Smith, D., Couzos, S., and Biros, E. (2020) Integrated pharmacists within ACCHSs: Support for practice-based activities. External Commissioned Report. Australian Government, Canberra, ACT, Australia.

PDF (Appendix 16- MSAC submission) - Published Version Restricted to Repository staff only

Abstract

Objective: To measure and describe the practice-based activities of pharmacists integrated within Aboriginal Community Controlled Services (ACCHSs). Integrated pharmacists delivered ten core clinical, non-dispensing roles targeting Aboriginal and Torres Strait Islander adult patients with chronic disease, health care staff and systems support (the IPAC project).

Design and participants: Eighteen ACCHSs across multiple sites in Queensland, Northern Territory and Victoria participated in a non-randomised, prospective, pre and post quasi-experimental community-based, and pragmatic study that integrated registered non-dispensing pharmacists within ACCHSs. Pharmacists delivered the ten core roles including medication management reviews, assessments of appropriateness and adherence, education and preventive health advice, participated in team-based collaborations and stakeholder liaison, conducted drug utilisation reviews and supported transitional care. Activity data was entered into a bespoke electronic pharmacist logbook to record core activities related to participants, healthcare providers, and health service systems. De-identified patient-related data was entered only for IPAC consented participants. The logbook had dual functionality for data entry and reporting. Raw activity data was downloaded from the logbook into Microsoft Excel and analysed using pivot tables with content analysis of free text questions to categorise and count responses.

Results: Twenty-six integrated pharmacists provided an aggregated 12.3 full-time equivalent (FTE) services in 18 ACCHSs, for up to 15 months, from the 2nd August 2018 to 31st October 2019. Patient-related activity included at least two self-reported patient medication adherence response surveys (N-MARS) for 1,127 participants, paired Medication Appropriateness Index (MAI) audits for 357 participants, and paired Assessments of Underutilisation (AoUs) for 353 MAI participants. A total of 639 Home Medicines Reviews (HMRs), 757 other comprehensive medication management reviews (non-HMRs), and 1,548 follow-up assessments to either a HMR or non-HMR, were also conducted. Activities provided for healthcare providers or systems-related work included provision of medicines information on 1,715 occasions, 358 occasions of formal education and training services, 47 completed stakeholder liaison plans, 3,233 contacts with community pharmacists, 1,901 occasions of transitional care services, and 26 drug utilisation reviews. Approximately 62.5% of the integrated pharmacists’ time recorded in the logbook was spent on patient-related activities.

Conclusion: Integrated pharmacists delivered the ten core roles as defined in the IPAC project exhibiting a high level of activity as documented in the logbook. Extensive collaboration and communication with other healthcare providers was evident through team-based collaboration, transitional care for participants, the development and implementation of stakeholder liaison plans and extensive contact with community pharmacy. Integrated pharmacists were pivotal as a point of contact for stakeholders involved in medicines-related care such as community pharmacists, and staff in local hospitals, rehabilitation and dialysis units. Pharmacists also provided medicines-related information, education and advice. Drug utilisation reviews and medication management reviews facilitated improvements in prescribing quality and other supports for participants. Analysis of these activities in the IPAC project provided evidence that delivery of non-dispensing pharmacist services was feasible within ACCHS settings, and contributed to the integration between the pharmacist and other health care staff, as well as enhancing communication and collaboration with community pharmacy and other stakeholders. These findings are generalizable to other Aboriginal Health Services in urban, regional and remote settings.

Item ID:	87559
Item Type:	Report (External Commissioned Report)
Keywords:	qualitative, pharmacy, pharmacists, primary health care, integrated care, Aboriginal, Torres Strait Islander, chronic disease
Additional Information:	Report to the Pharmaceutical Society of Australia for the IPAC Project. This report is publicly available at the following website: https://www.health.gov.au/resources/publications/integrating-practice-pharmacists-into-aboriginal-community-controlled-health-services-final-report
Funders:	Australian Government Department of Health & Ageing
Projects and Grants:	Pharmacy Trials Program
Date Deposited:	03 Oct 2025 04:40
FoR Codes:	42 HEALTH SCIENCES > 4203 Health services and systems > 420319 Primary health care @ 50% 32 BIOMEDICAL AND CLINICAL SCIENCES > 3214 Pharmacology and pharmaceutical sciences > 321403 Clinical pharmacy and pharmacy practice @ 50%
SEO Codes:	20 HEALTH > 2001 Clinical health > 200102 Efficacy of medications @ 50% 20 HEALTH > 2001 Clinical health > 200105 Treatment of human diseases and conditions @ 50%
Downloads:	Total: 3 Last 12 Months: 3
	More Statistics