National Medicines Symposium 2024 speakers (L to R): Steve Waller, Professor Jennifer Martin, Professor Libby Roughead, Tegan Taylor[/caption]
This CPD activity is sponsored by Reckitt. All content is the true, accurate and independent opinion of the speakers and the views expressed are entirely their own.[/caption]
Most pharmacists are probably unfamiliar with – or entirely unaware of – HealthPathways. But with local information on hundreds of conditions, it’s essential reading for all primary care roles, including community pharmacists.
Operating for the past 15 years, HealthPathways is a boon for primary care clinicians. They use it as an aid to assessment, management and referral decisions for more than 550 conditions and diseases.1
Every one of Australia’s 31 Primary Health Networks (PHNs) has its own pathways tailored to its region, including local contacts and referral pathways for patient care.
Treatment guidelines for long COVID, for example, might include information on where to refer a patient for specialised care or allied health follow-up.
General practitioners (GPs) often use HealthPathways during consultations to remind them of best-practice approaches and to find information on specialist services and assistance available to patients. The pathways also contain resources that can be printed off for patients to take away with them.
‘Each pathway includes links to the most current information for patients and clinicians, as well as further education for those who would like to know more,’ says Richard Nankervis, CEO of the Hunter New England and Central Coast PHN.
‘Health Pathways also features resource pages on a range of topics, including medication information that pharmacists would find particularly useful. Because the content is developed at a local level by individual HealthPathways teams, in collaboration with local general practitioners, specialists and allied health professionals, the pathways are unique in providing evidence-informed guidance that reflects local reality, reduces unwarranted variation and can be agile and responsive to the current landscape.’
New pathways are constantly under development, and existing pathways are regularly reviewed to incorporate changing evidence, technology and local circumstances, Mr Nankervis adds.
As a clinical editor at Primary Health Tasmania, Angus Thompson MPS helps ensure the medicines information provided on the PHN’s pathways is accurate. He says the main benefit is that they are a ‘one-stop shop’ for information.
‘HealthPathways is designed to help primary care clinicians in their management of patients. We are mainly talking about GPs, but it also includes pharmacists, nurse practitioners and other allied health professionals. It helps them navigate the local health system and ensure their patient can access the services they need,’ he says.
‘HealthPathways brings all the information together in one place. While the background on the condition and best practice for management is going to be the same whether you’re in a PHN in Melbourne or Tasmania, the services and the referral pathways will be different.’
As well as providing information on different medical conditions, some PHNs have HealthPathways that provide links to directories of local providers including pharmacists. Being aware of these links and ensuring they are listed in any such directories can help pharmacists promote their services.
GP pharmacists also report finding HealthPathways incredibly useful during patient consultations.
Top tips for HealthPathways
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Case 1
Bente Hart MPS (she/her) Consultant clinical pharmacist Braidwood, New South wales
My awareness of HealthPathways has grown after becoming involved in PSA’s Palliative Care Access to Core Medicines project. This aims to support palliative care in the community by improving access to vital medicines at the end of life.
As part of the project, we spoke with community pharmacists about receiving training in palliative care and agreeing to stock a core medicines list. The pharmacies that stocked the medicines have been listed on the palliative care pathway, so GPs would know where they could direct patients. Often these medicines are needed quickly. Having a list saves families visiting multiple places – helping them get access to medicines when they need it.
If community pharmacies stock items like palliative care medicines or MS-2 Step, it would be really beneficial they talk to their local PHN about getting listed.
HealthPathways is where many GPs go for a single source of truth, and if a pharmacy isn’t there, they might not even know the pharmacy exists. Credentialled pharmacists should also get in touch with their PHN to get their services listed.
HealthPathways is often geared towards GPs finding services for their patients, but it’s important that pharmacists know about it, too.
I’ve found that GP pharmacists tend to know more (see opposite), but many community pharmacists aren’t really familiar with it, even though it’s a great source of information for everyone.
Case 2
Brownen Wright MPS (she/her) GP pharmacist/accredited pharmacist Perth, Western Australia
I welcome Janine* into my consultation room at the practice. She is a 46-year-old woman with a recent diagnosis of non- alcoholic fatty liver disease (NAFLD), and elevated levels of alanine transaminases and gamma-glutamyl transpeptidase noted. The GP suspects medicines might be playing a role in this elevation too.
To assist with the consultation, I bring up the Liver Conditions pathway on HealthPathways, such a time-saving tool with localised health information. As I scroll through the pathway, I am reminded of medicines that I should consider,1 which include, but are not limited to, statins, anticonvulsants, antibiotics (flucloxacillin, erythromycin or amoxicillin + clavulanate), and complementary medicines,1-3 such as black cohosh, Chinese herbal medicines and green tea extract. I also consult my other clinical references for more information. As Janine and I get chatting, I discover she has been taking a regular supplement (black cohosh) for some time, as recommended by a friend for menopause symptoms. We discuss the risks versus benefits, including evidence that its use is limited and may be hepatotoxic.3-4
Janine makes an informed decision to stop taking the supplement and agrees to trial a prescription medicine, including using a green prescription (also known as community exercise programs) to assist with symptoms. I book her in for further discussion with her GP.
She also agrees for me to organise a referral for a comprehensive Home Medicines Review with a local independent accredited pharmacist known to the practice.
Knowing that a new diagnosis can be overwhelming, Janine agrees she would like some printed information to review at home. The ‘Information – For Patients’ section of the HealthPathways provides me with the perfect patient-friendly printout on NAFLD and how to understand liver function testing.
Janine leaves saying she likes having a general practice pharmacist as an extra person added to her circle of care.
*Some details have been changed for privacy reasons.
References
- HealthPathways Community. What is HealthPathways? At: healthpathwayscommunity.org/About
- Smith E, Desmond P. Prescribing in patients with abnormal liver function tests. Australian Family Physician 2013;42(2):30–3. At: racgp.org.au/download/Documents/AFP/2013/January/February/201301smith_emily.pdf
- Natural Medicines Research Collaboration. 2022. Black cohosh. At: https://naturalmedicines.therapeuticresearch.com/
- Australasian Menopause Society. 2018. Alternative therapies. At: menopause.org.au/hp/management/alternative-therapies
