MedsCheck for pain to be trialed


Health Minister Greg Hunt has announced a $20 million trial program to help people suffering chronic pain, to be run through community pharmacies

The Guild and PSA have welcomed the move, which will see pharmacists assist patients who are taking medication to deal with chronic pain of three or more months.

In the Pain MedsCheck trial, pharmacists will evaluate a patient’s medicines, analgesic use and pain management program in a face-to-face consultation, to ensure it supports their clinical need.

They will then develop a written action plan which includes education, self management and referral to a doctor or other experts when additional support is warranted.

The Pharmacy Guild will manage the trial in partnership with the PSA.

“All community pharmacies will be able to participate in this service,” Mr Hunt said in announcing the trial.

“Community pharmacies participating in the trial will build relationships with GPs and other health professionals who support patients with chronic pain.”

Mr Hunt pointed out that one in five Australians live with chronic pain, rising to one in three for those aged 65 and over.

“Evidence shows that patients who actively engage in self-management techniques report lower levels of pain-related disability, as well as improvements in mood, better general health and a reduced use of medicines.

“We believe deeply in the role of community pharmacies and they play a key role in our world-class health system.

“This new trial will complement existing activities being undertaken ahead of changes to the availability of codeine that occurs on 1 February 2018.

“This is in addition to the Turnbull Government’s investment of over $1 million to ensure health practitioners and consumers are informed about changes to accessing codeine-containing medicines.”

Guild national president George Tambassis says the move is “great for patients, and a significant boost to the capacity of community pharmacies to make a contribution to the management of chronic pain”.

“It is particularly appropriate that this trial program is getting underway at a time when the management of pain is undergoing a significant transformation with low dose analgesics containing codeine becoming prescription only from 1 February,” he says.

“There is often a lack of access to appropriate advice and support on chronic pain in the community, and it is difficult for patients to access effective treatment that is timely and affordable.

“Community pharmacists see patients on a regular basis without the need for an appointment. As such, pharmacists are ideally placed to provide a patient-based solution to support patients who are suffering from chronic pain.”

The PSA also welcomed the trial.

“PSA applauds the Federal Health Minister for funding and supporting this new trial, which is strongly supported by Australia’s pharmacy profession.

“Pharmacists in the community are already available to provide advice on pain management and the safe and effective use of medicines. Pharmacists have also noted they are frequently concerned about patients whose pain is not being adequately controlled and who may be using medications inappropriately.”

Dr Jackson says PSA welcomes this opportunity for pharmacists to be funded to spend extra time with patients to review and discuss some of these concerns.

“Noting the issues that organisations such as Painaustralia have highlighted regarding the issue of chronic pain in Australia, this service gives community pharmacists the opportunity to improve pain management of patients with chronic pain,” Dr Jackson says.

“Community pharmacists advising patients on the safe and optimal use of medicines in managing their pain, or referring patients for a more detailed investigation by their GP we expect will result in better care for Australians.

“PSA looks forward to developing Standards and Guidelines for the Pain MedsCheck service for the profession, along with delivering education and resources to support the service.”

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11 Comments

  1. Bruce ANNABEL
    25/01/2018

    Now that’s a great idea. The taxpayer funded MedsCheck hopefully will be the catalyst to pharmacists involving themselves with patients suffering chronic pain and offer alternate medication and more holistic solutions.

  2. Shrek6
    20/04/2018

    Not only is this a huge waste of taxpayer funds, it is a very dangerous program. This is a knee jerk action done by the federal govt, because they have been criticised for doing nothing to aid chronic pain sufferers and they have also been criticised that CP sufferers will be badly affected by their terribly implemented anti Codeine/Opioid campaign.

    Pharmacists are not clinicians and know nothing about the care of chronic pain sufferers. This is adding another layer that will not only complicate things but will make it more dangerous to the consumer. The govt should have put this money into providing programs to aid CP sufferers, by way of getting them into multidisciplinary pain clinics much earlier where they can be taught to self manage their pain better.

    Using pharmacists is not only insulting and intrusive to the consumer, it will only cause much more isolation and stigma.

    Bad idea. Should be stopped immediately!

    • Jarrod McMaugh
      22/04/2018

      I agree that there should be more funding for multidisciplinary pain clinics (which include pharmacists in that team, by the way), as well as referral pathways & more infrastructure for both pain & addiction.

      You are incorrect about pharmacists though; they certainly are clinicians.

      I think there is a big misunderstanding about what a pain MedsCheck is…. Not helped by the fact that Greg Hunt described it as managing patients…. Which it very much is not.

      A MedsCheck is for education. Many people with chronic pain do not require this service – it isn’t compulsory or replacing any other service.

      Yet there are a good portion of people with chronic pain or with an opioid substance use disorders (or both since they aren’t mutually exclusive) who will benefit from a focused, private education session about their medication. This is what a pain MedsCheck is about. Who else delivers education to people in pain about their medication?

      • Shrek6
        22/04/2018

        You are obviously a pharmacist and/or are in the business and will receive funding from the govt. So you of course will promote this scheme and you won’t be completely honest about it either.

        And NO, Pharmacists are not clinicians and have little to no knowledge of chronic pain and how it should be managed. The current hysteria over the so-called opioid addiction crisis, has been overblown by including all people who take these drugs and labeling them all as drug addicts.

        Very many CP sufferers live a well balanced active life, whilst taking this medication in low too moderate doses, plus they never ask for increases. They can work and remain as active members of society, only to have doctors remove these drugs and give them nothing to replace them. These people then end up off work and cannot function. They become depressed and there will be some who commit suicide. These are issues the govt refuse to even consider or discuss publicly. Not only that, the media also won’t discuss the fact many people are now suffering badly from these govt decisions.

        Pharmacists are not medical clinicians and they should never be involved in anything medical other than looking after the medication people take. For you to try and say this is not true, is not only misleading, it will become a very dangerous thing for any sufferer who believes you and your colleagues, then ends up suffering badly from all the bad advice they will receive.

        And what you say is untrue. I have read the brief and the information given to Pharmacists, where they are given parameters within which to work. And it is not only about drugs. It is also about advising CP sufferers to use other services, whilst the pharmacists change their medication. All of this done by someone who is not qualified and without the direct involvement of the consumer’s own GP and specialist.

        All we are doing is creating another level of police, who are going to force people off of these drugs, whether they are addicted or not. And none of you will ever be able to know if they are addicted or not.

        This is dangerous territory. We need to be very careful that we don’t see this form of policing turn into human rights abuses, which I can see occurring on many occasions.

        Stop misleading people about this. There is already enough damage being done to consumers with the pressure put on GPs to stop prescribing these drugs, from the govt, the AMA and also their own insurance companies, forcing them to remove all types of Opioid medication from CP sufferers.

        This is a very bad scheme and will end up with many innocent people suffering at the hands of uneducated people who are not qualified or equipped to even discuss this subject with patients, let alone advise them.

        • Jarrod McMaugh
          22/04/2018

          I think you need to take a step back and look at how you are addressing this topic. At the very least, you are very much misinformed. At the worst, you are coming on to a pharmacist’s journal, making inflammatory comments about the profession (liars, unable to handle conflict of interest, not clinicians) with no justification.

          These things you are saying are wrong. As I said, you are misinformed. Clearly you are upset – you may well have a right to be, but this doesn’t give you the right to accuse an entire profession of misleading or lying to anyone.

          I am going to address each of your points directly.

          “You are obviously a pharmacist and/or are in the business and will receive funding from the govt. So you of course will promote this scheme and you won’t be completely honest about it either.”

          Yes, I am a pharmacist. You can also see a lot of the public comments I have made on the topic of chronic pain, and the very badly managed codeine scheduling if you like. My name is visible, and if you google it, you will find plenty of instances of me discussing this topic; about how it is poorly managed, that there has been little to no investment in pain treatment or referral pathways.

          “And NO, Pharmacists are not clinicians and have little to no knowledge of chronic pain and how it should be managed. The current hysteria over the so-called opioid addiction crisis, has been overblown by including all people who take these drugs and labeling them all as drug addicts.”

          You are completely wrong when you say that pharmacists are not clinicians. You can have your opinion, but you are factually incorrect when you say this. To suggest that pharmacists have no knowledge of chronic pain would be the same as me saying that people who suffer with chronic pain have no knowledge of chronic pain. Your second sentence in that paragraph I completely agree with. There has been a massive stigmatisation of people who have pain, people who have addiction/substance misuse disorder, and people who have both.

          “Very many CP sufferers live a well balanced active life, whilst taking this medication in low too moderate doses, plus they never ask for increases. They can work and remain as active members of society, only to have doctors remove these drugs and give them nothing to replace them. These people then end up off work and cannot function. They become depressed and there will be some who commit suicide. These are issues the govt refuse to even consider or discuss publicly. Not only that, the media also won’t discuss the fact many people are now suffering badly from these govt decisions.”

          I agree that many people with chronic pain have been very much capable (and continue to be capable) of managing their pain without any further intervention by health professionals. I would also agree that many people under-dose their pain, either due to bad advice, fear, or poor prescribing. The impact of poorly managed pain (acute and chronic) is a major cause of harm within Australian society. I don’t think anyone would reasonably debate this…. and yes I agree this is poorly understood by politicians and media.

          “Pharmacists are not medical clinicians and they should never be involved in anything medical other than looking after the medication people take. For you to try and say this is not true, is not only misleading, it will become a very dangerous thing for any sufferer who believes you and your colleagues, then ends up suffering badly from all the bad advice they will receive.”

          Pharmacists are clinically trained. To suggest they are not is either misinformed or wilful ignorance. To suggest that I am misleading people when saying this is not only incorrect, it is very ironic. Please educate yourself about the role and training of pharmacists before continuing to make these claims.

          “And what you say is untrue. I have read the brief and the information given to Pharmacists, where they are given parameters within which to work. And it is not only about drugs. It is also about advising CP sufferers to use other services, whilst the pharmacists change their medication. All of this done by someone who is not qualified and without the direct involvement of the consumer’s own GP and specialist.”

          I need to address this, because you are directly calling me a liar, then either lying yourself, or displaying a huge misunderstanding for the pain medscheck. I say this, because the information about the pain medscheck has not been published. I was at the launch of the program with Greg Hunt. I am part of the policy committee with the Pharmaceutical Society of Australia, and even I have not seen the “brief” as you put it for the program. You may have read some media releases on the topic, but you absolutely have not read the program outline or details.

          “All we are doing is creating another level of police, who are going to force people off of these drugs, whether they are addicted or not. And none of you will ever be able to know if they are addicted or not.”

          Pharmacists are not police. This is also not “another level” as it is a completely voluntary service that is offered to those who wish to access it. Any person who is experiencing chronic pain may wish to utilise the service, but there is no obligation to do so.

          “This is dangerous territory. We need to be very careful that we don’t see this form of policing turn into human rights abuses, which I can see occurring on many occasions.”

          At this point, you are being ridiculous and hysterical. Again, you are acting as if this is compulsory – as if every person will require a pain medscheck in order to have their pain assessed and their medications deemed appropriate before a pharmacist will allow you to take it. Nothing could be further from the truth.

          “Stop misleading people about this. There is already enough damage being done to consumers with the pressure put on GPs to stop prescribing these drugs, from the govt, the AMA and also their own insurance companies, forcing them to remove all types of Opioid medication from CP sufferers.”

          ‘Stop Misleading People’ is advice you need to take…. or at least stop misleading yourself. It really seems like you have read no further than headlines (tabloid ones at that) and jumped to conclusions that cannot be justified. Not only that, pain medschecks have nothing to do with altering any person’s medications. Medscheks already specialise in other areas like diabetes….. I have never heard a person worrying that they would suddenly have their insulin regimen change.

          “This is a very bad scheme and will end up with many innocent people suffering at the hands of uneducated people who are not qualified or equipped to even discuss this subject with patients, let alone advise them.”

          This last paragraph takes the cake. “Uneducated People” – you have zero understanding of what a pharmacist does, or their qualifications. There is no person who is more qualified to discuss medication with any person than a pharmacist. Yet again, the medscheck service is not about changing anyone’s treatments – it is about determining how well a person understands their treatments, identifying side effects, and giving advice on how to optimise treatment.

          Your posts show a high level of fear. Again, this may be justified, as getting control of chronic pain is difficult and frustrating. The fact that you are so passionate on the topic is laudable, but perhaps you should redirect this passion in to educating yourself on the topic about which you are getting so angry.

          I think everything you have said about pain is accurate, yet nothing you have said about pharmacists is accurate. This is as bad as if someone decided to go to a pain forum and say that everyone who experiences pain is just making it up and has no real insight into their treatments. It is neither true not helpful.

          Consumer feedback about medschecks and other services offered by pharmacists is very important and valuable… but this isn’t what is happening here. This is reactionary flailing in anger, and it’s neither constructive or valuable. If you want to get an accurate understanding of medschecks (for pain or otherwise), or the CLINICAL role that pharmacists perform, then please contact me – as I said I am easy to find, and my email is publicly available; as is my pharmacy if you are located in Melbourne.

          • Shrek6
            22/04/2018

            My posts were a reflection of what a very large number of consumers have
            said and what they believe. Being involved in forums around the internet and in this country has given me the opportunity to see what has been happening out there to these people.

            Much of what I have stated is not my belief, but that of people who have written the many stories I have read, including some who went on to commit suicide, because their doctors took away their medicine, contacted other GPs to ensure they could not get it anywhere else, and these people were only on low doses in the first place.

            You can come across as forthrightly as you wish and you can try and do what most left wing ideologues do when they wish to summarily dismiss someone who disagrees with them by saying that they are just angry, but you cannot deny
            certain facts.

            You are a pharmacist, you are not a GP or a specialist. if you were medically trained then we would all be wasting our time going to the doctors then coming to you for medication. Wouldn’t we?

            Sure you have some medical training so you know what the drugs are for, but don’t try and say that you know what a doctor knows, because that would be lying. And this is what you are implying. A bit disingenuous if you ask me.

            I’m not trying to rain on your parade or create an argument with you. I’m only trying to point out the dangers of a scheme that should not be in place when there is already a far better way of treating CP.

            No one, me either, is trying to say that pharmacists are not important or an integral part, but for the fed govt to spend this money on this scheme when they refuse to put it in multidisciplinary schemes, which will always be far better, is criminal.

            When I see so many people losing the lives they were having, just because GPs have taken away the medication they have been taking, then find out that pharmacists are now being added as yet another level to police the drug intake of CP sufferers, then one can only react with dismay. And yes you are being added as another level of control.

            If you had the eyes to see, you would see it from a consumer’s point of view, but unfortunately you do not!

            By the way, I am neither angry, lying or just out to cause trouble. If you lived on the other side of these idiotic schemes that only see the lives of many people destroyed, then you might also react with some degree using emotive language due to your level of frustration.

            For the sake of transparency. No, I will not reveal my name. I am a very long standing CP sufferer. And no, I have not suffered at the hands of a foolishly scared GP who has taken my medication off of me. I have a good GP who has taken the time to actually learn the law and know that he doesn’t have to be intimidated by these lunatics who are pushing this campaign against all people who use these drugs.

            Please don’t make the same mistake many people make. You also know nothing about me and it is far too easy for you to judge and make generalisations about who I am and that I’m just some angry little cave dwelling twat who is only here to give you trouble.

            The fact is, I am simply making statements that I have picked up from other people, plus some of my own. For you to summarily dismiss them, is very poor form on your part.

            And yes, I acknowledge that you have agreed with some very important points, but they do not address the mistrust that exists between pharmacies and consumers and the fact that you are NOT medically trained to the level where you can deal with the care of anyone suffering CP or any other disease or condition. If you were, then there would not be any such qualification called a General Practitioner!

            There are a very large number of complaints out there from CP sufferers who are treated like drug addicts when they go into a chemist to buy their medication. Having 16 year old girls give them the 3rd degree every week in front of all these other people in the shop, is the most insulting and degrading experience. Do you allow your staff to mistreat your customers like this?

            Maybe you should try it some day. You might learn a thing or two!

          • Jarrod McMaugh
            22/04/2018

            I am very aware of the feedback from people who experience chronic pain. This is why I support groups like Chronic Pain Australia – who represent consumers – rather than Pain Australia, who wants to tell people who experience chronic pain what is best for them.

            Your understanding of “clincial” is similar to a GP’s… In other words, only doctors do clinical work, and any other health professional is an unqualified technician. This isn’t correct. There are divisions between the roles of health professionals for a reason.. but if you think a GP is more qualified at their role than I am at mine, you are mistaken.

            I will again point out that the majority of your perceptions about pharmacists are very far from the mark. I am.more than happy to engage with you and help you get a better understanding, just as I am for any person with any health condition understand the role of pharmacists.

            But you need to address the way you communicate your concerns. Go to any group and insult them (intentionally or not) a d you should expect a response far less civil than what you have received.

            Again, I am very visible online. You can find my email address if you want me to send you reliable information rather than opinions or heresay…. And this doesn’t require you to make your name known.

          • Shrek6
            22/04/2018

            Again, I have not insulted you intentionally at all. I have only voiced the concerns of many others including myself that unqualified people will be used in the ‘clinical’ care of people who suffer chronic pain. And I have now gone to great lengths to point that out. Odd that you have not accepted this???

            And I also find it very odd that you say you are more qualified than a GP.

            Okay, so GPs are not qualified pain specialists, but neither are pharmacists. If you wish to say that you personally have studied and qualified in these disciplines, then well and good. But I have not attacked you personally or anyone else for that matter. I have only used generalised statements about Pharmacists with the emphasis on the ‘s’ at the end, where I disagree that they are qualified enough to be advising CP sufferers.

            Like I said, you too have judged me harshly and not tried to read into what I have said, thus your insulting attack. If I have offended you, then I apologise. It was not my intent. But I find it odd that you cannot read my frustration into what I have written, all you have done is ‘be’ offended.
            That is childish for goodness sake!

            Anyway, I’ll leave it at that. I don’t really need to speak to a pharmacist to help with my pain condition. I have people who are qualified to do that. It is good though that you are seeking to further qualify yourself above what pharmacists normally are and that you support organisations that support people who suffer. It’s a shame that most other pharmacists don’t have your attitude, because if they did, they wouldn’t be insulting their customers at the front counter.

          • Jarrod McMaugh
            22/04/2018

            You clearly have taken anything from this at all.

            You’ve continued to say Pharmacists arena lifted or clinical.

            You aren’t listening at all.

            Chronic pain requires a health care team. In that team, the patient is the most important participant. To assist them with education about their condition and medication, no health professional is more qualified than their pharmacists – this includes GPs and specialists.

            I have heard all you have said, and specifically acknowledged those points you make that are valid.

            I am not personally insulted by the way you have raised this, but I need to stress to you that the may you come to this particular forum and claim.ybat pharmacists are unqualified and not clinicians is insulting. As I said, this would be the same as going to any health Forum and saying that people with a lived experience of a condition have no insight or understanding of their condition. What audience would I then hope to maintain if I did such a thing?

          • Shrek6
            22/04/2018

            No it is you who are putting words in my mouth now. I have clearly (above) mentioned how important it is for pharmacists to be involved, but you are not GPs and you are not pain specialists. Your value is in medication, which I have already acknowledged.

            If you believe that pharmacists are much more qualified than pain specialists, then this discussion has now gone into the realm of idiotic or stupidity, because clearly pharmacists are not.

            If they were, there would be no specialists of any kind and we would all simply go visit the Chemist.

            Please get your facts right and stop accusing me of something I have not done!

          • Jarrod McMaugh
            22/04/2018

            You aren’t reading what I say.

            Pharmacists don’t replace any other person in the health care team – they educate people about their medication & condition. No other health professional is well placed to do this. How does this remove the need for your specialist or GP?

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