by clicking the arrows at the side of the page, or by using the toolbar.
by clicking anywhere on the page.
by dragging the page around when zoomed in.
by clicking anywhere on the page when zoomed in.
web sites or send emails by clicking on hyperlinks.
Email this page to a friend
Search this issue
Index - jump to page or section
Archive - view past issues
Australian Journal of Pharmacy : November 2006
medication management in review What is the right pharmacy model to meet future professional challenges? Maximising the skills of our workforce to provide better care for patients, to address our national health priorities and to get more value for our health dollar might be a no-brainer but it is an issue that, until now, pharmacy has been relatively slow to react to. BILL KELLY, CEO of the Australian Association of Consultant Pharmacy, looks at why and how pharmacy should and can meet these challenges with a considered approach to specialisation in healthcare delivery homes (RMMRs) in 1997 heralded two important changes to the practice of pharmacy. It meant, for the first time, recognition of a new professional service and, equally as importantly, the payment for a service independent of supply. The extension of this arrangement to home medicines reviews (HMRs) late in 2001 further cemented the concept of remunerated cognitive services and set in place a process that could ultimately determine how pharmacy is practised in the future. These services were also indicative of the pharmacy profession embracing new or expanded roles specifically addressing patient needs, rather than just meeting their medication supply needs. Given the maturity of the MMR processes and pro- gram (and its acceptance by overseas col- leagues as the gold standard), it is only natural to look to how the concept can be further extended into areas that not only support ever-increasing health needs and national health priorities, but also max- imise the contribution of the profession to the overall health workforce. However, pivotal to this issue is an T understanding of what is pharmacy’s cur- rent model of community pharmacy practice? Surprisingly, it is not something HE introduction of remunerated medication reviews in nursing that is easy to define nor has it been given the attention it deserves. Put simplistically, it has probably just two elements: supplying medications and providing professional services. The real- ity of course is that it is more than that— though just how much more is where it gets interesting. Western Australian pharmacy aca- demic Con Berbatis and his colleagues1 looked at this in their national database survey of Australian community phar- macy, identifying and quantifying the range and frequency of health-related activities or services involved in contem- porary Australian community pharmacy. While not all services could, or should, be provided in all pharmacies, they certainly identified pharmacy’s potential to deliver more primary care services, as well as rec- ommending a wider use of accredited pharmacists in their delivery. Core or specialised services But which of these services should be con- sidered part of a general practice model and which should be considered a more specialised offering? MMRs were set up as specialised professional services—given that they have an accreditation frame- work and attract differential remunera- tion. There’s a reasonable case to argue that this model should be retained and, 36 ? THE AUSTRALIAN JOURNAL OF PHARMACY VOL.87 NOVEMBER 2006 indeed, expanded to other areas. How- ever, other medication review-related services under consideration for introduc- tion as part of Fourth Community Phar- macy Agreement, such as medication profiles,may well be considered to be part of the general community practice model and not be treated like the MMR service. There is, however, no argument against the need for pharmacy to provide addi- tional professional services to meet Aus- tralia’s increasing health needs and health workforce issues. For example, University of South Australia pharmacy academic, Elizabeth Roughhead and colleagues,2 commented that: ‘...there is considerable high quality evidence to support the value of professional pharmacy services in the community setting, including demon- strating improvements in outcomes for patients...consideration must be given as to implementing these services more broadly within the country’s health sys- tem.’ This has been recognised with the range of services models and activities investigated through the Third Commu- nity Pharmacy Agreement research and development program and the subse- quent, though cautious, progression to further pilot studies in the areas of dia- betes and asthma management in the cur- rent Agreement.