‘Pharmacists must be supported.’

PM promises over $25 million to improve medication management programs in response to Aged Care Royal Commission’s Interim Report

The Federal Government will deliver a $537 million funding package to respond to the Aged Care Royal Commission’s Interim Report, Prime Minister Scott Morrison announced on Monday.

This package will include:

  • investing $496.3 million for an additional 10,000 home care packages;
  • providing $25.5 million to improve medication management programs to reduce the use of medication as a chemical restraint on aged care residents and at home, and new restrictions and education for prescribers on the use of medication as a chemical restraint;
  • delivering $10 million for additional dementia training and support for aged care workers and providers, including to reduce the use of chemical restraint; and
  • investing $4.7 million to help meet new targets to remove younger people with disabilities from residential aged care.

“The Royal Commission’s interim report is clear – as a country, the government, the aged care sector and the entire Australian community, we can and must do better in providing improved support for our older Australians,” said Mr Morrison in a joint response with the Minister for Health Greg Hunt, Minister for Aged Care and Senior Australians Richard Colbeck, and Minister for the National Disability Insurance Scheme Stuart Robert.

He said that from 1 January 2020, the government will establish stronger safeguards and restrictions for repeat prescriptions of risperidone.

“Doctors will still be able to prescribe it but will be required to apply for additional approval if risperidone is to be prescribed beyond an initial 12-week period,” said Mr Morrison in a media statement.

“These changes have been developed following recommendations from the Pharmaceutical Benefits Advisory Committee, and in collaboration with doctor’s groups and the broader health sector.”

Education resources for prescribers will also be developed to support the appropriate use of antipsychotics and benzodiazepines in residential aged care, and targeted letters will be sent to high prescribers.

The additional $25.5 million in funding for medication management programs includes support for pharmacists to ensure more frequent medication reviews can occur, said Mr Morrison.

PSA and the Pharmacy Guild welcomed the announcement, with both groups describing the boost in funding as “a step in the right direction”.

“The government’s decision to allow more medication reviews to be delivered to a section of our community in dire need of this critical intervention is to be applauded,” said PSA national president, Associate Professor Chris Freeman.

“The PSA has long advocated for a cycle of care that delivers medication reviews conducted at a frequency and level that is dependent on patient needs, with meaningful follow-up, rather than being arbitrarily capped by funding restrictions.”

A/Prof Freeman said the government’s announcement acknowledges the important role of pharmacists in ensuring the safe and quality use of medicines for elderly Australians.

“It is essential, if we are to address the inappropriate use of medicines for older Australians that pharmacists are able to spend more time on the ground in residential aged care facilities and in patients’ homes delivering this vital service.”

“As medicines experts, pharmacists must be supported to spend more time across the health care system reviewing patients’ medications, providing advice to other members of the health care team and educating consumers about medicines safety, including utilising the accessible network of community pharmacists,” A/Prof Freeman said.

The Guild highlighted the role of community pharmacists.

“Community pharmacists stand ready to play our part in improving the situations faced by too many Australians in aged care,” said Guild national president George Tambassis.

“The important role of local community pharmacies in providing comprehensive support to residential aged care facilities and to older Australians living in the community must be maintained to ensure that efficient and effective care is provided where and when it is needed,” he said.

The Guild added that more flexible funding in home care packages could allow for the full scope of services that community pharmacies provide.

Meanwhile SHPA has responded that embedded pharmacists should still be considered as a crucial strategy in tackling overprescribing in aged care.

“Investment to improve access to Residential Medication Management Reviews (RMMRs) for aged care residents is welcome,” said SHPA Chief Executive Kristin Michaels.

“We are mindful, however, that research shows, in many cases, the majority of pharmacy recommendations made through RMMRs do not translate into action by prescribers.

“To remedy this critical disconnection pharmacists must be included in residential aged care teams,” she argued.

“The fact remains most aged care facilities do not have a pharmacist on staff, despite research consistently finding beneficial outcomes from the provision of clinical pharmacy services.

“We will continue to call for embedded pharmacist roles as the most effective path to improving the safe and quality use of medicines among this vulnerable population,” said Ms Michaels.

See the Prime Minister’s full response to the Royal Commission interim report here

You may be interested in reading:

Commission recommends lifting of RMMR caps
Urgent call for pharmacist prescribing rights, embedded pharmacists and more medication reviews after interim report released by Royal Commission into Aged Care

Doctors quizzed over aged care prescribing: Royal Commission
Pharmacists must be enabled to protect patients from poor outcomes associated with their medicines, say experts

RMMRs and HMRs ‘inadequate’: SHPA
There should be one full-time integrated pharmacist for every 200 aged care residents, says hospital pharmacy group

We want to be embedded in aged care, say pharmacists
Not a zero-sum game: pharmacists should be able to perform medication management activities – whether they come from community pharmacy or elsewhere, says PSA

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1 Comment

  1. Embedding pharmacists will not work. In a already stretched industry, how will providers add a pharmacist onto their pay rolls? Factor in, small vs big facilities, a small pool of pharmacist workforce (with basic clinical training ie. accreditation) and requirements to offer enough hours for a sustainable role.

    The current contractural / consultant model works well.

    1) Deliver RMMR more efficiently (On site reviews and collaboration with health care teams)

    2) Increase scope of QUM activities. Clearly defined with expected outcomes

    3) Overall funding per Bed to provide RMMR / QUM services

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