Home' Australian Pharmacist : Australian Pharmacist October 2012 Contents 766 Australian Pharmacist October 2012 I ©Pharmaceutical Society of Australia Ltd.
Outer south metropolitan Perth
in Western Australia has a large
Aboriginal population. As with other
Aboriginal populations, these people's
health is, on average, poorer than
their non-aboriginal counterparts
living in the same area.
In response to this, an Aboriginal Wellness
Centre -- Moorditj Koort -- was established in
Kwinana. It allocates patients with chronic
disease to a case worker who is charged with
ensuring they attend health appointments.
As with all consumers using the health care
system, self management of chronic diseases
is di cult and the case worker helps clients
improve their health management skills.
Allied health professionals visit the Centre
at various times and Aboriginal clients are
bought to the centre for appointments.
Diabetes educators and podiatrists visit
fortnightly to tend to these patients.
Specialists also visit regularly and clients can
see them at the centre instead of needing to
travel out of the area.
Treating chronic disease usually involves
using multiple medications with often
complex regimens. People may be concerned
about the supply of medications, the cost,
how to sustain lifestyle changes, how to
remain compliant with medicines or what
to do about potential or actual side e ects.
To most e ectively help these people
manage their chronic disease, it is essential
they have information about managing their
medications -- in conjunction with the other
services o ered.
This raised the question, 'Would there be a
bene t in having a pharmacist present at this
Aboriginal wellness centre?'
To answer this question, a consultant
pharmacist was placed in the centre
once each fortnight -- on the same days
the podiatrist and diabetes educator
What follows is a list of some of the
interventions that occurred over a 12-month
period. It should be noted that in many
instances, Aboriginal speci c information
lea ets were used.
• Discussions about possible side e ects and
whether they relate to medications, or not.
These queries were from patients and
from allied health professionals (AHPs.)
This has sometimes included further
discussion with the GP involved in the care
of the person.
• Opportunistic visits to client homes to
aid them with their medication issues,
e.g. storage, compliance and queries
about the medicines. In many cases, the
pharmacist would not normally have been
able to enter the client's home. However,
since a relationship had previously been
established at the Aboriginal centre, the
pharmacist was invited inside.
• Identi cation of inappropriate storage of
• General health discussion about insomnia
and non-pharmacological management of
this problem with patients.
• Clients queried information in the general
press about the use of over-the-counter
medicines and complementary medicines.
• There were queries about adverse e ects
of medications used to treat children and
grandchildren of clients.
• Seven Home Medicine Reviews (HMRs)
were conducted. These were possible
because the pharmacist conducting the
reviews was someone the Aboriginal client
knew from the health centre.
• Adverse reactions were noted due to
improved adherence following the
commencement of a blister pack. This
then led to discussion with the GP about
• The client, case coordinator and
pharmacist were able to discuss some
HMR reports with the client's GP in a case
• Follow-up about interventions and
HMRs were made opportunistically
when patients returned to the Aboriginal
Wellness Centre for other reasons.
• Several talks were given to members of
the Aboriginal community. These covered
general medicine information and also
the safe use of antibiotics and preventing
the spread of infections.
• Talks were given to AHPs about the role
of medicines in their specialities, general
medicine information and antibiotic
resistance. Hygiene and reducing the
spread of infections was also discussed.
• General discussions with allied health
professionals highlighted potential
adverse e ects of medicines that would
not have otherwise been discovered.
• Liaising with local community
pharmacies to 'trouble shoot' various
client issues relating to supply and cost of
Whilst it is di cult to exactly quantify the
bene t these interventions have made,
it is clear that placing a pharmacist in the
Centre has been bene cial. Health literacy
is perhaps even lower in this group than
in others and increasing this through the
pharmacist's education sessions and by
providing general information during
discussions will help improve their health.
Whether or not this model provides a
cost saving is di cult to ascertain. As with
other interventions that pharmacists make
in retail settings and via HMRs it is hard
to de nitively con rm whether or not a
particular issue (e.g. an adverse medication
reaction or an unplanned hospital
admission) would have occurred without
the intervention. Therefore a monetary
value cannot easily be placed on this service
However what is clear is that access to a
pharmacist's medication knowledge in
this informal environment provides an
opportunity for questions to be asked
-- both by patients and by allied health
professionals. It also o ers an opportunity
for the pharmacist to ask questions of the
patients and to follow up with medication
management suggestions and strategies.
This then allows for education, reminders
and the identi cation of the need for
further medication changes.
A pharmacist on the
By Helen Brown
Helen Brown is NPS Visiting Pharmacist,
Perth South Coastal Medicare Local.
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