Aged care innovator is PSA’s 2021 ECP of the Year

Just 3 years out of university, Maria Berbecaru MPS made history by implementing an Australian-first aged care pharmacy service. She hopes her experience will inspire others and help make embedding pharmacists in aged care the norm.

A 2016 graduate of the University of Tasmania, Maria Berbecaru credits two experiences during her intern year at Swansea Pharmacy, on Tasmania’s east coast, with igniting her interest in aged care. 

The first was assisting nursing staff during medicine administration rounds at a local residential aged care facility (RACF), where she answered questions about the crushability of medicines and the correct administration techniques of eye preparations and inhalers.

A few months later, Ms Berbecaru shadowed the visiting consultant pharmacist who conducted medication reviews at the RACF, helping with patient interviews and sitting in on discussions about drug-related problems with the pharmacist and local GP. 

‘I was intrigued by how well-received the medicine suggestions were by the GP and the beneficial impact the pharmacist had on residents’ overall health,’ she says. 

‘Witnessing first-hand the significant impact pharmacists could have on the well-being of individuals is what sparked an interest for me to pursue a pathway into aged care.’

Finishing her internship, Ms Berbecaru began working at Lindisfarne Amcal Pharmacy in Hobart and gained her accreditation. Since then, she has not only pursued aged care but has been a pioneer – implementing Australia’s first integrated community pharmacy delivered medicine supply and on-site clinical service model at an RACF. The service began in a single RACF in January 2019 and expanded to a second location this year, providing care to approximately 250 residents. 

Although there have been similar models trialled in Australia, most have relied on dedicated grants. Ms Berbecaru’s model, on the other hand, was established in collaboration with the RACFs, which help fund her employment at the Lindisfarne pharmacy. 

Real-time results

From daily ward visits, helping nurses with patient admissions, assisting visiting GPs with rounds, to performing residential medication management reviews (RMMRs), Ms Berbecaru’s duties at the RACFs vary depending on the day.

‘My goal is to promote and elevate the embedded pharmacists in aged care model.’

It’s this variety that she enjoys most. ‘Every day is different and presents different challenges that keep me on my toes,’ she says. ‘I also enjoy the interprofessional collaboration, where everyone works towards improving delivery of care for the residents. 

‘For example, [if I identified] a resident was experiencing pain despite using pain medicines [I would] discuss the pain in further detail with the resident and communicate this to the GP via phone or email. The GP either reviews the resident’s pain during their next visit to the facility or accepts the medicine recommendation [I have] put forward.’ 

She also does 3-monthly psychotropic reviews, which have had a measurable impact. 

The use of antipsychotics at the first RACF to adopt the resident aged care pharmacist is now less than 6% of residents, down from almost 20% when Ms Berbecaru started.

Looking ahead

Ms Berbecaru says being recognised so early in her career is an honour and a reminder that the work she does matters, but that it is a ‘collective win’.

‘I wouldn’t have achieved what I have without the individuals who supported me, taught me and tolerated me … Together we are treading on new territory and illustrating the importance of pharmacists within aged care.’ 

When she isn’t exploring new hiking tracks with friends or increasing her heart rate by skydiving or aquatic parasailing, she hopes to inspire other pharmacists to become involved in aged care.

‘My goal is to promote and elevate the embedded pharmacists in aged care model …  Additionally, [I’d like] to assist with solidifying a sustainable funding model, so that this unique role becomes widely adopted across other residential aged care facilities in Australia.

‘I believe with the right opportunities, guidance and a sustainable funding model in place, embedded residential clinical pharmacists will become the norm. 

‘They will be pivotal members of the care team, promoting safe prescribing, appropriate use and administration of medicines and optimising resident care,’ she believes. 

What change in pharmacy in the past 2 years were you most excited about?

The expanding scope of pharmacists’ practice and recognised need for them within healthcare teams. For example, pharmacists practicing within GP clinics, immunising pharmacists (and their increased vaccination scope) and embedded residential clinical pharmacists has increased public awareness and understanding of pharmacists’ significant impact within care teams and the health system overall.’

What action in PSA’s Pharmacists in 2023 is the most important?

I believe all 11 actions are equally important, but if we draw attention to Action 3, embedding pharmacists within healthcare teams, it will be both a short-term and long-term solution to reduce the burden on Australia’s strained healthcare system. Pharmacists are the ‘cogs’ of the healthcare machine.

The PSA Early Career Pharmacist of the Year Award is proudly sponsored by Symbion.