Pictured from left to right: Prof Jane Lawrence, Prof Gino Martini, Prof Tony Moffat and Prof Parastou Donyai.
By RPS Chief Scientist, Professor Parastou Donyai
On the afternoon of Thursday 10 November 2022, alongside my colleagues, I hosted a packed Celebration of Science event at the London office of the Royal Pharmaceutical Society. Not only did we host our first face-to-face large event post-pandemic, we also got the chance to reflect on the past, the present and look to the future together as a community of scientists, researchers and pharmacists.
The last session of the afternoon allowed us to do this in conversation with a panel of all previous RPS Chief Scientists; Professor Tony Moffat, Emeritus Professor at UCL School of Pharmacy and RPS Chief Scientist (1994–2004); Professor Jayne Lawrence MBE, Head of Division of Pharmacy and Optometry at the University of Manchester, and RPS Chief Scientist (2007–2017); and Professor Gino Martini, Chief Executive of Precision Health Technologies Accelerator, and RPS Chief Scientist (2017–2021).
I wanted to know what each of my esteemed colleagues, in their tenure as Chief Scientist, considered to be the major scientific developments of the time.
Professor Moffat reminded us of the move from prescription only medicines to pharmacy medicines some 20-30 years back, including the availability of emergency hormonal contraception. These changes had a real impact on patients, he explained, as pharmacists were able to inform and help them to access medicines that were previously unavailable to them, or they had been too embarrassed to access otherwise. At the same time, diagnostics were progressing, and pharmacists were able to run clinics to help with diabetes, high blood pressure and smoking cessation. Pharmacists became ‘the scientists on the high street’, and this was seen as a real strength of the profession.
Professor Lawrence, among other things, worked to produce a substantial RPS document ‘New medicines, better medicines, better use of medicines’. A ground-breaking report, this guide to the science underpinning pharmaceutical practice demonstrated the breadth of scientific knowledge and understanding necessary to support the full spectrum of pharmaceutical practice. Professor Lawrence commented on the slow development of science on the one hand, and on the other, talked about exciting growth in certain areas with huge potential for things such as liposomes and lipid nano particles which would pave the way for new formulations and vaccine preparation.
Professor Martini’s tenure was dominated by the COVID-19 pandemic. This period saw pharmacies remain open while GP surgeries were closed. Pharmacists remained accessible to the public and needed accurate information, access to medication and vaccines to help their communities during uncertain times. What stood out for me was the link between all these reflections – pharmacists, it seemed to me, have remained the scientists on the high street, with the public recognising their vast training and expertise, underpinned by their scientific education.
What did the panel members think might happen to the balance of science in pharmacy courses which now have to accommodate additional independent prescriber teaching?
Professor Moffat maintained that pharmacists had always been prescribers, in the wider sense of the word. The Department of Health did initially restrict pharmacists to supplementary prescribing, but Professor Moffat was pleased that undergraduates are now going to be taught prescribing skills right at the start of their careers. With pharmacogenomic testing being introduced, it seems only a matter of time before community pharmacists are conducting these tests and prescribing for patients accordingly, he added.
Professor Lawrence noted some younger pharmacists don’t see the need to engage fully with science and do not embrace the scientist identity as part of their role. She emphasised the importance of keeping scientific knowledge strong in pharmacy – without this, we cannot fully help our patients. She argued that more pharmacists should be encouraged to undertake research at doctorate level, and that we all have a role to play in encouraging younger generations to engage in scientific research. She added this is specifically important in terms of formulation science, where pharmacists have unique knowledge.
Professor Martini added he has been able to create some funds to help encourage pharmacists to undertake PhD studies via the Stuart Adams Fellowship. There is also a need to highlight the value of pharmacists, Professor Martini explained, in the healthcare industry where high-profile roles can be undertaken by pharmacists.
Pharmacists and science
One way in which pharmacists can utilise their scientific education, of course, is to help accurately inform others about medicines. Professor Moffat recalled his opportunity to defend pharmacists’ sale of herbal remedies. He argued that pharmacists can predict drug interactions and warn patients when not to take herbal medicines that might otherwise cause harm if taken alongside existing medicines.
Professor Lawrence, during her tenure, had been invited to a House of Commons Select Committee examining the effectiveness of homeopathy. There was consensus among the panel that ideally pharmacists should not be selling homeopathic medicines as there is no scientific evidence to support their benefits.
Professor Martini recalled difficult decisions that had to be made around communicating on vaccines and medicines safety during the pandemic when evidence was scarce and misinformation rife. There was also consensus about the need for pharmacists to remain aware of psychoactive substances with potential for misuse, from nitrous oxide to OxyContin, with support for the testing of drugs at festivals expressed too. Reduction of harm in this way was seen as an important way of utilising pharmacists’ scientific expertise. The purchase of drugs using online sources was also seen as a concern.
What’s in the future?
Professor Lawrence sees huge potential in personalised medicine. Our increased understanding of diagnostics and enhanced science in this area means pharmacists should be able to conduct tests and recommend drugs tailored to each patient. And previously discarded drugs, that perhaps have been trialled in the wrong population, might be re-purposed; a developing area. Professor Martini also sees huge potential in diagnostics, capitalising on the populations’ increased understanding and familiarity with tests in informal settings. The future is about getting the right therapy to the right patient supported by diagnostics, he emphasised. Professor Moffat concurred. And he ended the discussions by reminding us of what we already know about how to progress our profession, reflecting the sentiment in the room: education, education, education.