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Monday, January 17, 2022

Pharmacists needed in aged care settings to improve quality of life for residents: PSA

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The Pharmaceutical Society of Australia (PSA) is renewing its call to the Federal Government to fund pharmacists embedded into aged care facilities, to improve medicine management and overall quality of life for older Australians.

Older Australians living in residential aged care facilities, the PSA says, continue to face significant threats to their health, due to harm arising from misuse or mismanagement of their medications.

The Royal Commission into Aged Care Quality and Safety identified growing concerns of inappropriate medicine use in aged care facilities.

Pharmacists embedded into aged care facilities undertake a wide range of professional activities.

Every day that a pharmacist is not working alongside aged care staff in caring for older Australians is a day residents are in danger from medication harm

PSA national president, Associate Professor Chris Freeman

Their involvement is proven to improve collaboration between health professionals; reduce medication misadventure; improve transitions of care; and address medicine-related questions and concerns from patients, particularly around medicine safety, polypharmacy and reducing chemical restraints.

PSA national president, Associate Professor Chris Freeman, says aged care pharmacists are desperately needed.

“Every day that a pharmacist is not working alongside aged care staff in caring for older Australians is a day residents are in danger from medication harm,” he says.

“It is crucial that service providers are allowed the flexibility to determine how they secure pharmacist services.

“Some facilities may choose to employ a pharmacist directly, some may choose to contract pharmacists through community pharmacies, or via a third party.

“It can’t be a one size fits all approach as every facility is different.”

Freeman says this approach will ensure that aged care facilities can consistently deliver a patient-centred, multidisciplinary service aimed at identifying, resolving and preventing medication-related problems. 

It’s time for the role of accredited pharmacists in aged care to evolve, with funding for a more proactive presence in this space – and to support better medication management.

Chair of the Interdisciplinary Team-based Care Community of Specialty Interest, Debbie Rigby

“PSA has been championing pharmacists employed by aged care facilities across the ACT, South Australia, Victoria and Western Australia – all of which have received overwhelmingly positive feedback from residents, staff and the broader health care team,” he says.

“PSA believes pharmacists working in this space should receive training and be accredited so that services can be delivered consistently and to the highest of standards. This has the support of the aged care sector.

“Now is the time for action, and for the implementation of the findings from the Royal Commission.”

Debbie Rigby, chair of the Interdisciplinary Team-based Care Community of Specialty Interest, says embedded pharmacies in aged care facilities have been a long time coming.

“It’s nearly 25 years since the first pharmacists were accredited to conduct medication management reviews, and this wealth of experience should be acknowledged and celebrated,” she says.

“Many accredited pharmacists working in the aged care sector feel frustrated by program rule restrictions and less-than-optimal collaboration with prescribers.

“However, many accredited pharmacists have built strong professional relationships based on trust and respect with aged care staff and GPs and know they can contribute more to quality use of medicines and medicine safety for this vulnerable population.

“It’s time for the role of accredited pharmacists in aged care to evolve, with funding for a more proactive presence in this space – and to support better medication management,” Rigby says. 

Report findings paint a telling picture

PSA’s Medicine safety: aged care report found that:

  • Over 95 per cent of people living in aged care facilities have at least one problem with their medicines detected at the time of a medicines review; most have three problems
  • Fifty per cent of people with dementia are taking medicines with anticholinergic properties, which can worsen confusion and other symptoms of dementia.
  • One fifth of people living in aged care are on antipsychotics; more than half use the medicine for too long.

The report from the Royal Commission in to Aged Care Quality and Safety recommended that the Federal Government immediately improve access to quality medication management reviews for people receiving aged care by:

  • allowing and funding pharmacists from January 1, 2022 to conduct reviews on entry to residential care and annually thereafter, or more often if there has been a significant change to the person receiving care’s condition or medication regimen;
  • amending the criteria for eligibility for residential medication management reviews to include people in residential respite care and transition care;
  • monitoring quality and consistency of medication management reviews.

The PSA says the royal commission detailed well-known issues in medicine management – notably the use of restrictive practices which could not be justified in 90 per cent of cases, and overuse of sedating medicines.

A flexible model, it says, is needed to give aged care providers and residents the best access to pharmacist-delivered care, and accreditation of pharmacists entering aged care to perform medication reviews must remain mandatory to support a high quality of care.

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