Experts propose new pharmacist role in care transitions
A new report by the Society of Hospital Pharmacists of Australia (SHPA) has highlighted the barriers and enablers to the implementation of hospital-initiated post-discharge medication reviews in Australia.
The report, published in SHPA’s flagship Journal of Pharmacy Practice and Research (JPPR), identified barriers in both hospital and primary care, including time pressures, limited resources, low awareness of available review programs and updated rules.
Enablers included facilitation of hospital initiated medication reviews (HIMRs) via GP referral pathways, educational visiting and onsite GP and aged care pharmacist roles.
Currently, the Home Medicines Review (HMR) and Residential Medication Management Review (RMMR) programs exist in the Seventh Community Pharmacy Agreement (7CPA).
The report authors propose trial funding of Transition of Care Stewardship (ToCS) pharmacists in hospitals as a key driver of increased access to timely HIMRs, with additional funding forecast to build capacity of primary care pharmacists and maximise their role in improving medication safety of high-risk patients at care transitions.
“The role of a ToCS pharmacist working collaboratively with hospital doctors and GPs could ensure a safe discharge as bed pressures increase.
“Our vision is that a ToCS pharmacist will facilitate HIMRs and a ‘warm handover’ of the medication-related information for at-risk patients transitioning from hospital to either home or residential aged care (including respite care),” an SHPA representative said.
The report follows SHPA’s 2020 release of a framework to support the identification and referral by hospital-based clinicians of high-risk patients, after successful advocacy resulted in changes to the 7CPA program rules to broaden the referral base to include specialist medical practitioners.
SHPA President Tom Simpson said the practice update and subsequent expert report is emblematic of the organisation’s core focus on advancing expert, specialised pharmacist care that places the patient at the centre of collaborative care teams.
“SHPA looks forward to working with partners in government, pharmacy and primary care to improve medication safety outcomes for aged care patients after they have been admitted to hospital.
“In particular, we look forward to ensuring implementation of hospital-initiated medication review (HIMR) pathways, and that ToCS pharmacists have appropriate and seamless touchpoints with the upcoming onsite Aged Care pharmacist program, so that we can fully realise wraparound, patient-centred care.”
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