Page 12 - Submission to the 2015-16 Federal Budget

‘AUSTRALIA’S MAINSTREAM MEDICAL MODEL FOCUSES ON COMPLIANCE WITH MEDICAL ADVICE AND OFTEN IGNORES THE COMPLEX HISTORICAL AND SOCIOCULTURAL INFLUENCES THAT SHAPE PATIENTS’ RESPONSES TO THEIR HEALTH AND HEALTH CARE.’81
information, and lack of health professional engagement and patient support.91,92
Initiatives already in place such as the Aboriginal Health Service Remote Access (AHSRA or Section 100) Scheme, the Quality Use of Medicine Maximised for Aboriginal and Torres Strait Islander peoples (QUMAX) program and the Closing the Gap PBS Co‐payment measure (CTG) have removed some of the financial barriers to accessing medicines, and have resulted in some increases in medicine utilisation by Aboriginal and Torres Strait Islander people.
However, complex medicine regimens result
in some Aboriginal and Torres Strait Islander
people finding medicines confusing and difficult
to manage. Currently, communication from the doctor and/or pharmacist about medicines is often incomplete or ineffective. Dispensing protocols, the lack of pharmacist interaction and cultural training, and the physical settings of community pharmacies have made it difficult for some Aboriginal and Torres Strait Islander people to have productive relationships with their community pharmacists.93
HMR accredited pharmacists are currently providing very limited clinical pharmacy services to Aboriginal
Australians. Although pharmacists would like to provide more HMRs to Aboriginal people the absence of pharmacist‐AHS relationships are barriers to providing this service.94
Proposed solution
PSA recommends that the Federal Government consider an an adaptation of the PhIP to allow Aboriginal Health Services (AHS) across Australia to improve medication adherence and reduce
the progression of chronic disease, by integrating clinical pharmacists in the AHS team. This would allow Australia’s 200 AHSs to access up to $125,000 per year to employ a pharmacist, in keeping with the general practice proposal.
This initiative would give AHSs around Australia much greater access to the expertise of a pharmacist and where required, to deliver essential medication adherence and medication education services in a culturally appropriate environment.
Demonstrated benefits
Appropriate, effective interactions of Aboriginal and Torres Strait Islander people with culturally responsive clinical pharmacists could improve medication adherence and reduce the progression of chronic disease.95
Greater understanding and empowerment about medicine choices are likely to improve medicine adherence. In some cases, limited pharmacist interaction, and the physical settings of community pharmacies have made it difficult for Aboriginal and Torres Strait Islander patients to have productive relationships with pharmacists.96
Investment by the Government in such initiatives would be offset by reductions in chronic disease expenditure and reduced hospitalisations for
the population of Australians beset by the poorest health outcomes. Making better use of pharmacists to improve the QUM by Indigenous Australians must be an integral element in the Government’s efforts to achieve health equality between Indigenous and non-Indigenous Australians.
Box 4. Establishing clinical pharmacists within primary care settings, such as general practice and Aboriginal Health Services, can:
• reduce PBS expenditure
• reduce overall healthcare costs
• increase medication safety and adherence
• improve patient health outcomes and quality of life
• reduce medicine wastage and/or inappropriate medication use
• assist with transition of care across health care settings.
12 Integrating pharmacists into primary care teams I ©Pharmaceutical Society of Australia Ltd.