Abstract
Australia's indigenous population has significantly poorer health outcomes than the rest of the Australian population. Continuity in medication management, an important step in achieving better health outcomes, requires a number of steps to be accomplished.1 Clinical pharmacy services such as the provision of medicines information, clinical interventions and medication reviews have been shown to improve the quality use of medicines; yet little is known about the current provision of clinical services to people served by Aboriginal medical services, or about the barriers and facilitators experienced by pharmacists in providing clinical pharmacy services to indigenous Australians. This project was part of a larger research project exploring issues around the provision of Home Medicines Reviews (HMRs) and other clinical pharmacy services for Aboriginal and Torres Strait Islander Australians. In this aspect of the research, we focused on barriers and facilitators from the pharmacists’ perspective. The aim of this project was to explore how clinical pharmacy services are provided to the people served by Aboriginal medical services, and to identify barriers and facilitators relevant for the improvement in provision of these services from the pharmacists’ perspective. Pharmacists across Australia accredited to undertake HMRs, as well as pharmacists working in Aboriginal and Torres Strait Islander health, were sent an email invitation to participate in the study. The email contained a link to an online survey consisting of both open- and close-ended questions. Data were extracted from the online survey tool and analysed. A total of 187 pharmacists participated in the study; however only 88 respondents were currently working with indigenous clients, reflecting the small number of pharmacists currently engaged in providing indigenous pharmacy services. More than half of all respondents indicated that they worked within 30 km of an Aboriginal Health Service (AHS), however most (72.6%) had not visited an AHS in the last 12 months. For those that had visited an AHS in the last 12 months, the main purpose was supply of medication, rather than clinical services. The greatest barriers identified to working with an AHS were lack of a relationship with the AHS (57.9%) and lack of financial viability for delivery of clinical services (61.6%). The majority of respondents (90.8%) perceived involvement of Aboriginal Health Workers or AHW nursing staff in HMRs as a facilitator in the provision of clinical pharmacy services. Most respondents reported that increased clinical pharmacy services and HMRs could improve both understanding of illness and understanding regarding medicines among indigenous communities. This study showed that while pharmacists support the provision of clinical pharmacy services and HMRs for Aboriginal communities, they currently provide very limited clinical services to this population. Pathways and mechanisms to facilitate relationship building between pharmacists and AHSs and communities, as well as viable funding strategies, are needed to facilitate the provision of clinical services and medication reviews for indigenous Australians. I would like to thank Sanofi and the Society of Hospital Pharmacists Australia for providing financial support for this work through the Sanofi Pamela Nieman Continuum of Care Research Grant. I would also like to acknowledge the research team from the University of Sydney: Ms Lindy Swain, Ms Clare Griffits and Professor Lesley Barclay. This work was published in part in The International Journal of Clinical Pharmacy.2
Published Version
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