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.