Letter in response to: Page, A., Hyde, Z., Smith, K., Etherton‐Beer, C., Atkinson, D. N., Flicker, L., Skeaf, L., Malay, R., & LoGiudice, D. C. (2019). Potentially suboptimal prescribing of medicines for older Aboriginal Australians in remote areas. Medical Journal of Australia, 211(3), 119–125. https://doi.org/10.5694/mja2.50226

Tobias Speare, John Wakerman

Research output: Contribution to journalLetter

5 Citations (Scopus)

Abstract

The report by Page and colleagues is an excellent and welcome addition to the limited body of knowledge concerning medicine use and prescribing practices for Aboriginal and Torres Strait Islander peoples, particularly in remote Australia. The authors highlight the association of inappropriate prescribing with the unrealised benefits of recommended treatments and poor clinical outcomes, including falls, frailty and hospitalisation. It would be useful to know if the harmful impacts of inappropriate prescribing were similar or amplified in the remote context and involving Indigenous persons, including incidence of adverse effects, impact on quality of life and potentially preventable hospitalisations.
The potential interventions raised by the authors include ‘prescriber alerts and targeted training for remote area medical professionals’ and ‘multifaceted solutions,’ with no mention of the potential significant role of pharmacists in enhancing quality use of medicines and addressing inappropriate prescribing. Pharmacists have demonstrated their value in urban settings. The omission of a discussion about the role of the remote pharmacist only highlights the evidence gap about the role of pharmacists and effective models of pharmacy service provision in remote Australia. Just as medical practice differs in remote areas, there are distinct challenges to providing pharmacy and other services in remote Australia, requiring appropriately trained health professionals and models of service provision suited to the remote context. Several relevant research projects are currently underway, including Integrating Pharmacists within Aboriginal Community Controlled Health Services to Improve Chronic Disease Management (IPAC) project, Indigenous Medication Review Service (IMeRSe) study and the Community Pharmacy in Health Care Homes project. They are investigating the role of pharmacists in achieving quality use of medicines in primary health care and importantly incorporate Indigenous and remote Australian cohorts. These projects will hopefully provide further guidance regarding pharmacy services in remote and Indigenous Australia.
Original languageEnglish
Number of pages1
JournalMedical Journal of Australia
Publication statusPublished - 26 Aug 2019

Keywords

  • Aging
  • Chronic disease
  • Indigenous health
  • Prescribing
  • Prescription drugs
  • Rural health services

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