Aged care pharmacist pilot a winner

New research has explored the benefits of pharmacists joining allied health teams in Australian residential care facilities, with promising results.

Australian Pharmacist spoke with Nicole McDerby from the University of Canberra Faculty of Health, whose research team recently won the National MedicineWise Excellence in Consumer Information award.

By placing a pharmacist within a Canberra residential care facility for two days a week over a six-month period, the team’s pilot program aimed to address inappropriate polypharmacy, the frequency and efficacy of medication reviews, and the pharmacist’s experience working within aged care.

‘To the best of our knowledge our project is the first evaluating the feasibility and outcomes associated with pharmacists working as part of allied health teams in Australian residential aged care homes. It is possible that some pharmacists have worked in this space, but there is no documented evaluation of this role,’ the PhD candidate said.

‘Our project looked at a number of aspects of quality use of medicines including: medication administration safety, nursing time spent on medication administration, appropriate storage of medicines, supporting rational prescribing and de-prescribing unnecessary medicines, formal and informal medication reviews, influenza vaccinations, and policy and procedure development to improve medication safety.’

‘We let the pharmacist develop the role based on the needs of the residents and staff at the site. The role was an expansion of current clinical pharmacist services in aged care; it looked a bit more like the role [that] hospital pharmacists perform, and was completely separate and additional to the supply role of the community pharmacy.’

‘There was good collaboration between the residential care pharmacist and the supply pharmacy throughout the project, which enabled some positive changes to improve process for staff at the home and the residents.’

By working closely with residents, the pharmacist was able to resolve medication issues, provide as-needed follow up for residents with ongoing issues, and evaluate their recommendations.

‘This type of follow-up is not funded for pharmacists providing RMMRs [Residential Medication Management Reviews], which is currently the primary pharmacist review service in Australia. So if follow-up is to occur under this service, the time spent is not remunerated for the pharmacist,’ Ms McDerby said.

The judges described the research as an Australian first, piloting a residential care pharmacist model within the aged care setting.

‘The research highlighted many promising areas for improving quality use of medicines, including improved safety in medication administration in a population at high risk of medication misadventure,’ the judges wrote.

Benefits extended beyond clinical outcomes, with patients enjoying the direct access to the pharmacist during the pilot period.

‘The nursing staff commented that the residents loved having a pharmacist on-site who they could have an informal discussion about their medications with,’ Ms McDerby said.

‘The nurses mentioned that many of the residents enjoyed the ability to discuss medications with their community pharmacist prior to transitioning into residential care, and was something the residents missed given that they were no longer able to readily access their local pharmacist.’

Ms McDerby is also a clinical pharmacist, and is a PhD candidate in pharmacy at the University of Canberra. She will be presenting some preliminary pilot results at the upcoming ConPharm in Brisbane.