Pharmacists as patient advocates: A series of case studies illustrating the impacts of a regular pharmacist service in residential aged care (nursing homes)

Renly Lim; Rebecca Bilton; Gereltuya Dorj; Luke Bereznicki; Debra Rowett; Jun Ni Ho; Anthea Freeman; Elizabeth E Roughead

doi:10.1016/j.rcsop.2023.100268

Pharmacists as patient advocates: A series of case studies illustrating the impacts of a regular pharmacist service in residential aged care (nursing homes)

Explor Res Clin Soc Pharm. 2023 Apr 14:10:100268. doi: 10.1016/j.rcsop.2023.100268. eCollection 2023 Jun.

Authors

Renly Lim¹, Rebecca Bilton¹, Gereltuya Dorj¹, Luke Bereznicki², Debra Rowett¹, Jun Ni Ho¹, Anthea Freeman¹, Elizabeth E Roughead¹

Affiliations

¹ Quality Use of Medicines and Pharmacy Research Centre, UniSA Clinical and Health Sciences, University of South Australia, Adelaide 5000, Australia.
² School of Medicine, University of Tasmania, Hobart 7000, Australia.

Abstract

Background: Medicine-related problems are common in older people living in residential aged care facilities (RACFs). Recognising the significant medicine-related problems, the Australian government has announced a $345 million funding package to employ on-site pharmacists in RACFs starting in 2023. The new on-site pharmacists are to provide a range of clinical services to reduce medicine-related adverse events, promote quality use of medicines, and improve clinical governance and education. Underpinning these services, the authors argue that pharmacists play the critical role as resident advocates.

Objective: This study aims to demonstrate how pharmacists can enhance their advocacy responsibility within and beyond the clinical environment to not only reduce medicine-related adverse events but also improve residents' overall health and quality of life.

Methods: This study uses a case series methodology to demonstrate pharmacists' diverse roles in advocating for residents and their families. The case studies were based on participants enrolled in the Reducing Medicine-Induced Deterioration and Adverse Reactions (ReMInDAR) trial, a randomised controlled trial testing the effects of a regular pharmacist service across the Australian RACFs.

Results: Pharmacists' advocacy ranged from persistence in follow-up with a resident's general practitioner (GP) to ensure the GP was aware that a patient was experiencing bleeding and bruising while on an anticoagulant, to advocating for a new bed for a resident with peripheral oedema who had been sleeping in his chair due to fear of falling out of his current bed.

Conclusions: Our trial focussed on pharmacists serving as the residents' advocate to improve their overall health and quality of life, rather than just addressing a list of medicine-related problems. The pharmacist model used in the ReMInDAR trial supports pharmacists to work to their full scope of practice, helps guide the Australian government's new on-site pharmacist program, and serves as an exemplar pharmacist in aged care model internationally.

Keywords: Adverse drug event; Health services research; Patient advocacy; Pharmacists; Residential aged care facility.

Publication types

Case Reports