Clinical guidelines and protocols

Professional practice is guided by a vast array of resources in the form of protocols, clinical and practice guidelines, standards and codes

Australian Pharmacy Law and Practice

Australian Pharmacy Law & Practice addresses the current issues surrounding pharmacy law and regulation in Australia. As the Federal Government moves to implement a national registration and accreditation scheme for pharmacists, the pharmacy workforce is set to become more mobile as a result. There has been no greater time than now for practising pharmacists and students to understand the implications of current legislation and legal provisions underpinning their area of practice. This text provides a comprehensive analysis and discussion of the legislation and practice standards which are relevant to the practice of pharmacy. As well as covering specific pieces of legislation relating to the regulation of pharmacy practice and drug control, Australian Pharmacy Law & Practice includes important sections on legal concepts and the Australian constitution; the evolution of pharmacy practice and ethics; privacy legislation; occupational health and safety; and professional conduct including matters regarding investigation, discipline, and legal proceedings. Australian Pharmacy Law & Practice is the first text of its kind to address pharmacy practice in all its facets in the unique context of the Australian legal framework. It will be a valuable resource to students and overseas trained pharmacists seeking registration in Australia, as well as to qualified practitioners who seek to better understand the laws and standards that govern the profession. * Unique to the Australian marketplace – presently there is no publication dealing specifically with pharmacy law and ethics in this country * Each chapter includes – learning objectives, review questions and activities, and further readings * The inclusion of quotation from case law – provides an opportunity for readers to learn from histor

The impact of dispensing fees on compliance with opioid substitution therapy: a mixed methods study

Background: Opioid substitution therapy (OST) programs involve the dispensing of OST medicines to patients to address their dependence on heroin and/or other opioid substances. OST medicines are subsidised by the Australian government but patients need to pay the dispensing fees. This study explored opinions from OST patients and stakeholders about the potential impact of dispensing fees on compliance and OST program retention. Current and past experiences and the potential impact of OST dispensing fees were evaluated. Methods: Mixed methodology was used to obtain data from OST patients and stakeholders. This involved 1) interviews with OST stakeholders, 2) a focus group of OST patients and 3) surveys of OST patients in Perth, Australia, between June and August 2013.Results: The majority of the eight stakeholders declared cost as the factor mostly impacting on OST compliance. Almost all of the stakeholders commented that there was a positive correlation between time on the OST program and success in terms of relapse. Most stakeholders advocated for OST fees to contribute towards the Pharmaceutical Benefits Scheme Safety Net, and for fee subsidy. Focus group themes supported stakeholder interview findings. A total of 138 surveys were completed. Survey analysis illustrated a strong correlation between patient debt and impacted lifestyle: 82.4% (p < 0.001, Chi-square test) of the 138 survey participants stated that dispensing fees impacted significantly on patients’ finances and lifestyle, specifically those patients with major debt. The cost of dispensing fees was identified by 46.3% (64/138) of survey participants as the biggest impacting factor on patient success. Logistic regression models showed that the cost of dispensing fees was also found to significantly influence both the occurrence of debt (57.7%, p < 0.0001) and lifestyle difficulties (80.0%, p = 0.0004). Conclusion: Findings provided insight into OST patients’ financial difficulties with data suggesting that dispensing fees are likely to have a negative impact on OST patients’ compliance with therapy, retention in the OST program and lifestyle. Government sponsorship of the OST dispensing fees should be considered as sponsorship would potentially increase the retention rates of income-poor OST program recipients

The Mismatch between Australian Population and General Practice Medical Workforce

Aims: To review and analyse Australian general practitioner's workforce data for the 2000 to 2010 period by comparing this to Australian population trends and to make informed recommendations about GP workforce planning. Study Design: Descriptive analysis of the available Australian government data on GP workforce and the Australian population between 2000 and 2010. Place and Duration of Study: Griffith University, Australia, between April and November 2011. Methodology: Australian GP workforce data for the 2000 to 2010 period was obtained from the Australian Department of Health and Ageing (DoHA) website and population data was obtained from the Australian Bureau of Statistics website. A descriptive analysis of workforce trends using variables of interests such as overseas trained GPs, gender, age, professional services during the 11 year period was compared to population trends data. A new GP Workforce Index ratio (GPWIR = No. of GPs <35yrs 砎o. of GPs 35yrs to 64yrs of age) was derived from the data and calculated for each year of the study period. Results: The ratio of female to male GPs has increased by 35% and the percentage of overseas graduates has increased by nearly 35% in the 11 year period, an indication that the 0.12% number of GPs as a percentage of Australian population between 2000 and 2010 was only sustained by increasing the intake of foreign trained graduates. Vocationally registered GPs have increased by 20% in same period. The GP workforce index ratio (GPWIR) decreased from 0.223 in 2000 to 0.118 in 2007; this was followed by a slight increase from 0.120 in 2008 to 0.128 in 2010. Conclusion: The impact that an increase in the number of female GPs graduating from medical schools may have on the overall number of GP services available to the Australian population requires further study, since it was noted in the literature that female GPs are more likely to work part-time than male GPs. The GPWIR may be a useful indicator for evaluating the proportion of the <35yrs old GPs as a proportion of overall GP workforce. Lower GPWIR may be associated with GP workforce shortage. GPWIR increased in the last 3 years of the study corresponding with an improvement in GP supply. In this study, the GPWIR proved to be more effective in predicting overall National GP workforce shortage trend than the DoHA GP per Population ratio of 0.71:1000 (Primarily used for regional and rural workforce shortage prediction). The Department of Health and Ageing may need to keep supporting rural and remote migration of GPs and also maintain an increase in the number of students entering medical schools.Griffith Health, School of Nursing and MidwiferyFull Tex

Exploring an increased role for Australian community pharmacy in mental health professional service delivery: evaluation of the literature

Background: Australian general practitioners primarily treat mental health problems by prescribing medication dispensed by community pharmacists. Pharmacists therefore have regular interactions with mental health consumers and carers.Aims: This narrative review explored the potential role of community pharmacy in mental health services.Method: Medline, CINAHL, ProQuest, Emerald, PsycINFO, Science Direct, PubMed, Web of Knowledge and IPA were utilised. The Cochrane Library as well as grey literature and “lay” search engines such as GoogleScholar were also searched.Results: Four systematic reviews and ten community pharmacy randomised controlled trials were identified. Various relevant reviews outlining the impact of community pharmacy based disease state or medicines management services were also identified.Conclusion: International studies involving professional service interventions for mental health consumers could be contextualised for the Australian setting. Australian studies of pharmacy professional services for chronic physical health conditions provided further guidance for the expansion of community pharmacy mental health professional services

Responses of pharmacy students to hypothetical refusal of emergency hormonal contraception

Objectives: To explore pharmacy students' ethical behaviour and care towards patients in relation to the provision of emergency hormonal contraception (EHC). Methods: Three hundred and forty-seven pharmacy students were presented a hypothetical scenario involving refusal of EHC, based on religious or moral grounds, and asked to write responses as to how the patient should be managed; 270 (77.8%) responded. Key findings: Of all respondents, 90.4% referred the patient to another health professional to facilitate continuity of care, with referrals increasing as students progressed through the programme. Religion had no influence on referral, while female gender was related to increased referral. Conclusions: Gender difference, if continued into practice, has the potential to negatively impact on patient care

Evaluation of the first pharmacist administered immunisations in Western Australia: a mixed methods study

Objectives This study evaluated the uptake of Western Australian (WA) pharmacist vaccination services, the profiles of consumers being vaccinated and the facilitators and challenges experienced by pharmacy staff in the preparation, implementation and delivery of services. Design Mixed-methods methodology with both quantitative and qualitative data through surveys, pharmacy computer records and immuniser pharmacist interviews. Setting Community pharmacies in WA that provided pharmacist vaccination services between March and October 2015. Participants Immuniser pharmacists from 86 pharmacies completed baseline surveys and 78 completed exit surveys; computer records from 57 pharmacies; 25 immuniser pharmacists were interviewed. Main outcome measures Pharmacy and immuniser pharmacist profiles; pharmacist vaccination services provided and consumer profiles who accessed services. Results 15,621 influenza vaccinations were administered by immuniser pharmacists at 76 WA community pharmacies between March and October 2015. There were no major adverse events, and <1% of consumers experienced minor events which were appropriately managed. Between 12% and 17% of consumers were eligible to receive free influenza vaccinations under the National Immunisation Program but chose to have it at a pharmacy. A high percentage of vaccinations was delivered in rural and regional areas indicating that provision of pharmacist vaccination services facilitated access for rural and remote consumers. Immuniser pharmacists reported feeling confident in providing vaccination services and were of the opinion that services should be expanded to other vaccinations. Pharmacists also reported significant professional satisfaction in providing the service. All participating pharmacies intended to continue providing influenza vaccinations in 2016. Conclusions This initial evaluation of WA pharmacist vaccination services showed that vaccine delivery was safe. Convenience and accessibility were important aspects in usage of services. There is scope to expand pharmacist vaccination services to other vaccines and younger children; however, government funding to pharmacists needs to be considered

Preparing community pharmacists for a role in mental health: An evaluation of accredited Australian pharmacy programs

Background: Australian community pharmacists are well placed to provide medication-related support and contribute to optimization of outcomes for mental health consumers and their caregivers. However, little is known about the actual competencies of community pharmacists to provide this care. To determine how graduates are being prepared to competently assist mental health consumers and their caregivers, an exploration of the mental health content of university pharmacy programs that set the foundation for pharmacists' professional roles is needed. Aim: To investigate the mental health content of accredited Australian pharmacy qualifying programs. Method: A review of publically available online profile information for accredited degree programs was conducted, and program coordinators from the 18 accredited pharmacy degree programs providers in Australia were surveyed. Results: Mental health education is embedded in core subjects such as pharmacology, pharmacotherapy, and pharmacy practice. Multiple options are employed to deliver mental health teaching, including lectures, workshops, and experiential learning. However, while education is intended to align with pharmacists' expected level of professional competencies, there is a lack of national standardized outcome-based competency criteria for new graduates and wide-ranging inter-program variations were evident. Conclusion: A lack of standardized content in pharmacy qualifying programs that underpin pharmacists' mental health knowledge and skills might result in variations to practice competencies. Further work is needed to determine how variations impact the way pharmacists deliver care to mental health consumers and their caregivers