a model for those in private practice in regulated pricing, prescribing, and other practices.

He predicted a growing demand for pharmacists, driven by an aging population and the prevalence of chronic diseases.

Lam pointed to the needs of elderly patients in residential care homes that are short of nurses and lack professional knowledge about medication management. He believes community pharmacies can offer medication guidance for the elderly.

However, he expressed concern that Hong Kong’s primary healthcare planning is still premature and lacks policy support. He urged the medical authorities to leverage its eHealth mobile application service to effectively integrate primary healthcare resources.

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The Primary Healthcare Blueprint pledged to build a community-based primary healthcare system and establish a Primary Care Department this year to integrate resources. The document outlined objectives to strengthen governance, pool resources, reinforce manpower, and improve data connectivity and health surveillance.

Wu Xinyu contributed to this story.