Include pharmacists in aged-care settings, recommendations say

The Society of Hospital Pharmacists of Australia (SHPA) has welcomed the patient safety measures that have emerged from the later stages of the Royal Commission into Aged Care Quality and Safety.

Aligned with recommendations made by the SHPA, the Counsel Assisting’s Proposed Recommendations at Final Hearing reflect the importance of facilitating hospital pharmacist expertise at crucial points in the care journey for older Australians.

Recommendations include: the inclusion of pharmacists in residential aged-care teams; the embedding of medicines reviews into home care packages; and improving the transition between residential aged care and hospital care.

SHPA Chief Executive Kristin Michaels said the supported presence of a pharmacist in the residential aged-care setting is integral to safe, quality care.

“The crucial role of pharmacy in aged care is undeniable, with Australian research indicating [that] 91% of aged-care residents take at least five regular medicines, and 65% take more than 10, every day.

“The recommendation (18) to engage a pharmacist as part of minimum allied health care, supported by capped base payments per resident and activity-based payments for the direct care provided, is a strong step toward reducing medicines misuse and medication-related hospitalisations and injuries among this vulnerable cohort.

“Importantly, and as advocated by SHPA, the presence of a dedicated Geriatric Medicine Pharmacist will ensure the optimal efficacy of Residential Medication Management Reviews (RMMRs) for aged-care residents, and we welcome the recommendation (70) to allow and fund pharmacists from 1 January 2022 to conduct reviews on entry to residential care, and annually thereafter.”

Michaels also welcomed the recommendations’ focus on transitions of care, a high-risk setting for older Australians.

“Care teams are flying blind if medication histories and medication reconciliations are not conducted and clearly communicated after care transitions, such as upon admission or discharge to hospital, or arriving to residential aged care.

“SHPA welcomes the recommendation (72) that discharge to residential aged care from hospital should only occur once [an] appropriate clinical handover and discharge summary has been provided to, and acknowledged by, the residential care service, and provided to the person being discharged.”

Michaels said SHPA members look forward to the final recommendations and resourcing announcements in 2021.

“Hospital pharmacists are passionate about evidence-based care. SHPA will continue to advocate for investment in clinical pharmacy services for aged-care residents — including 1:200 pharmacist-to-resident ratios — so pharmacists can identify and manage medication-related issues and reduce harm.

“When present in the right place at the right time, pharmacists can identify deprescribing opportunities and foster high-quality clinical handover as patients move between care settings, which is vital for their wellbeing and quality of life.”

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