Older Australians can receive home or residential aged care; pharmacists' roles and availability in these spaces vary. Regardless of where they work, pharmacists may take on broader roles and responsibilities as multidisciplinary palliative care team members than simply managing medications.
The Pharmacist may liaise with the interprofessional care team to promote best outcomes. Pharmacists who work with older adults receiving palliative care at the end of life may contribute in numerous ways during end of life.
Pharmacist role in the home setting
Various Commonwealth-funded activities available to ensure a pharmacist can review people in their home environment. While these are general measures aimed at improving the medication management of all Australians, they are instrumental in considering the medication needs of someone with palliative needs.
Critically, these also offer an opportunity for the caregiver to understand more about the medications of the person for whom they are caring.
For older Australians with palliative needs living in their home dwelling:
- The MedsCheck service involves an in-Pharmacy one-on-one discussion and medication review provided by a pharmacist.
- These services address concerns or questions a person has about their medicines.
- Importantly, anyone can arrange a MedsCheck if concerned about the person's medications, including themselves.
Home Medication Review (HMR)
- The HMR Program intends to support the quality use of medicines and assist in minimising adverse medicine events by helping people to better understand and manage their medications.
- The HMR must be requested by the person's usual GP and accredited pharmacists must perform the review.
- There are provisions for other medical officers to initiate an HMR (e.g. hospital doctor), which is particularly useful when the hospital admission results in significant changes to the person's medications.
Pharmacist role in residential aged care
The funding models for pharmacists employment in residential aged care settings is evolving. The federal government have recently pledged $350 million to fund community pharmacists to work on-site in residential aged care homes in a clinical role, and have called for the Australian Pharmacy Council (APC) to help develop accreditation standards to provide quality assurance oversight of these roles. You can find more information in the How this will work section of the Department of Health and Aged Care website.
The current referral-based system for clinical reviews through the residential medication management reviews (RMMRs) funding mechanisms remain.
Residential Medication management review (RMMR).
- The RMMR Program intends to support the quality use of medicines and assist in minimising adverse medicine events for people living in approved Australian Government-funded Aged Care Facilities.
- The RMMR must be requested by the person's usual GP and conducted by accredited pharmacists.
- There are provisions for other medical officers to initiate an RMMR (e.g. hospital doctor), which is particularly useful when the hospital admission results in significant changes to the person's medications.
Quality use of Medicines
- Supports the delivery of services and activities by pharmacists to support the quality use of medicines within Australian Government-funded Aged Care Facilities.
While some groups do not consider pharmacists as 'allied health', their unique skillset and knowledge overlap with other allied health professionals' practices. For example, advice offered by allied health professionals may impact medication administration and management. Indeed, other allied health professionals will notice these issues, including physical or cognitive decline and dysphagia and can flag the pharmacist's involvement.