Home' Australian Pharmacist : Australian Pharmacist February 2016 Contents Australian Pharmacist February 2016 I ©Pharmaceutical Society of Australia Ltd. 31
'As a profession we spruik of how pharmacy
practice has evolved into a professional service
focus however there are few examples of how
these services are integrated into the wider health
'As an example, a pharmacist integrated into
the general practice team may aid in the
transition of care for patients when they are at
their most vulnerable, at hospital discharge.
The pharmacist here could act as a medication
management conduit between the hospital
and community setting, liaising closely with the
general practitioner and community pharmacist,
ultimately improving the quality use of
medicines and preventing hospital readmissions,'
Dr Freeman said.
According to Professor Calder, Australia still has a
siloed approach to healthcare.
She said that pharmacy is 'the walk in provider of
health information and education.
'It's taken a very long time for people to recognise
that the role of the pharmacist should be as
a primary care provider not just a medication
service provider,' said Professor Calder.
'A long time ago in aged care we achieved funding
for pharmacists to undertake medication reviews
because there is so much polypharmacy. I ran a
polypharmacy conference in the 1980s.'
'That [medication reviews] has really not been
embedded, it's not a systemic approach. It's an
optional extra that some people use and some
people don't. It ought to be systemic because we
know that polypharmacy continues to be a major
issue in older people's healthcare.
'We have pharmacists now who are well
positioned to work in tandem with general
practices to provide that holistic approach to
healthcare, but there is no way in which they are
supported to do so. And yet medication review is
a constant issue in anybody with chronic disease --
a constant issue.
'We expect GPs to keep abreast of the latest
information about adverse reactions and
interactions. That is not sensible when there is an
expert down the road -- or in a GP practice down
the corridor. How much more sensible is that!'
Prof Roughead said people with multiple chronic
conditions had high numbers of errors in their
care, drug interactions and conflicts across their
treatments as well as conflicts with management
approaches across their healthcare, all of which
contributed to poor health outcomes and
In her submission she suggests
developing 'a hierarchy of
funded services that meet the
needs of people with multiple
Prof Roughead also highlights that
the majority of government funded
services were established in the 1980s
when Australia's healthcare system was
focused on acute care and people saw one
practitioner. She gives the example of the
pharmacy sector, where medication specific
counselling alongside dispensing of a medicine
is still a suitable service for people with a single
'However, this service alone is inadequate
for people with multiple chronic illnesses
who require more complex services such as
medication review services or adherence services,
in addition to pharmacist participation in case
conferences in order to ensure coordinated care,
pharmacist participation in case conferences
and services to coordinate care will become
critical as more and more health practitioners
develop prescribing rights (e.g. doctors, dentists,
nurses optometrists and other allied health
professionals in the future).'
She said that identification of and funding
for a care co-ordinator will be critical to
the implementation of successful services.
Otherwise, there is potential for duplication of
services and unnecessary services.
'The care coordinator role does not need to be
limited to any single health profession, but could
vary according to the needs of each individual
patient, however, the role of the care coordinator
should be clearly defined,' Prof Roughead said.
1. Chronic diseases. Australian Institute of Health and Welfare. At: www.aihw.
2. MedicalDirector Research. Chronic care challenge: How technology can
enrich patient care. 2015.
3. McNamara K, Knight A, Livingston M, Kypri K, Malo J, Roberts L, Stanley S,
Grimes C, Bolam B, Gooey M, Daube M, O'Reilly S, Colagiuri S, Peeters A,
Tolhurst P, Batterham P, Dunbar JA, De Courten M, Targets and indicators
for chronic disease prevention in Australia, Australian Health Policy
Collaboration technical paper No. 2015-08, 2015. AHPC, Melbourne.
4. Roughead L. Submission to the Standing Committee on Health -- Report
into Chronic Disease Prevention and Management in Primary Heath
Care. Quality Use of Medicines and Pharmacy Research Centre University
of South Australia. At: www.aph.gov.au/Parliamentary_Business/
ˆ Dr Chris Freeman
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