Background

In 2015 the Australian Medical Association proposed to the Commonwealth Government to integrate non-dispensing pharmacists into general practice with the aim of reducing hospitalisations due to medication misadventure and reducing utilisation of medication.

Significant changes to Australia’s population are predicted over the next 40 years. Australians are forecast to live longer with life expectancy of 95.1 years for men and 96.6 years for women, compared with 91.5 and 93.6 years in 2015. As well as living longer the structure of the population is predicted to change, with the proportion of the population aged over 65 set to double and those aged over 85 predicted to be four times higher.

The ageing population, coupled with an increase in prevalence and burden of chronic disease has resulted in increased demand on the Pharmaceutical Benefits Scheme with subsequent increasing medication use. As medication prescribing and use increases there is a resultant increase in drug related problems.

There is a significant cost to the health system associated with drug related problems including over-prescribing, medication misuse and adverse drug events often resulting in preventable hospital admissions. In 2015 the Australian Medical Association proposed to the Commonwealth Government to integrate non-dispensing pharmacists into general practice with the aim of reducing hospitalisations due to medication misadventure, and reducing utilisation of medication. The proposal highlighted an independent analysis undertaken for the AMA by Deloitte Access Economics that showed the integration of pharmacists within general practices could deliver net savings to the health system of $545m over a four years period.

COORDINARE’s Population Health Information Snapshot shows that all areas within the Southern NSW catchment were reported to have higher than NSW state average figures for opioid prescription rates. There were pockets of the catchment in the Goulburn-Yass area and the Snowy Mountains area that reported higher than NSW and Australian national average figures for opioid prescription rates. The South Coast area was reported to have exceptionally high opioid prescription rates, ranking 7th amongst 91 areas in NSW and 36th amongst 333 areas in Australia, placing the South Coast in the 2nd highest Australian decile for opioid prescription rates.

Qualitative evidence from COORDINARE’s Needs Assessment suggests that sub-optimal medication management and irregular medication review contributes to avoidable hospitalisations and re-admissions. Further to this, challenges with communication between tertiary and primary care regarding medications prescribed on hospital discharge can lead to adverse events.