The peak body representing Australian pharmacists is calling for funding to test an in-house pharmacist model to improve medication safety in residential aged care in its budget submission.
The program is among several solutions to address harm caused by medicine misuse the Pharmaceutical Society of Australia is recommending April’s 2019-20 Federal Budget provides for.
For aged care it is calling for $17 million in seed funding for a 12-month program to trial the integration of pharmacists in facilities to improve the quality use of medicines and particularly reduce harm caused by overuse of psychotropic medicines, opioids and antibiotics.
PSA vice president Dr Shane Jackson said the proposed program involved a half-time pharmacist per 100 aged care residents.
“The pharmacist will be embedded on site in aged care facilities so they can lead the medicines safety agenda,” Dr Jackson told Australian Ageing Agenda.
Medication management issues are the most frequent complaint in aged care so it is important that pharmacists lead this agenda otherwise the same issues will continue to occur, he said.
“Psychotropic use in aged care facilities has been a problem for 20 years. We continue to do the same things that we have done in the past and we get the same outcomes. So we must do something different,” Dr Jackson said.
Under the proposal, the aged care pharmacist’s role includes:
- education and training of facility staff
- leading clinical governance and resident-level activities around appropriate use of medicines
- supporting the facility to meet accreditation standards related to medication management.
The benefits include a reduction in the use of chemical restraints, fewer hospitalisations from adverse drug events, improved quality of life among residents and increased staff access to pharmacist expertise in medication management, PSA said in its submission.
Embedding pharmacists in facilities also enables greater collaboration between the multidisciplinary team members, PSA said with reference to research by the University of Canberra and Goodwin Aged Care Services from their 2017 pilot of an in-house pharmacist.
The initial program would test the methodology, the number of pharmacists needed and the types of activities that get the best outcomes, in order to inform a large scale implementation trial involving a couple of hundred facilities nationally, Dr Jackson said.
He said a component of the model used the methodology of the successful REDUSE program, which is a pharmacist-led intervention that brings all health professionals caring for an aged care resident together to reduce the use of psychotropic medications (read more about REDUSE here).
“That methodology around REDUSE, which centred around psychotropics, can be applied across all the medicines that a resident is taking or all the medicines that are being used in an aged care facility,” Dr Jackson said.
Support from early adopter
The proposal has the backing of ACT provider Goodwin Aged Care, which in December last year became the first residential aged care organisation to employ an in-house pharmacist across its three residential aged care facilities following the successful pilot (read more here).
Goodwin’s executive manager of residential care Robyn Boyd said the findings of the pilot showed having an on-site pharmacist within the facility provided significant benefits to both residents and employees.
She recommended the Federal Government act on getting more pharmacists into facilities.
“The provision of an onsite pharmacist at residential facilities must become the industry standard to ensure the quality use of medication,” Ms Boyd told AAA.
“This would facilitate end-to-end assessment of medication management and prevent sector issues such as polypharmacy and over-prescription.”
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