Limited oversight of antimicrobial use in aged care puts all Australians at risk

Antimicrobial resistance is one of the greatest challenges facing healthcare in Australia, yet data released today shows prescription rates in aged care facilities are on the rise and residents and care staff receive limited support to ensure that these medicines are being used effectively.

 

The 2018 Aged Care National Antimicrobial Prescribing Survey (NAPS) found nearly 10 per cent of aged care residents were prescribed antimicrobials. This compares to 8.8 per cent in 2017.

 

“In just one year we have seen a significant and concerning increase in antimicrobial prescribing,” Pharmaceutical Society of Australia National President A/Prof Chris Freeman warned.

 

“The World Health Organisation has named antimicrobial resistance as a global health threat. Antimicrobial resistance means our most powerful medicines, such as antibiotics, may no longer be effective in treating infections like pneumonia.”

 

“Over prescription of antimicrobials and misuse of these life saving medicines are factors in the rise of resistance.”

 

According to the latest NAPS, antimicrobial review or stop dates are not documented for 58.9 per cent of prescriptions; the documentation of indication was missing for 25.1 per cent of prescriptions; and almost one-fifth of antimicrobials were prescribed for as needed administration.

 

“This means residents may be taking antimicrobials longer than necessary, or worse when they don’t even need to,” A/Prof Freeman said. “There is no clear finish date or prompt for a health care provider to check in with an aged care resident, or the care staff to make sure they are still taking or have ceased taking an antimicrobial based on their current health. This lack of support to aged care residents, and to facility staff is putting aged care residents and the wider community at risk from the epidemic of antibiotic resistance.

 

“Pharmacists are experts in medicine, with a primary responsibility at all times to see that medicines are used safely, effectively and judiciously.”

 

“PSA would like to see the expertise of pharmacists more broadly recognised and utilised. This is again, another example of inappropriate medicine use within aged care, often caused by the prescriber making the wrong decisions about medicines.”

 

“The report released today highlights the real necessity for pharmacists to have more time in aged care facilities and other health care teams to ensure doctors do the right thing with prescribing medicines so that we can improve the safe use of medicines within aged care.”

 

Media contact: PSA Media – 0487 922 176

Leading Queensland pharmacists honoured

Exceptional Tasmanian Pharmacists recognised

Pharmacist prescribing on the way

The Pharmaceutical Society of Australia (PSA) has welcomed the Pharmacy Board of Australia’s position statement on pharmacist prescribing which outlines the way ahead for pharmacists to prescribe as part of a collaborative health care team.

 

PSA National President A/Prof Chris Freeman said following the extensive work conducted by the Pharmacy Board including competency mapping and broad stakeholder engagement, the position statement now lays the platform for pharmacist prescribing, especially collaborative prescribing to be implemented to support the safe and appropriate prescribing of medicines by pharmacists to improve Australians’ access to healthcare.

 

“PSA is pleased that the Pharmacy Board has concluded that under the National Law there are no regulatory barriers in place for pharmacists to be able to prescribe collaboratively under two of the three models outlined in the Health Professionals Prescribing Pathway (HPPP).

 

‘Prescribing via a structured prescribing arrangement’ and ‘prescribing under supervision’ can be progressed immediately, and implementation of these models through for example, expansion of continued dispensing for chronic disease medicines can address a significant proportion of the administrative burden that community pharmacists see day to day with patients running out of their medicines,”  he said.

 

A/Prof Freeman said collaborative prescribing agreements within general practice, aged care, hospitals, and community pharmacy can address concerns about patients not reaching treatment goals, improve the monitoring of adverse events, and in aged care could go a long way to reducing the medication related misadventure that occurs in this setting.

 

“It is incumbent now upon state and territory jurisdictions with their medicines and poisons legislation to review their legislation to remove any unnecessary barriers to pharmacists ‘prescribing via a structured prescribing arrangement’ and ‘prescribing under supervision’.

 

“We are pleased that the Pharmacy Board has agreed with PSA’s position that there are no regulatory impediments to collaborative prescribing, and that autonomous prescribing would require an endorsement on pharmacists’ registration.

 

“As stated in our Pharmacists in 2023 report, we are committed to enabling pharmacists to practise to their full scope by advocating for expanded roles and new opportunities in prescribing, consistent with their recognised competency framework.”

 

In its submission to the Pharmacy Board, PSA surveyed pharmacists, interns and students to inform its response. Ninety-six per cent of respondents agreed pharmacists are already well placed to prescribe under a structured prescribing arrangement or under supervision.

 

The majority of respondents said they would prescribe under the proposed models, with 57% saying they planned to prescribe under a structured prescribing arrangement as soon as it was implemented.

 

In its submission to the Pharmacy Board, PSA outlined the core principles that must underpin pharmacist prescribing, including:

 

• Safety and wellbeing of the patient are fundamental priorities
• Patients are supported to receive patient-centred care in a timely manner
• Pharmacist prescribers have professional accountability and responsibility to patients as well as other members of the healthcare team
• The pharmacist prescriber works as a member of a collaborative care team with shared responsibility and implements highest standards of communication with patients and other team members
• Separation of prescribing and dispensing functions.

 

“PSA looks forward to working with the Pharmacy Board, state and territory jurisdictions and the wider profession to support pharmacist prescribers by establishing training requirements, implementing legislative and regulatory change, and developing the frameworks for collaborative prescribing” A/Prof Freeman said.

 

Media contact: PSA Media – 0487 922 176

New Chief Executive Officer to lead PSA

The Pharmaceutical Society of Australia (PSA) has appointed career-long health care advocate and health policy expert, Mark Kinsela as Chief Executive Officer.

 

Following an extensive executive search, Mr Kinsela was appointed by the PSA Board and will formally begin his new role on 2 December 2019.

 

“We are delighted to have someone of Mark’s experience leading PSA into its next stage,” Pharmaceutical Society of Australia National President, Associate Professor Chris Freeman said.

 

During his career, Mr Kinsela has been an adviser to the Commonwealth Minister for Health and Minister for Social Services and Aged Care. He has worked as a clinical nurse educator and trauma intensive care specialist and most recently was Chief of Staff at the Australian Digital Health Agency.

 

“Mark’s career has taken in all aspects of health care, from delivery through to policy. It has given him an exceptional level of expertise and insight into the challenges facing Australia’s health care systems and potential solutions, such as innovation and multidisciplinary care.

 

“PSA is focused on ensuring the role of pharmacists is optimised as Australia strives to provide quality, safe, and effective care to all.

 

“We believe Mark’s training as a health care provider and executive MBA, combined with his impressive professional background, will help PSA continue to ensure our profession has the opportunity to positively contribute to policy making at the highest levels and achieve the goals outlined in our Pharmacists in 2023 vision.”

 

A/Prof Freeman thanked interim CEO, Dr Shane Jackson for more than ably leading PSA during its CEO search.

 

“Dr Jackson was previously PSA President and generously agreed to act as CEO until the role was filled,” he said.

 

Dr Jackson will step down from the position of interim CEO, once Mr Kinsela officially commences and after this will continue to lead PSAs negotiations of the 7CPA.

 

 

Media contact: PSA Media, 0487 922 176

Victorian adolescents able to access vaccination by pharmacists

Trained pharmacists will be able to administer the influenza vaccination to people aged 10 years and above.

 

The Pharmaceutical Society of Australia (PSA) welcomes today’s announcement from the Victorian Minister for Health and Ambulance Services, the Hon Jenny Mikakos to lower the minimum vaccination age from 16 years to 10 years for pharmacist-vaccination in readiness for the 2020 influenza season.

 

PSA Victorian Branch president Ben Marchant commended the government’s decision to allow pharmacists to protect more Victorians from influenza.

 

‘Allowing trained pharmacists to administer vaccines to a wider cohort will significantly increase immunisation rates within the community’

 

‘This is particularly important given a total of 61,545 cases of laboratory confirmed influenza have been processed in Victoria so far in 2019 ’ Mr Marchant said. “Research has shown internationally and locally that pharmacists are considered highly accessible.’

 

‘87% of Victorians live within 2.5km of a pharmacy, which are generally open longer hours than other primary health services. This change will enable more people, including families, to access influenza vaccination, and build immunity within the Victorian community.’

 

The administration of vaccines by pharmacists complements the excellent work done by GPs, nurses, indigenous health workers and other immunisers.

 

PSA commends the Victorian government for making use of the pharmacists’ expertise and training to better protect the community against vaccine preventable diseases.

 

PSA continues to advocate for a national approach to pharmacist administered vaccinations to reduce confusion, ensure better access for patients to quality vaccination services and utilise the pharmacist workforce appropriately.

 

PSA encourages the Victorian government to continue working towards harmonising requirements for pharmacist- vaccination with other states in line with last year’s resolution Council of Australian Governments (COAG) Health Council , and also to better align training and regulatory requirements of with other health professions.

 

Media contact: PSA Media 0487 922 176

 

Report No. 21: Week ending 29 September 2019, Victorian Sentinel Practice Influenza Network, Victorian State Government, at https://www.vidrl.org.au/app/uploads/2019/10/2019-VicSPIN-report-21.pdf

COAG Health Council Communique, 12 October 2019, at https://www.coaghealthcouncil.gov.au/Portals/0/CHC%20Communique%20121018.pdf

More time on the ground for pharmacists in general practice and aged care

The Pharmaceutical Society of Australia is delivering two new two-year projects integrating pharmacists into general practice and aged care to address healthcare in regional South Australia.
 
PSA President of South Australia/Northern Territory Branch, Robyn Johns, said that in South Australia around 48 people every day or about 17,500 people a year are admitted to hospital due to a medication-related problem at a cost of around $98 million annually.
 
PSA’s Medicine Safety report highlighted Australian research which uncovered a staggering 81% of aged care residents being exposed to at least one inappropriate medicine1. The study of 533 people living in residential aged care was conducted across facilities in four states, including South Australia.
 
“The Pharmaceutical Society of Australia and Country SA PHN are working together to address this need through two projects integrating pharmacists into regional general practices and residential aged care facilities,” she said.
 
“Integrating pharmacists into residential aged care is the first project of its kind in regional South Australia.
 
“It will focus on ensuring quality use of medicines achieves better outcomes for aged care residents by reducing the use of high-risk medications, providing education and training to facility staff in the quality use of medicines and supporting facility staff to provide more effective medication delivery.
 
“The pharmacists will also undertake medication reviews for residents and support better transition into residential aged care for residents entering care from the community and/or hospital and for those returning to residential care from hospital.”
 
Integrating pharmacists into regional general practices commenced in 2018 and will continue and expand. Initial work has found that pharmacists have been able to successfully take part in many different types of activities including patient consultations, medication reconciliation and reviews, preventative health education, prescribing audits, MBS billing contribution, preventative healthcare, medicine information, and staff education.
 
“Importantly, pharmacists also demonstrated flexibility within their scope of practice in order to deliver value to general practices in ways that were not anticipated in the initial project scoping and which will be explored further through this expansion,” Ms Johns said.
 
Pharmacists interested in taking up the challenge of working more closely with general practice or in aged care are invited to register for a workshop at the PSA SA Office on 23 November 2019. Inquiries should be directed to Helen Stone on 08 8272 1211 or at helen.stone@psa.org.au .
 
Media contact: PSA Media 0487 922 176

Preparing pharmacists to work in general practice

New training to educate and equip pharmacists to work in general practice and improve health outcomes for patients is now available from the Pharmaceutical Society of Australia (PSA).
PSA has long advocated for pharmacists to be embedded wherever medicines are used, particularly in general practice.
 
PSA National President A/Prof Chris Freeman, one of the first pharmacists to work in a general practice in Australia, said PSA was committed to unlocking this opportunity for pharmacists.
 
“PSA’s Pharmacists in 2023 report states that by 2023, pharmacists should be embedded within healthcare teams to improve decision making for the safe and effective use of medicines,” A/Prof Freeman said.
“Pharmacists are already working successfully in general practice as part of PHN Trial Programs supported by PSA in North Western Melbourne, South Australia and Western Australia.
 
“The Government Workforce Incentive Program has been expanded to include pharmacists from January 2020, supporting general practices to employ pharmacists. This expansion will give pharmacists more opportunities to work in general practice.”
 
A/Prof Freemen said general practice pharmacists collaborate with GPs and other health professionals to improve medicine safety and manage patients with chronic illness.
 
“They improve health outcomes for patients by undertaking consultations with patients on the safe and quality use of medicines providing medication advice, conducting clinical audits and providing education to GPs and other practice staff,” he said.
 
PSA recommends that all pharmacists who want to work in general practice complete the PSA General Practice Pharmacist: Foundation Stage Training Program as a minimum training requirement.
 
PSA also provides a wide range of practice support tools including the Guidelines for General Practice Pharmacists, which are being released today, activity checklists and needs assessment for General Practice Pharmacists.
 
“As more pharmacists are embedded in inter-professional healthcare teams, PSA will support them to advance in their chosen career paths and provide the best possible care,” A/Prof Freeman said.
Further information about training and other practice support for pharmacists working in general practice can be found at www.psa.org.au/gppharmacist.
 
Media contact: PSA Media Phone 0487 922 176

Expansion of Tasmanian pharmacist vaccination services

Moves by the Tasmanian Government to expand the scope of pharmacist-administered services in Tasmania has been welcomed by the Pharmaceutical Society of Australia (PSA).

 

PSA has long championed a consistent approach in all states and territories for pharmacists to administer vaccines.

 

The announcement by Tasmanian Minister for Health Sarah Courtney MP to expand the schedule of vaccines brings Tasmania in line with other states and territories.

 

Tasmanian PSA Branch President Dr Ella Van Tienen said the range of vaccinations available through pharmacist immunisers now included dTpa and state-funded MMR for 16 years and older.

 

This is in addition to providing influenza vaccine to individuals aged 10 years and over.

 

“These vaccines targeting measles, mumps, rubella, diphtheria, pertussis (whooping cough) and tetanus are vital in saving lives and protecting the community from the spread of these potentially life-threatening diseases,” she said.

 

“We thank the Tasmanian Government for acting to protect our community by providing access to these vaccines for Tasmanians, and in particular for vulnerable people.

 

“Less than 40 per cent of at risk people over 18 years are considered to be fully vaccinated. The availability of these vaccines through pharmacist immunisers benefits consumers due to the accessibility of community pharmacy and the convenience, it also benefits the health system through higher vaccination rates and cost savings.”

 

PSA has worked with the Tasmanian government to update its pharmacist training course to reflect the expanded scope. Trained pharmacists will start offering these additional vaccination services over the coming weeks.

 

For further information please contact PSA media on 0487 922 176

 

Pharmacists protecting Australians from the deadly flu virus

The Pharmaceutical Society of Australia flatly rejects unsubstantiated claims from AMA president Dr Tony Bartone that pharmacist immunisers have used expired influenza vaccines – an action that would be unethical, unprofessional and illegal.

 

PSA, the peak national body for pharmacists, calls on Dr Bartone to retract his comments, apologise to pharmacist immunisers for the error, and release a statement reassuring all people who have received a vaccination from a pharmacist that their treatment is safe and effective.

 

PSA president Dr Chris Freeman said there was no evidence an expired vaccine had been used by a pharmacist, as was claimed by Dr Bartone earlier this week.

 

“Pharmacists take seriously their essential role in providing safe and appropriate medicines,” he said.

 

“All pharmacist immunisers are trained to the same standard as other immunisers in Australia, and pharmacists have stringent quality controls that prevent the use of expired or superseded stock, including influenza vaccines

 

“In 2018, more than 1 million Australians safely received their flu vaccinations from a pharmacist.

 

“Vaccination against preventable diseases is one of the most effective and safe health interventions available to Australians. The use of fear or doubt about vaccination safety as a tool to ignite fear needs to stop immediately for the benefit of all Australians.”

 

Dr Freeman said PSA will be working with all stakeholders to address the damage these comments by the AMA president have caused to the perception of vaccination as a safe and effective method of preventing influenza.

 

For further comment please contact PSA Media on 0487 922 176