Friday 9 November 2018
1. New opioid data drives urgency for national action
The release of new data showing growing incidence of opioid-related harm and misuse in Australia significantly adds to the building impetus for collaborative and effective nationwide action the Society of Hospital Pharmacists of Australia (SHPA) said today.
Released this morning by the Australian Institute of Health and Welfare (AIHW) in collaboration with Canadian Institute for Health Information (CIHI), the Opioid harm in Australia and comparisons between Australia and Canada report reveals deaths involving opioids have nearly doubled in the last ten years in Australia, while 3.1 million Australians had one or more prescriptions dispensed for opioids in 2016-17.
SHPA Chief Executive Kristin Michaels says opioid prescription to manage acute pain following surgery in a public hospital is a key trigger for potential misuse.
‘This report adds to a growing body of international evidence that shows the rise in opioid-related harm in comparable healthcare systems, and the need for urgent action.
This growth has been driven by a range of factors including unrealistic expectations of pain management, over prescribing and lack of evidencebased educational programs for health professionals.
‘Feeding into this environment, it is increasingly recognised that opioid use after treatment in hospital is an important factor, and therefore hospital pharmacists and their healthcare colleagues can play a key role in mitigating the risk of future opioid misuse and dependence.’
Ms Michaels says the data in the report cannot be ignored.
‘In 2016-17 there were 4,232 Emergency Department presentations, or 11.6 per day, for opioid poisoning and 9,636 hospitalisations, or 26 per day, with opioid poisoning as any diagnosis.
‘As medicines experts working in multidisciplinary medical teams that treat people who are the most acutely sick or experiencing the most severe pain, SHPA members understand the reality behind these alarming figures and we will continue to work to influence policy change both with them and on their behalf.’
Ms Michaels says SHPA welcomes the report’s focus on the risk of misuse of pharmaceutical opioids, which comes four months after SHPA’s inaugural Medicines Leadership Forum focused on minimising opioid harm.
‘With more than 2.2 million surgeries undertaken in 2016-2017, the area of post-operative care is a key target for reducing risks of premature mortality and long-term harm related to opioid misuse among Australians of all ages.
Thursday 1 November 2018
2. Pharmacists shine as first Advancing Practice credentials awarded
Across the country members of the Society of Hospital Pharmacists of Australia (SHPA) are among the first cohort of pharmacists to be credentialed as part of the Advancing Practice program, which provides independent recognition of professional impact and achievement in Australian pharmacy.
Of the 34 pharmacists credentialed in Round 1 of the program, 31 hold SHPA membership; SHPA Chief Executive Kristin Michaels congratulated this ‘first class’ of participants for embracing the leading program.
‘With an ageing population and more people using more medicines than ever before, it is essential Australia supports a more highly skilled, flexible and adaptable future pharmacy workforce.
‘Advancing Practice is a cornerstone of this effort, and SHPA is proud to lead investment in this crucial national program that objectively measures practitioners’ influence and impact on pharmacy practice to guide their ongoing development.
‘A warm congratulations to all SHPA members, and all pharmacists, who were credentialed in Round 1 – your achievement not only shows great commitment to self-development, but also dedication to innovative medicines management and patient care.’
Following portfolio evaluation, Advancing Practice credentials are awarded at three levels: Stage I Advancing Practice (conferring postnominals AdvPP[I]), Stage II Advancing Practice (AdvPP[II]) or Advanced Practice Pharmacist (Adv. Prac. Pharm.)
Paul Firman, Chair of the SHPA Queensland Branch says his Advancing Practice credentialing marks more than just the end of his portfolio-building journey.
‘When I opened my portfolio report yesterday the four months of gathering and presenting evidence felt immediately worthwhile – it is a very special opportunity to be able to have your career contributions expertly and objectively evaluated. ‘For me, the key word is “advancing” – the great benefit of gaining considered and textured feedback on every aspect of my portfolio is I now have a much clearer idea of what I want to improve, and where I want to go, than I’ve ever had before.’
Ms Michaels says Advancing Practice signals to the Australian community that the profession is practising at a high level.
‘With Round 2 evaluations underway, and Round 3 applications closed, it is exciting to see pharmacists everywhere embracing Advancing Practice as a robust and independent recognition process
Tuesday 23 October 2018
3. JPPR doubles down on deprescribing
The concept of deprescribing is front and centre in the October issue of the Journal of Pharmacy Practice and Research (JPPR) which, through a number of perspectives, supports the mitigation of subtherapeutic or potentially harmful polypharmacy as integral to all pharmacy practice.
SHPA Chief Executive Kristin Michaels says deprescribing focus in the flagship journal of the Society of Hospital Pharmacists of Australia (SHPA) is a timely loop back to the origins of the now-common term.
‘We believe the first published use of the phrase “deprescribing” was in the pages of JPPR, so it is fitting we see new discussions and perspectives on this crucial aspect of medicines management again in SHPA’s flagship journal.
‘Deprescribing is a concept championed by all pharmacists and one strongly backed by SHPA, evident in each of our five Choosing Widely recommendations around ceasing or limiting administration of primary preventative medicines, antibiotics, antipsychotic medicines, NSAIDs and sub-therapeutic doses of codeine, depending on particular prevailing circumstances.’
In his editorial JPPR Editor-in-Chief Dr Chris Alderman questions why ‘the deprescribing movement, however meritorious, is unfortunately still struggling to find widespread traction, a notion that is difficult to grasp in a context of evidence-based medicine.’
Cognisant of the importance that deprescribing needs to be considered at all points in the care continuum, Dr Alderman points to carefully considered financial incentives as enablers of the time and effort needed to accommodate the finer points of good prescribing and medicines optimisation: ‘Given that money seems to be partially at the heart of the problem, could it also form part of the solution?’
At a time when the care of older Australians has risen to the forefront of national consciousness, October JPPR issue also sees ten recommendations for systems-level improvements in the quality use of medications for older people. The authors from New South Wales, Victoria and Western Australia emphasised the need for consumercentred care and the communication of medicines information, both to consumers and between health professionals, following a National Stakeholders’ Meeting on Quality use of Medicines to Optimise Ageing in Older Australians held in 2015.
Delivering on a proposal from the 2015 meeting, the article also reveals a complex ‘systems map’, ‘to better understand the complex pathways older Australians take through healthcare systems’, to support the recommendations. October JPPR is out now; free to SHPA members
Thursday 18 October 2018
4. SHPA Queensland Branch welcomes pharmacy policy support
Advocacy of the SHPA Queensland (Qld) Branch has contributed to parliamentary committee support for new policies enabling the state’s pharmacists to practice to their fullest scope and deliver higher quality pharmacy care in the state.
Policy positions of the SHPA Qld Branch supported this week by the Queensland Parliament’s Health, Communities, Disability Services and Domestic and Family Violence Prevention Committee included extending prescribing rights to Queensland pharmacists and the establishment of a pharmacy advisory council in Queensland to improve delivery of pharmacy care. In its report released on Tuesday, the parliamentary committee recommends pharmacists be allowed to perform low-risk prescribing, noting ‘any change in scope of practice utilisation should be underpinned by appropriate credentialing and training for the services being delivered’.
SHPA Chief Executive Kristin Michaels says the consensus is timely acknowledgment of pharmacists’ valuable medicines expertise.
‘In-step with our Queensland Branch and 5,000 members nationwide, SHPA welcomes the recognition that pharmacists represent an under-utilised pillar in Australian healthcare, uniquely positioned to contribute to high quality care within their practice scope.
‘It is with this optimising of practice in mind that SHPA continues to implement and support rigorous frameworks against which pharmacists can evaluate and improve their practice, such as the Residency Program, the Clinical Competency Assessment Tool (ClinCAT), Medication Management Review (MMR) accreditation, Board Certified Geriatric Pharmacist (BCGP) credential and the Advancing Practice program.’
Ms Michaels says the parliamentary committee support for the establishment of a Pharmacy Advisory Council in Queensland is strongly in the interests of optimal patient care.
‘Our Qld Branch supports a Pharmacy Advisory Council in Queensland as we believe it will facilitate higher quality of pharmacy care to the community, while complementing services delivered by hospital pharmacy.
‘It is great to see this position backed by other pharmacy organisations through this consultation and we welcome this recommendation in this report.’
The report also supports the review of pharmacy assistant (technician) training, an initiative strongly backed by the SHPA Qld Branch and SHPA nationally
Friday 12 October 2018
5. More than conversations: Pharmacists get to the heart of patient-centred care
Pharmacists and their multidisciplinary colleagues explore the contemporary meaning of patient-centred care in relation to digital health records, end-of-life care and mental health peer work among the contrasting perspectives in the latest issue of Pharmacy Growth, Research, Innovation and Training (GRIT).
The Spring issue of the Society of Hospital Pharmacists of Australia (SHPA)’s member-only magazine sees contributors from across the country dig beneath the buzzwords to unearth how truly patient-centred care is shaping patient outcomes, professional practice and Australia’s healthcare system.
SHPA Chief Executive Kristin Michaels says while the concept itself can be hard to pin down, patient-centred care is regarded as a hallmark of progressive and human health systems.
‘With the notion of patient-centred or led care significantly shaping the new edition of the National Safety and Quality Health Service Standards, which come into effect from 2019, it’s imperative that healthcare professionals question how this ideal manifests in their practice.’
Kicking off the conversation, James Grant, Chair of SHPA’s Electronic Medicines Management Leadership Committee gives his take on whether moving to an ‘opt-out’ My Health Record is a leap toward patient-centred care, or a step into a digital minefield.
‘Your average patient is not health trained or exceedingly health literate, and a complete and accurate medical history is the cornerstone of appropriately treating and supporting patients through illness and maintaining good health,’ says James.
In an eye-opening feature authored by Joanne Davis, End of Life Clinical Nurse Consultant and Kerry Watts, Clinical Pharmacy and GRIT Editorial Board Chair we learn how Advance Care Directives are giving individuals, families and healthcare professionals an opportunity to ensure patients come first as they approach end-of-life.
Taking us on a personal journey from patient to peer-worker, we hear how Melissa Asta – one of the first generation of professionals qualified with a Certificate IV in Mental Health Peer Work – is bridging the divide between clients and clinicians in achieving patient-led recovery.
‘When you say, “I’m the peer worker” and explain that I have my own experience of mental illness – that I was a client at this very facility, in fact – nine times out of ten, the person’s demeanour totally changes.
“You’re one of us,” they say.’
From culturally-appropriate care, to the role of research, and the evolution of innovative pharmacy assistant roles, patient-centred care is interrogated from all angles in the latest Pharmacy GRIT – available free to all SHPA members.
Tuesday 2 October 2018
6. Hospital pharmacy essential to patient safety and high-quality care in hospitals
Patient-centred quality care that ensures the safe and effective use of medicines should be the primary consideration in establishing and maintaining Australia’s hospital pharmacy departments, the Society of Hospital Pharmacists of Australia (SHPA) has affirmed today.
The reiteration of this core principle in the provision of clinical pharmacy services comes as discussions continue between ACT Health and hospital pharmacists in the ACT, represented by Professionals Australia, regarding pharmacist-to-patient ratios across the territory’s three hospitals.
Chief Executive Kristin Michaels says SHPA’s key Standard of Practice stipulates 30 as the maximum number of patients per hospital pharmacist.
‘Hospital pharmacists strive to uphold the National Medicines Policy through their daily work, of which the Quality Use of Medicines is a central objective.
‘To provide safe and quality care, inpatients require medication reconciliation on admission, daily medication chart review and medication counselling on discharge, however, these are unattainable in facilities where pharmacists are not adequately supported.
‘Hospital pharmacists are acutely aware they play an important role in enabling their facilities to meet the Medication Safety standard of the National Safety and Quality Health Service (NSQHS) and reducing hospital acquired complications, both key areas of concern for funding and accreditation.’
Ms Michaels says hospital pharmacists bring unique expertise to multidisciplinary medical teams across Australia.
‘On behalf of our members, who play a key role in patient safety and ensuring high quality care, we will continue to advocate for all health professionals in hospital pharmacy and the importance of fostering clinical environments that minimise any risk of clinical error or sub-optimal patient services.’