The over-use of chemical restraints was a major issue at last year’s Royal Commission hearings into residential care. Experts gave evidence that despite requirements that antipsychotics be reviewed every three months, two-thirds of aged care residents are still taking the same medication at the same dose year to year – now the Government is taking action.
Health Minister Greg Hunt has revealed the Government, the Pharmacy Guild of Australia – and for the first time the Pharmaceutical Society of Australia – have signed off on the 7th Community Pharmacy Agreement which will include $25.5 million in funding to improve medication management programs in both residential care and home care.
The Agreement – which will commence on 1 July 2020 – two weeks from now – and be in place until 30 June 2025 – provides funding for Residential Medication Management Reviews (RMMRs) for aged care residents.
These reviews – usually conducted when a person enters care by their GP in partnership with a pharmacist – are designed to prevent medication-related harm but are not mandatory; so a person could go months or even years without another review.
A Department of Health spokesperson tells us the Agreement will also provide more funding for the Home Medicines Review (HMR) program – which provide medicine reviews by a pharmacist in a person’s home – and the Quality Use of Medicines (QUM) program – which funds pharmacists to promote the safe and effective use of medicines in aged care homes, such as targeted education for staff on drugs used for chemical restraint (how will a pharmacist do this and how will they be accountable? How will the pharmacist do this over three staff shifts and be accountable?)
It seems like good news – but it comes with a catch.
Providers already have issues with trying to arrange for GPs to visit residents – how many will have the time available to work with facilities on RMMRs?
Pharmacists will also have to review medications on a regular basis with the GP – ideally every six months given the turnover in the resident cohort.
If you have 100 residents – each with their own set of medications – that would take at least 10 to 15 minutes of consultation between the GP and the pharmacist.
Times that by 100 and that is half a week’s work (20 to 25 hours) that needs to be completed twice a year at least.
The question is: is the aged care provider a big enough customer and the Government funding enough for the pharmacist to set aside the time?
Home care clients should theoretically be seeing their GP on a regular basis so that may be easier to manage.
And there will be additional paperwork and clinical work for managers and staff on the ground.
The Department’s spokesperson said the Government anticipates full details of the Agreement will be made publicly available in the coming days.
Watch this space then.
