Maximising pharmacists’ roles boosts consumer health outcomes

Many people don’t realise that pharmacists are amongst the largest and most accessible group of healthcare professionals in Australia.

Research shows consumers visit pharmacists – along with their GPs – more frequently than any other healthcare providers to utilise their unique expertise and skills in local communities every day across the nation.

Historically, the role of a pharmacist has involved a significant focus on dispensing of medicines. However, while dispensing of medicines remains a core activity for all pharmacists, the use of their medication management expertise is not limited to just a dispensing function. A pharmacist offers a wide range of professional services within their scope of practice, having the highest regard for consumer safety and promoting quality use of medicines.

Encouragingly, recent Community Pharmacy Agreements have also resulted in increased funding for professional pharmacy services due to the Federal Government recognising the important value of medication management and education services provided by pharmacists.

This works well for Australia’s growing pharmacist workforce that is highly trained and skilled, with a much younger age-profile than most other health professions.

Of course, this also means there’s great potential for pharmacists to contribute to emerging and innovative models of healthcare to benefit consumers.

In the lead up to the 2016 Federal election, the Pharmaceutical Society of Australia (PSA) urged all the major parties to consider innovative reforms to better utilise Australia’s pharmacist workforce to best meet Australia’s health policy objectives.

As the peak national body for pharmacists, PSA highlighted that while pharmacists are highly-trained health professionals located in all communities, their role is far more limited in Australia than in many other comparable countries.

Expanding innovative models of evidence-based, interprofessional health care and better utilising the role of pharmacists will improve overall health outcomes for consumers, and in particular help ease the burden on the health system.

An integral way of engaging Australian pharmacists’ full scope of practice is by ensuring pharmacists are included in interprofessional Health Care Home (HCH) teams, which has recently been promoted by the Federal Government.

Considering around 36 per cent of expenditure in primary care is spent on medications, and the high costs associated with medication misadventure and potentially preventable hospital admissions, there is a fundamental need to ensure the HCH model has a focus on medication safety and quality use of medicines – both require the unique skills and expertise of a pharmacist.

PSA has applauded the Government’s moves to trial the HCH initiative, a model designed to help transform primary health care and improve the efficiency and effectiveness of the health system, particularly for consumers with chronic and complex conditions.

The HCH trial – announced in August 2016 – is set to benefit about 65,000 Australians in clinics and Aboriginal Medical Services Australia-wide.

Of course, PSA supports a model where highly-trained pharmacists play an integral role in the HCH to optimise medication use to improve the health outcomes of consumers with chronic and complex conditions, and those who are particularly vulnerable during critical periods of care transition.

There is strong evidence supporting the HCH model where significant benefits have been demonstrated in interdisciplinary care, including pharmacists integrated within the health care team.

The inclusion of pharmacists in the HCH team also has the potential to reduce preventable medication-related hospital admissions and readmissions, leading to a reduction of overall primary care expenditure and significant savings to the broader health sector.

For this model of care, the roles that pharmacists could contribute as part of a HCH care team could include:

  • Identifying, resolving, preventing, and monitoring medication use and safety problems
  • Reducing poly-pharmacy and optimising medication regimens consistent with evidence-based guidelines
  • Recommending cost-effective therapies
  • Designing tailored adherence and health literacy programs
  • Developing consumer medication action plans with self-management goals
  • Communicating medication care plans to consumers and other health care professionals in the team
  • Liaison with community pharmacy and other health care providers to ensure seamless transitions between health care settings.

PSA is fully committed to working with the Health Care Homes Implementation Advisory Group and the Government to co-design a HCH model for the Australian context, which is based on best practice, evidence-based models of care to ensure consumers receive maximum benefit.

Another innovative reform being led by PSA to benefit consumers is integrating pharmacists into GP clinics.

This collaborative model will allow greater integration of pharmacists and community pharmacies within the primary healthcare team, to ensure alignment and coordination of services, including those funded in community pharmacies through the Sixth Community Pharmacy Agreement.

Of course, the integration of pharmacists in general practice has been successfully adopted in the United Kingdom, New Zealand, Canada and USA, where pharmacists are providing clinical services in general practice settings.

This international evidence shows pharmacists in a GP setting not only improves health but can also strengthen links between local general practices and community pharmacies.

Clearly, this healthcare model is good for consumers, good for pharmacists and pharmacies and good for general practitioners and their practices.

There are already several working examples within Australia of pharmacists working with GPs to provide a wide range of services to consumers, GPs and to support practice staff.

General practice pharmacists are assisting with medication enquiries from consumers and health professionals, conducting staff education, mentoring new prescribers, participating in case conferences, liaising to facilitate care across different health settings and evaluating drug utilisation to ensure optimal therapy.

To further improve collaborative care in community pharmacy, PSA has also successfully developed an evidence-based, international Award-winning program called Health Destination Pharmacy.

The Health Destination Pharmacy program is now in more than 25 pharmacies across Australia, empowering pharmacists to provide tailored, high-quality consumer healthcare in their local communities.

The whole-of-business approach of the Health Destination Pharmacy program was recently awarded for being a world-leader in overall pharmacy practice improvement, including for delivering effective evidence based healthcare services, improving effective business practices and increasing consumer engagement.

Essentially, the Health Destination program is about enabling pharmacists to do what they do best and what we know consumers want from them – to be accessible to provide evidence-based advice and assistance on minor ailments and medication management.

In conclusion, pharmacists can play an important role in an effective Australian healthcare system and their skills and expertise have wide-ranging health benefits for consumers.

Optimising pharmacists’ contribution in collaborative and integrated models of care has the value-adding capacity to strengthen evidence-based health policy and to significantly improve the health and wellbeing of all Australians.