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How to keep an accurate medicines list | Chris Braithwaite
- 1. How to keepan accurate medicines list: an organisational approach Chris Braithwaite Clinical Consultant Pharmacist Galambila Aboriginal Health Service
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- 3. Galambila AHS • Locatedon Gumbaynggirr land in Coffs Harbour, NSW • ~3000 active clients • 6.4 FTE General Practitioners • Full-time clinical pharmacist • 2 RN’s, 8 clinical AHWs, 3 mental health AHWs • Support, admin and project staff
- 5. A vehicle forimprovement • Accreditation standards! – QI2.2D: Safe and quality use of medicines • Our clinical team ensures that patients and other health providers to whom we refer receive an accurate and current medicines list1.
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- 13. Accurate medications listguide Reference: PSA Medicine Safety, Take Care2
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- 16. Lessons • Change isslow, but gradual with differing levels of uptake • Regular audits provide a platform for sustainable change • Critical to have GP champions • Important to understand and utilise clinical software as efficiently as possible • Beneficial for patient, AHS and community pharmacy • Anecdotally beneficial so far, measurables to be developed through the audit process
- 17. Questions? • Contact: – chris.braithwaite@galambila.org.au •Happy to provide copies of: – Procedure document – ‘Webster-Pak’ template letter in MD – Template for GP feedback
- 18. References 1. The RoyalAustralian College of General Practitioners. Standards for general practices. 5th edn. East Melbourne, Vic: RACGP, 2017. 2. Pharmaceutical Society of Australia 2019. Medicine Safety: Take Care. Canberra: PSA.
Editor's Notes
- #2 ACKNOWLEDGE THE TRADITIONAL OWNERS!
- #6 Also a really important clinical marker due to the extent of medication misadventure in Australia
- #7 Part of our procedure list now, which means: It is included as part of an induction for our new GPs and GP registrars Official documentation means it provides structure for ongoing feedback and improvement for our GPs
- #8 To counter the following issues: Short-term medications staying on the medication list when no longer relevant Also changed the default options as part of the IT induction, automatically defaulting to limited which meant risk of long-term meds falling off list
- #9 Requirement in hospital inpatient charts. Why not in primary care? Extra benefits! Has flowed on to GP review of ‘Past History’ as sometimes there is no corresponding indication e.g. PPI and GORD. The other side of this is ensuring the correct reason for cessation is noted when ceasing a medication. You can choose ‘completed without problems’ but this often doesn’t reveal the true story for a chronic disease medication.
- #10 45% of 5-55 when audited during the health assessment appointment in 2018 67% of 55+
- #11 Smaller pack sizes will be available for immediate-release prescription opioid products
- #16 Put in GP holding file, then patient file to ensure the GP is accountable to the feedback.
- #17 One example of a measurable outcome is a reduction in patients on opioids by ~30%