Home' Australian Pharmacist : Australian Pharmacist April 2012 Contents Australian Pharmacist April 2012 I ©Pharmaceutical Society of Australia Ltd.
THE NATIONAL PRESIDENT SAYS
The burgeoning ageing population is
often cited as presenting some of the most
challenging issues for the Government and
the health care sector. However, in addition
to these challenges there are some very real
opportunities for the pharmacy profession
to provide further services in residential
aged care facilities.
Aged care facilities are major users of
pharmacy services, but all too often the
services provided by pharmacists in these
facilities are not consistent and pharmacists'
expertise is underutilised. At PSA we see
opportunities for pharmacists to expand
their role in the aged care setting.
Services already being provided include
QUM activities and Residential Medication
Management Reviews (RMMRs), but there
has been little debate as to how pharmacists
can be more effectively included in the
collaborative health care team caring for the
populations in these facilities.
There are many daily occurrences in
residential care facilities -- including
crushing of medicines advice, clarifying drug
chart queries, drug information and adverse
effects of medicines information -- which for
best outcomes require pharmacist input,
thus providing a new stream of operation
for pharmacists while improving the heath
outcomes of older Australians.
Incorporating pharmacists in the
collaborative care team in these facilities
would also bring to these teams an
expertise in medicines which up to now
they may have been lacking.
Clearly, expertise in medicines by aged care
staff is critical as medication management is
a required standard for accreditation in aged
care facilities, where medicines use is much
higher and often much more complicated
than in everyday settings, and so the input of
a pharmacist would be extremely valuable.
This has been underscored in the recent
National Census of Medicines Use, a 24 hour
snapshot of Australians aged 50 years
This study found 87.1% of participants
took one or more medicines on the day
of the survey, while some 43.3% took
five or more medicines. The study went
on to find 46.3% of participants used
complementary medicines and 87.4% of
these participants used both conventional
and complementary medicines.
Other research shows 19% of medicine
users reported experiencing a problem with
their medicines, a figure which is all the
more astounding when viewed in light of
the Australian Commission on Safety and
Quality in Health Care findings that more
than 1.5 million Australians suffer an adverse
event from medicines each year.
Given the rate of medicines use in the
over 50s age bracket it would seem that a
permanent -- or at least semi-permanent --
and more integrated role for pharmacists in
aged care residential facilities is long overdue.
Health professionals engaged in caring for
the aged in residential facilities have some
very specific and targeted skills, which is
precisely why a team approach needs to
be developed to provide the best possible
outcomes for these patients.
Notwithstanding this, these teams have
tended not to incorporate the skills,
knowledge and expertise of team members
fully or effectively in their team models. In
some facilities, pharmacists conducting
medication reviews are asked to contribute
in other areas, but formalising their role is
A major advantage for any aged care facility
would be to have a pharmacist on staff to
provide expertise on medicines and to clear
up any medicines issues which staff may
have in a timely manner. The knowledge of
pharmacists is often needed in the unique
situations presented in aged care facilities
where medicines are prescribed in unusual
doses, administered in ways which differ from
the norm or are used in combinations which
staff may not have encountered before.
It therefore makes good health and business
sense to have a pharmacist on staff to solve
issues and relieve pressure on staff, thus
improving outcomes for patients.
Fully incorporating pharmacists into the
care team would enable them to contribute
and provide input on medicines use when
developing care plans for patients. Being
able to fully discuss individual patients with
the complete range of other professionals
involved in that patient's care would result
in better care for the patient and a more
efficient use of resources within the facility.
The sector also faces a skills and staff
shortage which can be seen in cases
when under-skilled staff members send
patients off in an ambulance to an acute
setting when many of them should have
been managed at the facility level. These
patients then take up a hospital bed for a
considerable time when, with the right skills
and support in the aged facility, they should
not have been sent to an acute hospital in
the first place.
These are costs the Government can
no longer support. As the aged care
population increases, and the Government
looks to ensuring Australia's heath care
system remains viable and sustainable,
opportunities must be developed by
heath professionals to help meet the
The total government expenditure on aged
care services in 2009--10 was $7.3 billion, with
the Australian Government the dominant
funder providing an estimated $7.1 billion.
Not all of this, of course, was in residential
facilities but a great deal of it was and
any system that can help reduce this
expenditure while improving the health and
wellbeing of the aged population must be
looked at closely.
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