Pharma-goss - (Incorporating Indigenous health) -By Rollo Manning
* Adherence support workers may be the answer
* Students still have sense of adventure
* Make up lost dollars in PBS to Aboriginal people in remote
Adherence support workers may be the answer
A new position should be created in the primary health care model for workers in Aboriginal health who can assist people understand the need for adherence to lifestyle and medicine taking behaviour.
This suggestion follows a look at medicine taking among the Aboriginal population across the north of Australia and a realization that many people do not understand that the chronic diseases from which they are suffering are not diseases that can be treated by bush medicines.
The diseases that are now causing the low age at death, as low as 45 years of age in some places, are ones that have been brought on by the effects of the colonisation of Australia and due to poor lifestyle choices.
A position of “Adherence Support Worker” has been developed in Africa towards assisting people suffering from HIV AIDS and could well be the answer in Australia for that section of the population that is marginalized across the north of the continent and with poor literacy levels and English as a second or third language.
Maybe Australia primary health care policy makers should be looking more to practices in Third World countries for an answer to the poor compliance rate among Australia’s Aboriginal population especially those from remote communities.
The Adherence Support Worker training program can be sourced from
Students still have sense of adventure
A recent visit to the Top End of the Northern Territory by 15 pharmacy students from Charles Sturt University in Wagga and Orange highlighted the enthusiasm that still exists in the student population for journeys of adventure.
The opportunity to learn first hand of the problems facing Aboriginal health, especially those living in remote communities, was seized upon and an excellent understanding was gained of the underlying social factors that rule against good health.
In fact in many age groups of younger people they have nothing but a continuing decline in health profile such that poor health becomes normal.
The party visited health centres at Nguiu on Bathurst Island, Barunga and Mataranka as well as a pharmacy in Darwin that supplies remote communities.
The Renal Clinic at Nightcliff in Darwin gave the students an insight into the severe situation that exists with renal failure a major killer of Aboriginal people.
The tour party was lead by Professor Patrick Ball, Professor of Rural and Remote Pharmacy at Charles Sturt University.
Each student had a choice of one of four topics:
- Mental health problems and management in rural and indigenous rural populations
- Compliance/concordance with medication/healthcare instructions in rural and indigenous rural populations
- Kidney Failure and its management in rural and indigenous rural populations
- Substance abuse in rural and indigenous rural communities
During the course of the visit they looked at each subject and made a presentation to the whole group at the conclusion of the tour.
The party also visited Kakadu National Park, Katherine Gorge and the Mataranka Hot Springs. The duration was 10 days and was hailed as a success with Professor Ball starting to look to a similar tour in 2008.
Make up lost dollars in PBS to Aboriginal people in remote
The $1.14 paid to pharmacies supplying PBS items to people in remote communities is $4.30 short of the $5.44 paid for dispensing PBS items to the mainstream population.
While the explanation is simple – there is no recording process or counseling opportunity – the question remains as to why remote living Aboriginal people should be subjected to a second rate PBS system.
Surely they are as entitled to at least a pharmacy service that suits the needs of the health centres where they have primary health care delivered.
It is the view of this column that the $4.30 shortfall should be made available as a block grant to the Aboriginal Medical Services Alliance of the NT to distribute in a way the allows the larger health services to employ their own pharmacists to apply quality use of medicine programs across the client population.
The amount of money would be determined by the number of PBS items supplied in the 2006-07 year multiplied by $4.30. It is estimated this would provide a fund of around $1.5 million. Pharmacists could be responsible for programs delivered on a regional basis – the way health services are being developed in the NT for remote areas.
If official pharmacy through the Pharmacy Guild, PSA and SHPA want to do something to assist with the intervention in the NT then this amount would be a small contribution from the 4th Community Pharmacy Agreement coffers.
There is nothing more important for a child that to have both parents live longer – and at the moment there are too many children deprived of parental support by the early age of death.
That’s all for now
Comments or questions should be directed to Rollo Manning at firstname.lastname@example.org