Medications are both the cheapest form of treatment but also contribute to health risks, with at least 2-4% of hospital admissions being drug-related and over 30% for those over age 75. As the population ages and chronic diseases increase, polypharmacy and non-compliance pose issues to addressing health effectively through medications. Pharmacists can play an important role in medication management through services like MedsChecks, Home Medication Reviews, and improving appropriate use and compliance to reduce costs and health risks.

1. A MEDICATED NATION THINK.CHANGE.DO Prof S.I. (Charlie) Benrimoj Head Graduate School of Health & Prof of Pharmacy Practice September 2011

3. Benefits but also risks

4. At least 2% to 4% of hospital admissions are drug related (75 years or over greater 30%)

5. 50 to 60% of patients are non-compliant

6. Patients taking multiple medications (PolyPharmacy) at risk

9. PHARMACEUTICAL BENEFITS SCHEME - 2007 to 2010: Number of Prescriptions Source: Expenditure and prescriptions twelve months to 30 June 2010 PBS

10. PHARMACEUTICAL BENEFITS SCHEME - 2007 to 2010: Government Costs 9.3% Source: Expenditure and prescriptions twelve months to 30 June 2010 PBS

11. PHARMACEUTICAL BENEFITS SCHEME - 2007 to 2010: Government and Patient Costs Source: Expenditure and prescriptions twelve months to 30 June 2010 PBS

12. 22 million Australians (2009) 8.3 medications per person (excludes private prescriptions and below $34.20 for general) $316 per person cost Government Source: Expenditure and prescriptions twelve months to 30 June 2010 PBS

13. Questions: Cost effectiveness? Improve compliance As well benefits of medication how can we minimise the negative clinical outcomes ? Medication Management reviews Monitoring Adverse effects

14. Critical issues: Medications Compliance 40 to 60% of patients do not take their medications Adverse Effects 2 to 4% of hospital admissions drug related Greater 30% in patients 75 years or older 10.4% of GP patients in previous 6 months Poly-pharmacy Patients of more than 5 medications Resistance in a specific disease: Cancer

15. Role of the Pharmacist Quality use of medicines Consumer Medication Information Compliance (DAA) Clinical Intervention (Meds check) Home Medication Review (HMR) Residential Review (RMMR) Basic and clinical research

16. MedsCheck: Medicines Review Program In-pharmacy, patient centred service: aims to enhance the quality use of medicines: educating community based patients about their medicines identifying any problems they may be experiencing with their medicines; and understanding interactions between medicines.

17. Compliance Source : PSA 2006

18. Horne et al (2006)

20. Explaining why and when

21. Storage

22. What to expect when taking them

23. What problems you should report to the GP

24. Checking that prescription medicines, over-the-counter medicines and vitamins are appropriate to take together

25. Clarifying any confusion with generic medicines

26. Compliance

27. Changing your medicines. Source:Http://www.nps.org.au/consumers/ask_an_expert/home_medicine_review

28. Eligibility for HMR Source : NPS

29. Numbers of HMRs Over Time