‘We need to step up.’

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Those doing “substandard” medication management reviews should be put on notice, says leading pharmacist

The University of Tasmania’s Associate Professor Juanita Breen, who has led research into reducing aged care psychotropic use, has told AJP she is pleased that the role of pharmacists has been highlighted in recommendations from the Royal Commission into Aged Care Quality and Safety.

A/Prof Breen gave expert evidence to the Royal Commission, as did pharmacist researcher Dr Janet Sluggett, an NHMRC early career fellow at Monash University’s Centre for Medicine Use and Safety.

“Personally I’m really happy that the role of accredited pharmacists was highlighted, that pharmacists in the future will be part funded to work in aged care homes, that the current review caps will be lifted, and that the evidence that Janet Sluggett and I presented in two hearings was acknowledged and heeded,” said A/Prof Breen.

She also approved of the Royal Commission’s finding that pharmacists could serve a vital function in psychotropic and antibiotic stewardship.

“Medication management, so often sidelined, was highlighted as a key concern,” she told AJP.

But importantly, pharmacists were named up as an important means to address these concerns.

“We need to step up and take advantage of this emerging opportunity to fulfil the expectations that the aged care recommendations have set for us.”

Counsel assisting during final submissions at the Royal Commission into Aged Care Quality and Safety proposed 124 recommendations, published late last month.

One of these recommendations requires approved providers to engage various allied health professionals, including at least one pharmacist. This is due to occur by no later than 1 July 2024.

The changes will be rolled out under a blended funding model with the Federal Government to provide 50%, explained A/Prof Breen. Monitoring of the quality of this provision has been emphasised.

A further recommendation called on the Australian Government to “immediately improve” access to quality medication management reviews for people receiving aged care by:

  • allowing and funding pharmacists from 1 January 2022 to conduct reviews on entry to residential care and annually thereafter, or more often if there has been a significant change to the care recipient’s condition or medication regimen;
  • amending the criteria for eligibility for residential medication management reviews to include people in residential respite care and transition care;
  • monitoring quality and consistency of medication management reviews.

A/Prof Breen highlighted the Commission’s strong comments about assessing the quality and consistency of medication reviews, saying authorities will no longer just monitor financial claiming.

“They criticised the current auditing arrangement so those doing substandard reviews should be put on notice,” she said.

Under the recommendations, GPs will also be required to initiate and take part in regular medication management reviews.

A/Prof Breen added that there were “big moves afoot” around restraint regulation.

The Commission recommended that the Australian Government introduce new requirements regulating the use of chemical and physical restraints in residential aged care by 1 July 2021.

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1 Comment

  1. Karalyn Huxhagen

    Those of us who have been in this space for a very long time welcome the changes but are fearful of the huge burden placed on ACFs post royal commission. The latest recommendations for a ‘critical incident register and intervention’ require police to attend each incident. This is a step too far IMHO. The onus is now on the pharmacist to stop aggression in residents.
    I welcome a more collaborative environment for medication management. I just despair of the toll put on ACFs to meet some of the new directives. Every ACF is under huge pressure to provide a service level. Most were doing a good to great job before commission. All are being punished instead of fixing the bad ones. The commission was needed but realism has been sacrificed in implementation of the findings

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