Onsite pharmacists – just what the doctor ordered
The Aged Care Onsite Pharmacist program will put trained professionals into residential facilities.
Aged care home medication delivery could be revolutionised by bringing residents and pharmacists closer together.
The mismanagement of medications, inconsistent safety procedures, and low vaccination rates in residential aged care homes has been a running sore in ongoing controversies around the institutional treatment of vulnerable older people.
Health authorities are pleading with providers to increase their vaccine rates, saying the lives of their patients and communities are being put at risk.
However, the Royal Australian College of General Practitioners recently reported that 97 aged care facilities had COVID-19 vaccination rates below 10%.
In total, 706 facilities reported having less than 50% of their residents vaccinated against COVID.
Of those with the worst coverage, 37 are in New South Wales, 17 in Queensland, eight in South Australia, one in Tasmania, 26 in Victoria, and eight in Western Australia.
Vape laws spark opposition
Queuing at the local pharmacy may get a little longer, and more complicated, following new laws that allow pharmacies to sell
e-cigarettes, also known as vapes.
As of 1 July, pharmacies are the only legal dispensers of vapes containing nicotine. A prescription will initially be required, but the law will change on 1 October meaning adults can buy them after consultation with the pharmacist.
Many pharmacy chains and independent chemists have indicated that they won’t stock the products, with the Pharmacy Guild describing the expectation that pharmacists become vape retailers as “insulting”.
“Pharmacists are healthcare professionals and community pharmacies do not want to supply this potentially harmful, highly addictive product without a prescription,” the guild’s national vice-president, Anthony Tassone, said.
The guild points out that vaping products have not been approved by the Therapeutic Goods Administration (TGA) and no nicotine-containing vape is listed on the Australian Register of Therapeutic Goods.
The laws were passed by Parliament after a compromise between Labor and the Greens.
From 1 October, pharmacists who wish to do so will be able to sell vapes to customers aged 18 or over with ID but without a prescription – because nicotine vapes are to be downgraded from schedule 4 to schedule 3 of the poisons standard. People under 18 will need a prescription.
Related reading: Pharmacy Guild, ABC
The Aged Care Royal Commission identified the delivery of medications as an essential area for improvement in aged care homes and recommended providers employ allied health practitioners, including pharmacists.
This month, the Federal Government began funding the Aged Care Onsite Pharmacist (ACOP) program at a cost of $333.7 million.
That means residential aged care providers will be funded to engage the services of pharmacists on-site through their local pharmacy or direct employment to deliver personalised medications including vaccinations, more frequent medication management reviews, and antipsychotic drugs.
The Royal Commission report emphasised the need to reduce medication-related harm in aged care, and onsite pharmacists will play an important role in that.
ACOP aims to:
Improve medication use and safety in the residential aged care homes, including safe and appropriate use of high-risk medications
Provide for continuity in medication management, such as day-to-day reviews of medications and prompt issue resolution
Provide easy access to pharmaceutical advice for residents and staff
Integrate on-site pharmacists with the health care team, including local general practitioners, nurses, and community pharmacy
Increase understanding and response to individual resident needs.
The government-funded initiative has won the support of the Pharmacy Guild of Australia for potentially elevating the role of the pharmacy as a service provider – not only delivering medications and dose administration aids, but also the quality use of medicines in the facility.
“There are other services that pharmacists can provide, vaccinations and other things that will increase as pharmacists begin to practise to full scope,” a Pharmacy Guild spokesperson said.
“There will be further opportunities for the community pharmacy to become a greater provider of pharmacy and healthcare services to the facilities in general.”
The ACOP funding model is split into two tiers:
Tier 1: A community pharmacy receiving payments to engage in a particular residential aged care facility.
Tier 2: A residential aged care facility can claim up to $138,282 per year for full-time equivalent employment of an on-site pharmacist.
Related reading: Ageing Agenda, Credentialed Pharmacist, RACGP, PPAOnline
