Home' Australian Pharmacist : Australian Pharmacist March 2014 Contents Australian Pharmacist March 2014 I ©Pharmaceutical Society of Australia Ltd.
NZ contract puts patients rst
By Andrew Daniels
The annual PSA Victorian Branch Neil
Naismith Lecture took on an international
flavour this year when Andi Shirtcliffe,
the Chief Advisor -- Pharmacy to the
New Zealand Government, spoke via the
internet to an audience in Melbourne.
The lecture was also streamed as a live
webinar to members across Victoria.
Ms Shirtcliffe described the NZ
Community Pharmacy Services Contract
(CPSC) which was introduced last year.
She told her audience that in response
to unsustainable cost growth of 8--9%
per year over the past decade, the CPSC
had shifted from a fee-for-dispensing,
volume based agreement to a
largely patient-centred model and
'Total dispensing volumes have reduced
since the commencement of the new
CPSA,' she said.
'The new service model emphasises
managing long-term patients'
medicines rather than dispensing
only. The changes include pharmacies
focussing on services to patients who
need extra help with taking/managing
their medications, with funding linked
to services for patients with complex
needs. And, pharmacies working more
closely with doctors to identify patients
who need extra help with taking/
managing their medications.'
While services such as clozapine
dispensing and methadone dispensing
were carried over from the old contract,
three new services were introduced:
• Community Pharmacy LTC (Long Term
Conditions) Adherence Support Service
• PHAMS (Pharmacy High Needs
Adherence Management Service)
• CPAMS (Community Pharmacy
Anticoagulation Monitoring Service)
"FOR THE PATIENT THIS MEANS THAT SUPPORT IS TAILORED TO THEIR
NEEDS AND ULTIMATELY LEADS TO IMPROVED HEALTH OUTCOMES."
Ms Shirtcliffe said the LTC service was
introduced because an estimated
5% of the NZ population will have long
term conditions, difficulty managing
medicines and illnesses and benefit from
adherence support and monitoring.
'The LTC Service is designed to provide
the services required by those patients
who not only have significant long term
conditions but also require a high level of
pharmacy support to remain adherent to
their medicines regimen. There is no extra
cost to the patient.
'Patients are contractually required
to have monthly contact with
pharmacists. This contact and other
relevant information is documented in a
medicines management plan. The plans
are communicated to the prescriber
where clinically relevant. A patient's
eligibility and management plan are
reviewed at least annually.
'For the patient this means that support
is tailored to their needs and ultimately
leads to improved health outcomes.'
Ms Shirtcliffe said that the Pharmacy High
Needs Adherence Management Service
(PHAMS) was an intensive medicines
adherence support dispensing service.
Input from a secondary care clinician was
needed to approve eligibility. However,
patients needed to be registered as a
LTC patient, fulfil certain criteria such as
high risk admission, risk to self or others,
unable to manage their medicines and
not be receiving help with managing their
medicines from other sources.
The Community Pharmacy
Anti-Coagulation Management Service
(CPAMS) Services is being implemented
though more than 70 community
pharmacies to 1,478 patients.
'Patients are tested in a pharmacy with
a finger prick sample of blood and their
warfarin dosage adjusted immediately
if required, rather than having to go
to the laboratory and be phoned later
with results. GPs are informed of all
test results, and provide input on dose
adjustment decisions for results that fall
outside a predetermined range. That is,
general practitioners retain control over
the patient's dosage,' Ms Shirtcliffe said.
'Feedback has identified that patients
are highly satisfied with the convenience
of the service and more motivated to
comply when they see their results on the
computer screen immediately.'
Voting for PSA State and Territory
PSA Branch committees will start on
31 March. Nominations for Branch
Committees opened on 6 March and will
close on 28 March.
PSA CEO Liesel Wett urged PSA members
to consider nominating for positions
on their Branch Committees and all
members to vote in the election.
'Our Branch Committees serve a very
important role and are a vehicle for
consultation with the board and
membership of the Society. Becoming a
Branch Committee member gives members
future of their profession,' she said.
'They are also pivotal to ensuring that
local circumstances are taken into account
when developing strategies and polices as
well as delivering PSA member services.'
Ms Wett said the pharmacy profession
was evolving and also facing difficult and
'The role of Branch Committees takes on
an even greater importance during times
like these,' Ms Wett said.
Members should look out for their
personal invitation to nominate which
will be issued this month, and which
includes appropriate nomination forms.
The timetable for voting is:
• 6 March nominations open
• 28 March nominations close
• 31 March voting starts
• 28 April voting closes
• 29 April ballots counted
and results declared.
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