..Information to Pharmacists
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    Your Monthly E-Magazine
    APRIL, 2002

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    ROLLO MANNING

    From a Rural/Remote/Isolated and Indigenous Pharmacy Perspective
    Who Pays For Safety?

    Pharmacists need to conduct some basic research to establish the merit of blister packing into Dose Administration Aids if they want to get reimbursed for carrying out the task.
    At a time when the cost of the PBS is under scrutiny, it presents the opportunity to show how it is cost effective, and may be improved, from the point of delivery.
    The answer lies in a differential dispensing fee to reward efficiency and safe practice. Words will not convince anyone…it needs action, and well-researched findings that show the merit in terms of health outcomes.

    The PBS will not reimburse pharmacists for packing Dose Administration Aids (DAA) while the Australian Council for Safety and Quality in Health grapples with the problem of reducing the estimated $350 million the health system is having to pay for hospital admissions due to medicine misadventures.
    70% of Australian pharmacies are packing DAAs from the old dosette box to the market leader in Webster packs. This provides safe administration with a maximum possibility of compliance with the medical practitioner's advice to the patient.
    How could this be?
    The irony of the situation is that while one Government agency (ACSQH) tries to reduce the incidence of poor compliance and reduce spending on hospital admissions, another, the PBS, will not reimburse for a safer system of administering PBS listed and supplied through pharmacy medicines.
    A Symposium in Canberra last month (March) tried to put together the pieces in a jigsaw puzzle involving Government agencies, the Pharma Industry, consumer groups and other parties who are stakeholders to the "Quality Use of Medicines" (QUM) principles.
    There has emerged a web of agencies with an interest in improving the manner in which medicines are supplied to consumers.
    Within the Department of Health and Aging function and spending there are at least nine which have among their responsibilities,
    the ne    ed to consider the Quality Use of Medicines.

    They are…
    QUMEP Quality Use of Medicines Evaluation Program
    PBAC Pharmaceutical Benefits Advisory Committee
    APAC Australian Pharmaceutical Advisory Council
    PHARM Pharmaceutical Health and Rational Use of Medicine

    AMC Third Community Pharmacy Agreement Management Committee
    ACPA Australian Community Pharmacy Authority
    NPS National Prescribing Service
    NICS National Institute of Clinical Studies
    ACSQH Australian Council for Quality and Safety in Health

    The principles of the Australian Council for Safety in Health are best suited for early activity and should provide the basis of a collaboration of the organizations and other parties bound together from a common understanding of the "Quality Use of Medicine".

    The principles of the Council are:

    * supporting those who work in the health care system to practise safely
    * improving data and information for safer care
    * involving consumers in improving health care safety
    * redesigning systems of health care to facilitate a culture of safety, and
    * building awareness and understanding of health care safety.

    This collaboration must happen in the context of the cost of medicines in health care and their contribution to both good health and bad health.
    Two Examples of Poor Quality Medicine
    Supply and a Solution

     

     
    Top: A tablet mess retrieved from a patient.
    Centre: Wasted medication retrieved.
    Bottom: Safe and less wasteful patient
    supply through Websterpacks.

    The Council is undertaking an "Initiative to Improve Medication Safety" to encourage collaborative improvement in medication safety.
    Its aim is to measurably reduce patient harm due to medication error within acute and primary health care services over a twelve-month period.
    The Council on Safety and Quality in Health is hoping this will encourage " the development of innovative responses to common problems that are sometimes too hard for individual organisations to tackle on their own, and allow wider uptake of effective solutions throughout the health care system.
    "Maybe the Pharmaceutical Society iof Australia, representing the professional arm of "pharmacy", and the "Pharmacy Guild" representing the commercial arm, should be involved in this process to put forward a case for payment of DAA materials and time.

    "Official pharmacy" can help, and should, to put forward a case and collect data to be included in a submission to the Council.
    Surely with all the money being spent on administration and conduct of these agencies, a picture can emerge of how the method of administering medicines is as important as the supply function.
    If readers want more information on the "collaborative initiative" they should contact admin@safetyandquality.org.
    QUM has been the theme for activity in pharmacy circles for the past 10 or so years and is an admirable program.
    It must however keep in touch with later developments and funding across the health spectrum.This means re-evaluating the manner of remuneration for SAFE practices and encouraging them more.

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