Medication safety must be key focus after 2018–19 MYEFO

While healthcare investment in the 2018–19 MYEFO will improve access to medicines for many Australians, the Pharmaceutical Society of Australia (PSA) is concerned that pharmacists, as part of the broader healthcare team, need to be included as an integral component of future investment in the healthcare system.

 

PSA National President Dr Chris Freeman said pharmacists and pharmacies were pillars of the health system and Australia had significant opportunities to make full use of their expertise.

 

“The government’s commitment to making changes to the Medicare Benefits Schedule (MBS) will benefit patients including people with severe eating disorders and those in rural and remote areas,” he said.

 

“We welcome these important changes to the MBS. However, pharmacists continue to be the only AHPRA registered allied health professionals not eligible to provide allied health services through Chronic Disease Management (CDM) items on the MBS.

 

“Medicines play a major role in the care and treatment of patients with chronic disease, so excluding pharmacists from the MBS for these CDM items makes no sense.

 

“PSA calls for pharmacists to be granted MBS access as part of Team Care Arrangements within CDM items to help improve health outcomes for patients.”

 

PSA welcomed the government’s extension of the Health Care Homes Trial for patients with chronic and complex conditions until 30 June 2021.

 

“As an integral element of the Health Care Homes Trial, community pharmacy is enabling people to get the most out of their medicines. However, barriers to pharmacist involvement still need to be addressed within the current model. We look forward to continuing to support pharmacists participating in this important trial,” Dr Freeman said.

 

“We also support the government’s increased investment in aged care to provide better care for our elders.

 

“We know medication management in aged care is a key area for improvement, so it is imperative that pharmacists are embedded within aged care facilities to ensure the safe and effective use of medicines.

 

“These announcements have again ensured that doctors are one of the first cabs off the rank when it comes to additional investment in healthcare. We need to make sure patients are front and centre when healthcare investment is considered.

 

“That is why we have continued to call for investment in medication safety by ensuring pharmacists are embedded within aged care and other settings.

 

“Pharmacists understand how important medicine safety is to residents’ health. By working with doctors, nurses and residents to ensure the right medicines are being taken in the right way at the right time, pharmacists can greatly improve health outcomes.

 

“We call on the government for some of the additional investment in research through the Medical Research Future Fund (MRFF) to focus on medicines safety. Medicines are still a leading cause of harm and hospitalisations and are an under-researched area with substantial gaps existing in the literature.”

 

Media contact:
Jarryd Luke
Senior Communications Officer
0487 922 176

New medicines advice: Prescribing cascades, polypharmacy, homeopathy

New recommendations on the prescribing of multiple medicines and the effectiveness of complementary medicines, including homeopathy, have been released today by Choosing Wisely Australia.

 

The Pharmaceutical Society of Australia (PSA) developed its inaugural Choosing Wisely list of six recommendations for Australians to consider around medicines use – this includes prescription, over-the-counter and complementary medicines.

 

NPS MedicineWise Client Relations Manager, Dr Robyn Lindner, said: “Sometimes people are unsure of what medicines they’re taking and why. We encourage you to discuss the implications of each new medicine with your healthcare provider and ensure you are fully informed about issues such as necessity, risks and side effects.

 

“These new recommendations will help guide health professionals and their patients in a discussion about appropriate use of medicines based on the latest evidence,” Dr Lindner said.

 

Each year, approximately 230,000 Australians are admitted to hospital as a result of medication misadventure.* This is almost four times the annual number of people who are hospitalised as a result of motor vehicle accidents. It also costs the Australian health system $1.2 billion each year, yet 23% of adverse drug events in primary care are preventable.

 

PSA National President Dr Chris Freeman said “While the use of medicines offers significant benefits for many people, they may also cause unnecessary harm. It is important that we balance the positive and negative effects of each medicine, tailored to each individual with their care goals front of mind.

 

“As experts in medicines, pharmacists have the ability to provide specialised review of a person’s medication regimen, resulting in recommendations or actions to help people get the most out of their medicines. Any person taking multiple medicines, high-risk medicines, or who is at high risk of medicine misadventure, including transitioning between care settings, should have their medicines reviewed,”  Dr Freeman said.

 

“In regards to homeopathic products there is no reliable evidence of efficacy. All health professionals should take the time to discuss with health consumers, who are taking or considering taking these products, the lack of efficacy and the risks in rejecting or delaying other treatments known to be safe and effective.

 

“Prescribing data shows that close to 25% of repeat antibiotic prescriptions were dispensed more than four weeks after the initial dispensing, indicating potentially inappropriate antibiotic use in the community. Pharmacists can help to reduce the burden of antibiotic resistance by first clarifying the clinical appropriateness of repeat antibiotic prescriptions before dispensing.”

 

Dr Freeman said many health consumers turned to complementary and alternative medicines for a variety of reasons and often sought expert advice from pharmacists relating to these products.

 

“Pharmacists and medical practitioners should present clear information to consumers about the safety of and evidence for complementary and alternative medicines and only recommend these products when the known benefit outweighs the potential harm,” he said.

 

The six PSA recommendations are:

1. Do not initiate medications to treat symptoms, adverse events, or side effects (unless in an emergency) without determining if an existing therapy or lack of adherence is the cause, and whether a dosage reduction, discontinuation of a medication, or another treatment is warranted.
2. Do not promote or provide homeopathic products as there is no reliable evidence of efficacy. Where patients choose to access homeopathic treatments, health professionals should discuss the lack of benefit with patients.
3. Do not dispense a repeat prescription for an antibiotic without first clarifying clinical appropriateness.
4. Do not prescribe medications for patients on five or more medications, or continue medications indefinitely, without a comprehensive review of their existing medications, including over-the-counter medications and dietary supplements, to determine whether any of the medications or supplements should or can be reduced or discontinued.
5. Do not continue benzodiazepines, other sedative hypnotics or antipsychotics in older adults for insomnia, agitation or delirium for more than three months without review.
6. Do not recommend complementary medicines or therapies unless there is credible evidence of efficacy and the benefit of use outweighs the risk.

 

Choosing Wisely Australia encourages people to ask questions around any test, treatment or procedure being recommended to them and offers a list of 5 Questions people can ask their doctors or other healthcare providers.

 

There have been 189 healthcare recommendations released through Choosing Wisely Australia by 42 colleges, societies and associations since the initiative launched in April 2015.

ENDS

 

*Australian Commission on Safety and Quality in Health Care. Literature Review: Medication Safety in Australia. Sydney: ACSQHC, 2013.

 

Media enquiries

• Choosing Wisely Australia: Lyndell Coutts, Communications Lead – 02 8217 8650 / 0429 050 103
• PSA: Jarryd Luke, Senior Communications Officer – 0487 922 176

 

About Choosing Wisely

Choosing Wisely Australia® is enabling clinicians, consumers and healthcare stakeholders to start important conversations about tests, treatments and procedures where evidence shows they provide no benefit and, in some cases, lead to harm. The campaign is led by Australia’s medical colleges and societies and facilitated by NPS MedicineWise.

 

About NPS MedicineWise

Independent, evidence-based and not-for-profit, NPS MedicineWise enables better decisions about medicines, medical tests and other health technologies. We receive funding from the Australian Government Department of Health.

 

About the Pharmaceutical Society of Australia

PSA is the only Australian Government-recognised peak national professional pharmacy organisation representing all of Australia’s 31,000 pharmacists working in all sectors and across all locations.PSA is committed to improving Australia’s health through excellence in pharmacist care. PSA believes the expertise of pharmacists can be better utilised to address the health care needs of all Australians.

 

PSA works to identify, unlock and advance opportunities for pharmacists to realise their full potential, to be appropriately recognised and fairly remunerated. PSA has a strong and engaged membership base that provides high-quality health care and are the custodians for safe and effective medicine use for the Australian community.

 

PSA leads and supports innovative and evidence-based healthcare service delivery by pharmacists. PSA provides high-quality practitioner development and practice support to pharmacists and is the custodian of the professional practice standards and guidelines to ensure quality and integrity in the practice of pharmacy.

PSA appoints new National President, doubles-down on increased roles, recognition and remuneration for pharmacists

The Board of PSA has unanimously appointed Dr Chris Freeman as National President of the peak body for pharmacists, following the decision by Dr Shane Jackson to stand down from the presidency to focus on immediate family challenges that have recently emerged.

 

Dr Freeman has a PhD in Pharmacy Practice and a diverse pharmacy background, having worked in hospital and community-settings, as well as academia and general practice during the past 15 years. He has served as PSA National Vice President since July 2016.

 

“It is a privilege to lead the PSA at a time when pharmacists are increasingly recognised as medicines experts and custodians of the Quality Use of Medicines agenda,” Dr Freeman said.

 

He paid tribute to the “energy and enthusiasm that Shane brought to the role of National President” and confirmed that “the PSA will double-down on its efforts to increase the roles, recognition and remuneration of pharmacists across Australia”.

 

Dr Jackson will remain on the PSA Board as Vice President and Chair of the Policy & Advocacy Committee. He said that “leading the PSA has been a great pleasure and honour, however for the immediate future I need to spend a little less time on planes and more time at home in Tasmania”.

 

“I thank all PSA members and staff for their support and commitment to the profession. I look forward to leading PSA’s approach to the 7th Community Pharmacy Agreement negotiations, alongside our Pharmacists in 2023 strategy in the year ahead,” Dr Jackson added.

 

Like Dr Jackson, the new PSA National President is an advocate for embedding pharmacists wherever medicines are used, empowering pharmacists to manage medicine use over the long-term, and equipping pharmacists to enhance community access to health services.

 

Dr Freeman considers general practice and residential aged care as exciting career paths for pharmacists alongside community pharmacy and hospital pharmacy practice. He currently works as a consultant pharmacist at Camp Hill Healthcare medical centre in Brisbane and as a lecturer at the University of Queensland.

 

“Shane and I are cut from the same cloth. We both want to see pharmacists practicing to full scope and this ambition will continue to drive the PSA forward,” Dr Freeman said.

 

“The PSA Board, branch committees and management team are resolute in our determination to unlock opportunities for pharmacists to realise their full potential,” he said.

 

“Our advocacy and policy work will intensify next year as we focus on CPA negotiations and extending political support for the recommendations contained in our Pharmacists in 2023 Action Plan.”

 

-ENDS-

Media contact:   

Jarryd Luke
Senior Communications Officer
0487 922 176

New report reveals extent of medicines overuse across Australia

A report showing that Australia is not making progress on the issue of medicines overuse, including antibiotics, opioids and antipsychotics, demonstrates the importance of embedding pharmacists wherever medicines are used, the Pharmaceutical Society of Australia (PSA) said today.

 

Released by the Australian Commission on Safety and Quality in Health Care, The Third Australian Atlas of Healthcare Variation shows Australians in some areas, particularly aged care, are at risk of harm from medicines overuse.

 

PSA National President Dr Shane Jackson said the overuse of medicines such as antibiotics, opioids and antipsychotics demonstrates how the health system needs to change so healthcare professionals such as pharmacists can deliver the right care to the people who need it most.

 

“Pharmacists are the medicines experts who can make sure medicines are used safely and effectively in residential aged care facilities.”

 

According to the report, the overuse of antipsychotics to manage behavioural and psychological symptoms of dementia in aged care is of ‘grave concern’.

 

Dr Jackson welcomed the recommendation in the report for a pharmacist to conduct a medicines review after six months, with the outcomes to be provided to the treating general practitioner and placed on the medication record for people aged 65 years and over being prescribed antipsychotic medicines in aged care.

 

“PSA has called for pharmacists to be embedded in residential care facilities to reduce inappropriate medicine use and help address the overuse of opioids and antipsychotics,” Dr Jackson said.

 

The report also found that the rate of opioid medicines dispensing per 100,000 people increased by 5 per cent nationally, calling for continuing focus on improving medicine use in this area.

 

“Pharmacists are a key group of healthcare professionals who can help improve medication safety and quality to reduce the potential harms of opioids.

 

“The Chronic Pain MedsCheck Trial funded by the Australian Department of Health is an important step towards improving opioid use.

 

“The rate of prescribing antibiotics to children aged 9 years and under is very high, with more than 3 million prescriptions dispensed from 2016 to 2017.

 

“Overuse of proton pump inhibitors (PPI) medicines for conditions such as gastro-oesophageal reflux disease has also been an issue for a long time, despite guidance that recommends step-down therapy to avoid long-term complications.

 

“With their unique expertise in medicines, pharmacists are best placed to support rational use of medicines including PPIs to protect people from serious adverse outcomes.

 

“The report highlights the gaps in our healthcare system that are exposing people to harm from some medicines. Pharmacists are here to help protect all Australians from the risk of adverse effects by making sure they receive the right medicine for them.”

 

-ENDS-

Media contact:

Jarryd Luke

Senior Communications Officer

0487 922 176