These findings provide insights to the pharmacy sector, previously unexplored in Australia, and informs future pharmacist workforce planning. To retain experienced, mid-career pharmacists in the profession, strategies to increase opportunities for career progression, better use of pharmacists' knowledge and skills and involvement in patient care are required to increase job satisfaction and improve retention rates.
Community pharmacy dispensing records can effectively identify patients with suboptimal asthma management, who can then be referred to their GP for review. Time constraints in busy pharmacies may limit the uptake and effectiveness of face-to-face interventions in the 'real world' setting, making mailed interventions an attractive option.
Background
The Australian Pharmaceutical Advisory Council guidelines for the continuum of quality use of medicines between hospital and community aim to establish a coordinated approach that encourages continuity in all areas of health care and the community. However, the implementation of these guidelines has been problematic.
Aim
To identify the number and nature of barriers encountered when organising a home medicines review (HMR) for patients at high risk of medication misadventure, after discharge from hospital.
Method
A liaison pharmacist organised an appointment for eligible patients (around 2 days post‐discharge) for the general practitioner to make an HMR referral. The pharmacist contacted the patient's community pharmacist to engage an accredited pharmacist to undertake the HMR and arranged for the HMR report to be sent to the outpatient clinic, the general practitioner and community pharmacist.
Results
38/50 patients consented to have their general practitioner contacted by the liaison pharmacist. General practitioners agreed to order an HMR for 34 patients. Barriers to HMR uptake included: low patient awareness of HMRs, a low level of general practitioner awareness of the HMR process, reluctance of some community pharmacists to participate in HMR delivery and the time taken for HMRs to be performed.
Conclusion
Once aware of the HMR service, the majority of patients were willing to participate and general practitioners were prepared to refer their patients for such a service. However, time constraints impacted on both general practitioners and community pharmacists, hence, consideration should be given to extending the support from HMR facilitators to include pharmacies as well as general practitioners.
Measuring the pharmacist workforce based on registration data significantly overestimates the available clinical pharmacist workforce: 708 (44%) respondents were no longer working in the profession, were not mainly involved in clinical practice or were working in non-clinical roles. A significant re-professionalisation program is needed if pharmacists' unique knowledge and skills are to contribute to better healthcare delivery.
Background: The risk of medication misadventure for patients is greatest during times of change, particularly on discharge from hospital. Patients at high risk of medication misadventure postdischarge should be identified and provided with interventions to ensure the quality use of medicines and positive health outcomes. Home medicines reviews (HMRs) can be used to improve patient health outcomes and reduce the risk of medication misadventure. Aim: To describe the impact of issues raised in post-discharge HMRs, organised via a hospital medication liaison service. Method: HMR reports of participants were evaluated. Issues identified by the accredited pharmacist in each HMR report were classified as either a 'pharmacist intervention' delivered during the HMR or 'information given' that was previously unknown to the medical team. A potential clinical impact of these issues was assigned and the overall clinical significance of all the issues identified in each HMR report was ranked. Results: In 21 HMR reports, 98 issues were identified, with the mean per HMR report of 4.7 ±2.2. Of the 98 issues, 25 were classified as 'pharmacist intervention' and 73 were classified as 'information given'. On 2 occasions, a potential clinical impact of 4 (potentially life-saving) was allocated to an issue identified in the HMR report. 90% of issues identified in the HMR reports were ranked as clinically significant. Conclusion: This pilot demonstrated that a liaison pharmacist was able to implement a hospital medication liaison model for patients at risk of medication misadventure. Evidence suggests that an HMR conducted post-discharge can identify clinically significant medication-related issues.
Learning outcomes have been developed through a collaborative process for pharmacy programmes across Australia through harmonisation of the various expectations and regulatory requirements for pharmacy education programmes. Application of these learning outcomes and exemplar standards will ensure that all graduates of all entry-level pharmacy programmes will have achieved at least the same threshold, regardless of the university from which they graduate prior to entering their internship year.
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