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Super clinics - Increasing Access to Medication Reviews

Stephen Carbonara
From an Independent Professional Pharmacist Perspective

Issue 65: October 2007
Page: 1 of 1 Author's Profile | Send to a Friend | Printer Version

I’m all for increasing public access to medicines. This is why I would support federal Labor’s idea of introducing ‘GP super clinics’.
As an extra idea to this proposal of a ‘one stop shop’, how about a new service be implemented?
Currently we have HMRs and RMMRs to service the medication review needs of society, but the uptake in these services (especially HMRs) has to date been quite slow.
Why is this the case?
Could it be that the current system is unattractive to those providing the service?
Is it because, in the case of HMRs; one can only receive full remunerated benefit if you happen to own a section-90 approved pharmacy business?
Does this therefore mean that the current scheme is essentially only aimed at roughly 35% of pharmacists in Australia?

If HMRs are to remain the guarded property of pharmacy owners, then we should seek to introduce a new service whereby medication reviews can be conducted in the ‘clinic’ or doctor’s surgery.
Basically, a clinical practitioner pharmacist would conduct a medication review interview with the patient in the clinic and would refer any findings and recommendations immediately to the GP with whom the patient is due to see at the same visit. Possible benefits are:

  • All necessary healthcare management steps are performed in the one place at the one time without referral ‘lag time’.
  • A specific medication review accredited, specialist pharmacist conducts the reviews instead of an ‘allocated’ accredited pharmacist depending on the pharmacy of referral.
    More reviews per pharmacist can be performed than can under the HMR system where pharmacists have to travel between patients.
  • Doctors’ and patients’ are able to decide exactly which accredited pharmacist performs their review, as referrals could be made to any accredited pharmacist at any clinic.
  • Patients eligible for reviews would be ‘invited’ to participate based on eligibility criteria rather than necessarily ‘referred’.
  • Access to patient history and records is enhanced as is efficiency of professional collaboration.
  • Treatment decisions are able to be made collaboratively and more rapidly.
  • Clinical equipment and instrumentation is available to be utilised at the time of the patient interview.
  • The referral system is streamlined and therefore becomes more efficient.
  • All accredited pharmacists will be eligible to provide the service, not just pharmacy owners.
  • The time a patient spends in the waiting room could instead be spent in a medication review interview.
  • Patients may not have to make an extra appointment on a separate day.

As a few more points, the remuneration for this service should be at the same rate as current HMRs, and there should be no limits imposed on the number of reviews each patient can have. A ‘capped’ system in this regard could lead to enforced service denial, and a resultant diminished level of care.

If we are serious about having people’s medicines reviewed for the benefit of patient health, then we need to INCREASE the number of reviews performed by making it more AVAILABLE to not only patients, but also the practitioners providing the service.
As a final question, could we allow pharmacists in these roles to participate in the ‘patient medication profiling’ scheme or the ‘diabetes medication assistance scheme’?

I’m sure this is capable of occurring.

Stephen Carbonara.


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