Home' Australian Pharmacist : Australian Pharmacist January 2013 Contents 50 Australian Pharmacist January 2013 I ©Pharmaceutical Society of Australia Ltd.
Continuing Professional Development
SUPPORTING PHARMACY PRACTICE
there will be full two-way integration with
Irrespective of the system used, the
following aspects of clinical interventions
should be recorded:4
• registered pharmacist providing the
• patient identifier (not necessarily
• patient age range (specific age not
• patient gender
• the medicine(s) involved
• clinical notes detailing the intervention
and any relevant medical history
• classification of the clinical intervention
• recommendation/follow-up action
• any communication with other health
care professionals or the consumer/
• any other relevant information.
The clinical notes should help inform
other pharmacy colleagues who may
encounter the patient following the
original intervention. This is important,
as it can help reduce the risk of
duplication and facilitate follow-up.
One recognised approach to making
clinical notes is the Structured, Objective,
Assessment and Plan (SOAP) method.5
Classifying interventions and
The DOCUMENT system permits the
classification of the type of DRP addressed
by the intervention. With this system,
each letter refers to a different type of
intervention (Drug selection, Overdose/
underdose, Compliance, Undertreated,
Monitoring, Education, Not specified and
Toxicity). Within each of these categories
are a number of sub-types, which enables
more specific classification.
Under the terms of the PPI program,
interventions that relate to monitoring,
education, and those which are not
specified are ineligible for remuneration.
Consequently only those interventions
under the 'DOCUT' components of the
DOCUMENT system need to be recorded
on the claim for payment. Nonetheless,
there are many examples of interventions
that address the 'MEN' components that
are clinically appropriate and pharmacists
should aim to record all interventions
irrespective of payment status.
As well as recording the type of DRP,
pharmacists should also document
the recommendation(s) that they
make to the prescriber or consumer to
resolve the DRP. In some cases, optimal
management may involve a number of
recommendations. All recommendations
should be documented. Examples of
common recommendations may include
drug, dose, formulation or frequency
changes, or referral to the prescriber
or other pharmacy service (e.g. a dose
An electronic recording system such
as GuildCare takes users through the
various steps including classification
and recommendations, and ensures
To be eligible for clinical intervention
payments under the PPI program,
• be a Section 90 pharmacy
• be accredited through a program such
as the Quality Care Pharmacy Program
• agree to display and comply with the
Community Pharmacy Service Charter
• register for PPI at www.5cpa.com.au
and maintain that registration
• keep records of intervention
activity for at least two years to
There are no specific accreditation
requirements for individual pharmacists
who wish to provide the service.
Recording professional activities such
as clinical interventions is essential to
optimise patient care, for audit purposes,
and to satisfy the requirements of the
Pharmacies may choose to record
interventions electronically or use a
paper-based system, however, electronic
systems have many advantages.
One such system is the GuildCare Clinical
Intervention Module that can import
information from dispensing systems.
This avoids the need for data re-entry,
which is both time consuming and
error prone. The development of even
more user-friendly systems will help
further reduce the barriers to recording.
Hopefully, at some point in the future,
Figure 1. Areas for intervention activity with 'added value'.
High-risk medications -- e.g. antithrombotics, NSAIDs and insulin are responsible for
many cases of medication-related hospital admissions.
High-risk patient groups -- e.g. post-acute coronary syndrome, good adherence and
persistence with the key therapies of antiplatelet(s), statin, beta-blocker and ACE
inhibitor is strongly associated with better patient outcomes; in COPD, a focus on
sub-optimal adherence/inhaler technique and smoking cessation may help reduce
the huge burden of hospital admissions for this common condition.
PBS 'big-ticket' items -- e.g. proton-pump inhibitors: stepping-down therapy where
appropriate is frequently overlooked but can be achieved and yield major savings.
Public health -- e.g. inappropriate use of antibiotic repeats may be misguided and
further add to existing resistance pressures.
'Under the 5CPA,
$97 million has been
made available for
over a five-year
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