6 February 2019

What pharmacists want from Canberra

News2 Pharmacy TheHill

Pharmacists are seeking federal funding to take on-site roles in aged-care facilities to reduce poor prescribing practices.

The measure tops the list of recommendations in the Pharmaceutical Society of Australia’s (PSA) pre-budget submission to the federal government.

The PSA emphasises ongoing concerns about excessive prescribing and the use of antipsychotic medicines for patients with behavioural and psychological symptoms of dementia in nursing homes.

It calls for $17 million in “seed funding” to embed pharmacists in residential aged care facilities “to improve the quality use of medicines and reduce harm caused by overuse of psychotropic medicines, opioids and antibiotics”.

“You need trained professionals there. You need nurses to care for residents, and you need pharmacists to help doctors and nurses make the right decisions around medicines,” PSA vice president Shane Jackson told The Medical Republic. 

The association says having a pharmacist in a nursing home would be more effective than the current approach of referring individual patients for medication reviews and would enhance communication with GPs.

The role would involve training and education of other health professionals and facility staff, clinical governance and support of accreditation standards.

The submission cited particular concerns from a 2017 national survey about the use of antibiotics in aged care facilities.

It found more  than half (55.2%) of antimicrobial prescriptions were for residents with no signs and/or symptoms of infection in the week before the start date,  27% of prescriptions had started more than six months before the survey date, and the indication for the medication was not noted in 23.7% of cases.

The PSA submission says non-dispensing pharmacists should be added to the list of allied health professionals who can deliver MBS services to patients with chronic diseases.

“At present, under MBS items 10950 – 10970, People with Chronic Conditions and Complex Care Needs, a GP may call on the specialist skills of an allied health professional through the CDM service to help them meet patient needs,” it says.

“Pharmacists are currently the only AHPRA registered allied health professional who?are not eligible to provide allied health services through the CDM services.”

Dr Jackson said allowing medications experts to use MBS CDM items would be “analogous” with the Workplace Incentive Program, designed to promote GP-led team-based care, which does include pharmacists.

The PSA also asks the government to fast-track work to extend pharmacy-based immunisation networks to all adult vaccines, and to establish funding for collaborative practice between Aboriginal Health Services and community pharmacies.

In its final key recommendation the PSA calls for the appointment of a Commonwealth chief pharmacist to improve coordination and responsiveness to medication issues in the health system.

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4 Comments on "What pharmacists want from Canberra"

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Dr Evan Ackermann
Dr Evan Ackermann
15 days 4 hours ago
Agree with Richard re Pharmacists an Aged Care Facilities The evidence is that RMMRs have no real clinical impact whatsoever. This is borne out in real life where we have had virtually mandatory RMMRs and the medication problems in aged care facilities persist I do not believe the extent of medication issue in aged care facilities are a result of GP care – but of a system that has not been responsive to complex needs of aged care patients. Included in that is the PBS. For every medication patients used – it has been dispensed by a pharmacists. The PSA… Read more »
Lou Lewis
Lou Lewis
14 days 23 hours ago
Evan, it is not often that I agree with pharmacists but for 90% of this article I am in agreemence with them , Having a pharmacist on site with make life easier for both the busy nursing staff and better for error reduction for the patients. If $17 million in funding will help this, then I am in favour of it, as $17 million is a drop in the ocean when it comes to medical funding. The only thing I am a bit pissed off about is , and I quote, “and to establish funding for collaborative practice between Aboriginal… Read more »
Dr Evan Ackermann
Dr Evan Ackermann
13 days 7 hours ago

do not mind that Pharmacists are imbedded in Nursing homes – but in a medication governance role replacing all the other current pharmacy services and not an addition to it.

With respect to chronic disease management – there are already heaps of PBS payments to pharmacists for chronic disease management. I do not see the sense in taking fees away from medical professions via the MBS is appropriate.If they want more – take funds from the PBS.

15 days 6 hours ago

As a GP with over 70 patients in RACF who stopped using medication reviews when I realised that a software program spat out the report and I could just as easily do this, I initially burred up over the thought of this input. However the important description here is ‘ non dispensing” pharmacists. These professionals, without any pressure from dispensing quotas could have a positive input.