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and it is likely that funding would only
follow proof-of-concept studies in rural
communities. There have been calls from
the Pharmaceutical Society of Australia
and National Rural Health Alliance to the
Commonwealth Government to allocate
funding for expansion of telehealth into
tele-pharmacy and funding for sessional
employment by pharmacists to provide
Quality Use of Medicines support in rural
areas.3,23 The Commonwealth Government
Department of Health and Ageing has also
announced the establishment of a Rural
Health Outreach Fund to support outreach
allied health services in priority areas such
as mental health and chronic disease
management.24 Apart from funding, the
study identified that competency, availability
of professional support and acceptance of
other healthcare providers are other factors
to be considered when establishing and
implementing the service delivery models.14
Some pharmacists commented on the
potential to re-engineer pharmacy practice
to better utilise pharmacy support staff
(e.g. pharmacy/dispensary assistants or
technicians) in medication supply.10,20,25
Participants considered pharmacy support
staff as appropriate personnel to undertake
independent operational or technical tasks
as they generally have undertaken training
in medication stock management and
legislation relating to medication storage
and supply processes.10,20,26,27 Again, limited
insights were provided on this model, as the
role of pharmacy support staff is restricted
by supervision requirements and limited
endorsements in the Regulation. Further role
modelling is warranted, supported by
investigation into indirect supervision
of the support staff by a pharmacist via
video-conferencing, which is aligned with
recent changes in the Regulation that
acknowledge the role of technology in
'supervision' and 'personal supervision' of
One of the limitations of this study is its lack
of focus on provision of medication support
to Indigenous communities, as Indigenous
issues were not identified by interviewees in
the study community. Separate investigation
is required into funding models and
legislative provisions (e.g. Section 100) to
address the unique needs of Indigenous
communities, particularly in more remote
or isolated areas. Another limitation is that
none of the proposed models had been
instigated in this community, and as such,
the research took an exploratory, theoretical
approach based on the perspectives of
those with experience in similar models
in other settings. Although the study was
conducted in one specific rural community
in Queensland, the service delivery models
have also been identified in other studies11
and thus the concepts discussed should be
applicable to the general rural settings in
Queensland or other jurisdictions.
Australia's rurality imposes a challenge to
delivery of healthcare services, including
pharmacy services. This research provided
rural healthcare providers' perspectives
on sessional support, outreach support,
and virtual support in providing clinical
pharmacy services and medication support.
The potential for extended medication
supply roles for pharmacy support staff
was also discussed. Despite the limitations
reported for the model, each model has its
place and application. It is intended that
the examples provided in this paper will
inform and inspire stakeholders, researchers
and pharmacists to exploit these models to
enhance provision of pharmacy services in
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