'Embedded' pharmacists could help shape aged care systems: study

Monash University has conducted research into the impact of ‘embedding’ pharmacists onsite at residential aged care facilities.

The move to include onsite pharmacists within interprofessional aged care teams comes after the Australian Government’s announcement in 2022 of a national rollout of embedded onsite pharmacists in all government-funded residential aged care facilities (RACFs). This was in direct response to recommendations from the 2019 Royal Commission into Aged Care Quality and Safety, and builds on evidence from national and international studies.

While the details are yet to be finalised, it is anticipated that the phased rollout of this new workforce model will now commence in 2024. Monash’s study examined early adopters of the model.

Conducted by the Centre for Medicine Use and Safety (CMUS) at the Monash Institute of Pharmaceutical Sciences (MIPS) and published in the Australasian Journal on Ageing, the study explored the role of an embedded onsite pharmacist model in supporting quality use of medications in RACFs.

Lead author Dr Amanda Cross, a pharmacist and Research Fellow at CMUS, interviewed 15 pharmacists from around Australia who had adopted the model.

“It was evident from the early adopters of this model that being embedded and onsite was important for being able to be an advocate for the resident, build enhanced relationships with the interdisciplinary team and drive system-level improvements in medication management,” Cross said.

The study looked at both resident-level roles (those actively contributing to collaborative outcome-focused resident-centred care) and system-level roles (leading clinical governance and quality improvement processes). The system-level roles were consistent with that of a knowledge broker, an individual who helps to translate evidence and guidelines into local practice.

Cross said that the system-level knowledge broker role could serve as a framework to help guide the new aged care pharmacist model.

“Pharmacists acting as knowledge brokers can help to improve policies and processes, link key stakeholders and build the capacity of individuals and the aged care provider organisations to support quality use of medications.”

Cross and her colleagues at CMUS are currently working on two Medical Research Future Fund projects investigating the role of embedded onsite pharmacists working as knowledge brokers in residential aged care. This includes implementing the new CMUS-led Australian Clinical Practice Guidelines for the Appropriate Use of Psychotropic Medications in People Living with Dementia and in Residential Aged Care.

CMUS Director Professor Simon Bell said the team’s study provided important insights into new resident- and system-level roles for pharmacists and the corresponding competencies that will be required.

Image caption: Aged care pharmacy. Image courtesy of Monash University.