‘It strikes me as a really powerful role.’

National Medicines Symposium 2021: Consumer advocate calls for more pharmacists in general practice, while pharmacy leader pushes for remunerated activities

Quality Use of Medicines (QUM) is about “less harm, less medication misadventure, increased consumer literacy and a reduction in unnecessary costs”, said Leanne Wells, Chief Executive Officer, Consumers Health Forum of Australia at the National Medicines Symposium 2021, hosted virtually on Tuesday 18 May.

The theme for NMS 2021 was ‘Evaluating quality use of medicines: How do we know if we’re making a difference?’

“Patient-centred models of care will advance QUM,” said Ms Wells.

“Non-prescribing pharmacists in general practice – that role strikes me as being a really powerful one,” she added.

“We’ve got the workforce, [pharmacists] can work with prescribers to use some of that localised data to look at prescribing patterns, medication reviews, and most importantly work with the GP to educate and better equip consumers – particularly those with many medications or who have English as a second language.

“There’s also pharmacists reaching into aged care facilities,” she said.

Use of medicines in these settings was brought to the fore after the Royal Commission into Aged Care Quality and Safety raised fundamental questions around the effectiveness of antipsychotic medications, stated Prof Michael Kidd, Deputy Chief Medical Officer, in his keynote presentation.

“People were given these medicines without their consent to control their behaviour, putting their health at very serious risk of harm,” he said.

“Considering non-medicinal options is fundamental to the quality use of medicines.

Restrictions have been placed on the drug risperidone. NPS MedicineWise has been funded to deliver programs to educate health professionals on the appropriate use of antipsychotics and other ways to manage the distressing features of dementia.”

Meanwhile PSA national president A/Prof Christopher Freeman said in his view, pharmacists could be doing more in aged care facilities by being in the facility more frequently.

They could also be working on QUM and medicines safety activities.

“One thing they could be more involved with is case conferencing, the ability to be involved with the resident’s GP, so everyone is driving in the same direction with the same set of goals, and the consumer is involved with that,” said A/Prof Freeman.

“Pharmacists should be remunerated for their participation in case conferencing, I think that would go a long way in a way that allows them to be involved.”

Prof Kidd said success in QUIM would include a reduction in medication misadventures.

However, he added, there is a long way to go to improve data collection for QUM and pursuit of indicators should be on the cards.

“At present we can only measure QUM funding and activity. Even if we know what medications were prescribed and administered, we usually don’t know the results unless there is a major incident. We don’t even know – if a medication review has been conducted – whether recommendations have bene adopted or why recommendations have not been enacted,” said Prof Kidd.

“How do we know what we’re doing is working as intended? Performance indicators are missing and they’re much needed across the spectrum of medicines use.”

A/Prof Freeman said it would “be great if we had an agreed set of goals or directions we could work towards so that a community pharmacist and the GP down the road, are all working in the same direction and we could track how we’re going” with QUM.

It is also important for both the GP and pharmacist to be supported through financial mechanisms to be able to achieve that outcome, he emphasised.

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1 Comment

  1. Kevin Hayward

    I have been working as a practice support pharmacist (non dispensing) in primary care GP surgeries for over 2 decades now, but it has been extremely difficult to fund in the Australian system. As an example we have been using item 735 to undertake multidisciplinary case conferences, only to be told by medicare that our dedicated chronic disease state management nurse was not eligible to participate in the team. Sometimes you feel that the system does not want pharmacists to enhance quality care, just dispense in a chemist shop.

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