Importance of medicine safety in mental health care cannot be ignored

Engaging pharmacists in the delivery of mental health care in Australia will lead to earlier intervention, improved treatment outcomes and a reduction in medication harms, the Pharmaceutical Society of Australia has argued in its response to the Productivity Commission’s Draft Report on Mental Health.

 

“Almost half of all Australians will experience mental ill-health during their lifetime. Tragically, thousands of people lose their life to suicide each year and it is estimated that for every death from intentional self-harm, as many as 30 people attempt to end their lives. This is a health crisis that touches us all and, as the Productivity Commission highlighted, we can do a lot better when it comes to providing care,” Pharmaceutical Society of Australia National President, Associate Professor Chris Freeman said.

 

“Medicines are a major treatment modality in most mental illnesses so it is disappointing the Productivity Commission report failed to question how we can improve medication efficacy and safety,” A/Prof Freeman said. “Utilising the medicine expertise of pharmacists in the multidisciplinary care team, tailoring medication therapies and reviewing patient’s medication management can positively impact adherence, effectiveness of medicines prescribed and safe use of medicines.”

 

“Access to health care is vital for people dealing with mental health illness, yet there are a range of barriers that can limit people’s access to a general practitioner. With the majority of Australians visiting their pharmacist around 14 times a year, our profession can help care for and triage patients experiencing mental ill-health or a mental health crisis.”

 

Research released last year found 85 per cent of pharmacists had interacted with someone at risk of suicide at least once and 10 per cent have interacted with someone at risk of suicide more than 10 times.

 

“Enabling pharmacists to recognise potential signs and symptoms of mental ill-health, support patients and refer on to GPs or emergency care, has the potential to not only improve outcomes, but potentially save lives,” A/Prof Freeman said.

 

“We have called on governments across the nation to provide funding to increase pharmacist mental health first aid training and reiterated this recommendation in our response to the Productivity Commission.

“PSA does not believe we can address mental health challenges without considering quality use of medicines (QUM) and hopes the Productivity Commission’s final report will tackle this vital issue.”

 

The Pharmaceutical Society made five key recommendations to the Productivity Commission:

1. Develop and implement regular review of medicines for people with mental ill health to reduce the time to respond to medicine-related problems and to reduce debilitating side effects from medicines which can be preventable.
2. Incorporate pharmacogenomic testing in primary care supported by medicines expertise of pharmacists for people with mental ill health to personalise medicine therapies to improve the safe and quality use of medicines.
3. Integrate pharmacists in suicide prevention strategies, including supporting pharmacists in their triage role of providing support to people they encounter in mental health crisis situations.
4. Support pharmacists, who are often one of the only front-line healthcare providers in rural and remote regions to incorporate early identification, triage and support for people with mental ill health.
5. Ensure pharmacists, as frontline health professionals in contact with people with mental ill health, have the required expertise such as mental health first aid, to support early identification, triage and support for people with mental ill health.

 

Click here for a full copy of the submission

 

Media contact: PSA Media – 0487 922 176

 

Download media release here

Utilise pharmacists to improve health care in NSW

South Australian government announces improved emergency access to medicines for people affected by bushfires

Tuesday, 14 January 2020

 

South Australians affected by the current bushfire crisis will now be able to access full quantities quantity of their Prescription Only Medicines (Schedule 4) without a prescription following an amendment to the Controlled Substances (Poisons) Regulations 2011, a move welcomed by the Pharmaceutical Society of Australia (PSA).

 

The provision brings South Australia into line with NSW, ACT and Victoria following similar announcements last week. The change in regulation gives the Health Minister the ability to declare an emergency, with pharmacists able to supply standard pack sizes, usually one month’s supply, to people affected by the emergency where it is not practical to get a prescription.

 

Medicines supplied under this regulation will be available at regular PBS prices following an announcement of a temporary expansion to the PBS Continued Dispensing initiative by the Commonwealth Government last Friday. The expanded PBS Continued Dispensing provision takes effect from Monday 13 January 2020 and expires on 31 March 2020.

 

Prior to this special authority being issued, South Australian pharmacists were unable to supply more than three (3) days’ supply of a Prescription Only Medicine without a prescription in an emergency.

 

Kingscote pharmacist, Patrick Tiong who supported people on Kangaroo Island after last week’s devastating fires welcomed the announcement: “Last week when we supported people who had lost their homes, the evacuees as well as tourists and volunteers, the current regulations were far less flexible and it limited our ability to help those affected people. I hope this change will help South Australians who need to continue taking their vital medicines when disaster strikes”
PSA South Australian President Robyn Johns said: “We welcome this morning’s announcement as a sensible move in ensuring people affected by bushfires can get urgent access to their regular medicines.”

 

Controlled Drugs cannot be supplied under this provision.

 

PSA National President Associate Professor Chris Freeman also welcomed the move: “PSA has been working with state and territory governments around the country to improve access to prescription medicines in emergency situations. After the current bushfire crisis subsides, we are keen to work collaboratively with all governments to permanently incorporate these more effective and affordable emergency supply provisions into our health system for future disasters.”

 

Media contact: PSA Media, 0487 922 176

Australian’s affected by bushfires will be able to access their medicines in an emergency at PBS prices

A temporary expansion of PBS Continued Dispensing to cover nearly all PBS medicines will mean Australians affected by the bushfire crisis will be able to access their vital medicines at regular PBS prices if they find themselves without a prescription, following a move strongly welcomed by the Pharmaceutical Society of Australia (PSA).

 

Under the temporary change announced this afternoon by Health Minister Hon Greg Hunt, from Monday 13 January 2020, pharmacists will be able to offer standard quantities of ongoing PBS medicines for the standard co-payment– being $6.60 for concession card holders, and up to a maximum of $41.00 for general patients – where PBS medicines are supplied without a prescription in an emergency situation.

 

This move supports the recent issue of temporary authorities to legally supply full-supplies of these medicines in an emergency in New South Wales, Victoria and the ACT.

 

Prior to this announcement, the PBS Continued Dispensing initiative only applied to PBS-listed oral contraceptives and cholesterol lowering medicines. This meant consumers were unable to access PBS subsidies when pharmacists supplied most medicines under emergency supply provisions. This resulted in patients suffering significant surprise out-of-pocket costs when accessing medicines in an emergency.

 

Natalie Thorton was evacuated from Eden to Merimbula with her husband and children. The last matter on her mind was remembering to take any prescription medicines with her. Mrs Thorton said “an emergency evacuation from an out of control bushfire was so traumatic, being able to walk in to the pharmacy and get the medicines my family required in a caring and supportive environment was one less thing that I had to worry about”.

 

In welcoming the move, PSA National President Associate Professor Chris Freeman said, “PSA have been working with the government and its departments on this issue for many months and we congratulate the leadership shown by the Health Minister on today’s announcement.”

 

“The last thing people need in the middle of this crisis is to find the money to pay for their medicines which would have otherwise been subsidised. This provision will make a huge different to unfair and unexpected out-of-pocket medicine expenses for people who are displaced by fires.”

 

“PSA’s existing Guidelines for the continued dispensing of eligible prescribed medicines by pharmacists provide clear information to pharmacists on how to appropriately supply of medicines in these situations. I am confident pharmacists will adhere to these requirements when supplying PBS medicines under this temporary expansion.

 

PSA believes more work is needed to enable provisions to be automatically available when the next disaster strikes.

 

“We are keen to work with the federal government in collaboration with their state and territory counterparts after this crisis subsides to permanently incorporate effective and nationally consistent emergency supply provisions,” Associate Professor Freeman noted.

 

“PSA will continue to advocate for a long term solution on behalf of all Australians. We need nationally consistent emergency supply rules for medicines which ensure patients get the medicines they urgently need at the price they know and can afford” said Associate Professor Freeman.

 

The expanded PBS Continued Dispensing provisions takes effect from Monday 13 January 2020 and expires on 31 March 2020.

 

PSA will communicate this temporary change to pharmacists in addition to information published on the Department of Health website via www.pbs.gov.au.

 

Download media release here

ACT joins NSW and Victoria in improving access to medicines for people affected by bushfires

Friday, 10 January 2020

 

People in the ACT affected by the bushfire crisis will now be able to access a standard PBS or manufacturers’ pack quantity of their Prescription Only Medicines (Schedule 4) without a prescription following the issuing of a temporary authority by the ACT Chief Health Officer, a move welcomed by the Pharmaceutical Society of Australia (PSA).

 

The emergency provision brings the ACT into line with New South Wales and Victoria following similar announcements in the past two days. Under the special authority pharmacists will be able to supply standard pack sizes, usually one month’s supply, to people affected by the bushfires where it is not practical to get a prescription.

 

Prior to this special authority being issued, ACT pharmacists were unable to supply more than three (3) days’ supply of a Prescription Only Medicine without a prescription in an emergency.

 

In welcoming the announcement, PSA ACT Branch Vice President Professor Mark Naunton said: “This is a sensible decision made by ACT Health to ensure patients maintain their access to medicines consistent with other affected states in the ACT region. The current bushfire crisis is starting to create an increased demand on Canberra’s pharmacists from patients who have been displaced from NSW and Victoria and are coming into the ACT.”

 

“Our community pharmacists are working incredibly hard to ensure this increased demand is managed to ensure patients are not adversely affected by this crisis, and this change helps pharmacists care for these people.”

 

“ACT’s pharmacists thank the ACT Health CHO for aligning so quickly to the changes made by NSW and Victoria to ensure consistency in emergency access to medicines in what can be a very confusing time for displaced people.

 

Controlled Drugs (Schedule 8) (e.g. opioid pain medicines), anabolic steroids, benzodiazepines and a small number of specialised medicines (‘Appendix D medicines’) cannot be supplied under this provision.

 

PSA National President Associate Professor Chris Freeman also welcomed the move: “The ACT is the third jurisdiction to recognise the challenges associated with accessing vital medicines in an emergency. PSA will continue to work with state and territory governments around the country to improve regulations regarding access to prescription medicines in emergency situations.”

 

The special provision takes effect immediately and expires on 31 March 2020. PSA will distribute guidance to Canberra pharmacists in addition to information published on the ACT Health website.

 

Media contact: PSA Media, 0487 922 176

 

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Victorian government acts to ensure people affected by bushfires can access essential medicines without a prescription

Victorian residents affected by the bushfire crisis will now be able to access a standard PBS or manufacturers’ pack quantity of their Prescription Only Medicines (Schedule 4) without a prescription following gazettal of a public health emergency order today, a move strongly welcomed by the Pharmaceutical Society of Australia (PSA).

 

Under the public health emergency order, Victorian pharmacists will be able to supply people affected by the bushfires with standard PBS quantities and smallest standard pack sizes of non-PBS medicines without a prescription when where a pharmacist is satisfied there is an immediate therapeutic need and obtaining a prescription is impractical. In most cases, this represents a months’ supply of that medicine.

 

Mallacoota pharmacist Emmanuel Chifefe Manzai said, “Until today in Victoria, if a pharmacist is satisfied that it is not possible for a patient to get a prescription for their chronic medicines the pharmacist is only allowed to give three days’ supply as an emergency.”

 

“I’m pleased this archaic regulation has been removed as it does not help patients especially in disasters like we are currently experiencing.  Patients are stuck here for weeks; giving them three days’ supply is just ridiculous. Mr Manzai continued “I’m pleased Victorian authorities have followed what the NSW government has done, by allowing pharmacists to dispense a PBS-quantity without a script in areas affected by the bush fires”

 

PSA National President Associate Professor Chris Freeman welcomed the announcement, noting “Victorian pharmacists working in affected areas, have stood up and gone above and beyond in supporting the health of their communities in this crisis. But up until now, the inability to supply more than three-days’ supply of medicines to people has been an unacceptable barrier to accessing and providing care to people in these fire affected zones.”

 

“This announcement means people separated from their prescription medicines or prescriptions will be able to access their regular medicines needed for managing chronic health conditions, such as blood pressure, depression, diabetes, asthma or chronic obstructive pulmonary disease (COPD).”

 

As part of the order, pharmacists must record that the sale or supply was made under the public health emergency order.  The order does not apply to Schedule 8 medicines (Controlled Drugs).

 

“We thank Minister Mikakos for responding to this urgent need and arranging this public health order.” Associate Professor Freeman said “We believe this is the first time such a public health order has been gazetted in Victoria.”

 

“PSA are keen to work with the Minister and her department after this crisis subsides to review how this provision could become engrained in regulation to ensure people are able to access medicines when the next emergency strikes.”

 

“PSA will be following up with all other states and territories to ensure these provisions can be enacted quickly should the time arise this bushfire season.”

 

“The next step is also to enable access to PBS subsidy for medicines supplied in emergencies so patients do not have the shock of unexpected out-of-pocket expenses when accessing the regular medicines during a crisis.”

 

The special provision takes effect immediately and is in force until midnight 1 April 2020 unless revoked.

 

PSA has distributed guidance to Victorian pharmacists this afternoon to communicate the order and guidance on the Victorian Government website at https://www2.health.vic.gov.au/public-health/drugs-and-poisons

 

Media contact: PSA Media, 0487 922 176

 

Download media release

Landmark Special Authority for NSW Residents Affected by Bushfires to Access Essential Medicines Without a Prescription

Wednesday, 8 January 2020

 

New South Wales (NSW) residents affected by the bushfire crisis will now be able to access a standard PBS or manufacturers pack quantity of their Prescription Only Medicines (Schedule 4) without a prescription following the issuing of a special authority by the NSW Chief Health Officer, a move strongly welcomed by the Pharmaceutical Society of Australia (PSA).

 

 

Under the special authority announced last night, NSW pharmacists will be able to supply people affected by the bushfires with standard PBS quantities and standard pack sizes of non-PBS medicines without a prescription when where a pharmacist is satisfied there is an immediate therapeutic need and obtaining a prescription is impractical. In most cases, this represents a months’ supply of that medicine.

 

 

Malua Bay Pharmacist, Raj Gupta, has kept his pharmacy doors open in the fires said “Patients I have known for years have come into my pharmacy having lost all their medicines in the fires. When you have lost your home, there is no power or telephone and it might be weeks before you can get in to see a doctor, to turn them away with just a few days of life saving medicines to tide them over because of some bureaucratic rule – it just needs to be fixed.
Prior to this special authority being issued, pharmacists were unable to supply more than three (3) days’ supply of a Prescription Only Medicine without a prescription in an emergency.

 

 

In welcoming the announcement, the PSA NSW Branch President Peter Carroll noted “The current bushfires across NSW have resulted in unprecedented demand on pharmacists working in multiple settings, especially in community pharmacy”.

 

 

“We have heard many stories and first-hand examples of pharmacists going above and beyond in their support of their communities. But up until now, the inability to supply more than three-days’ supply of medicines to people has been an unacceptable barrier to accessing and providing care to people in these disaster affected zones.”

 

 

“This announcement means that people separated from their prescription medicines or prescriptions will be able to access their regular medicines needed for managing chronic health conditions, such as blood pressure, depression, diabetes, asthma or chronic obstructive pulmonary disease (COPD).
Similar to other emergency supply provisions, Schedule 4 Appendix D medicines (e.g. benzodiazepines) and Controlled Drugs (Schedule 8) (e.g. opioid pain medicines) cannot be supplied under this provision unless authorised by a medical practitioner by telephone, email or facsimile.”

 

 

“We thank the NSW Ministry of Health for responding to this urgent need and issuing this special authority which is vital to ensure NSW residents affected by bushfires can continue access to medicines vital for their health.” Prof Carroll said “We understand this is the first time such a special authority has been issued in Australia.”

 

 

“Unfortunately, emergencies and disasters are regular events in NSW. We are keen to work with the NSW government after this crisis subsides to review how this provision could become engrained in regulation to ensure people are able to access medicines when the next emergency strikes.”

 

 

PSA National President, Associate Professor Chris Freeman congratulated the NSW Ministry of Health on this pragmatic and important solution in improving access to medicines in disaster situations. Associate Professor Freeman said “The NSW Government has been the first to listen to calls from the national peak body representing pharmacists. The NSW Government has shown leadership, compassion and a willingness to ensure NSW residents affected by these unprecedented fires can have safe access to medicines in an emergency”.

 

 

“The PSA will continue to advocate on behalf of Australians affected by the bushfires and their amazing and courageous pharmacists who care for them, to have nationally consistent emergency supply rules for medicines without having to foot the bill” said Associate Professor Freeman.
The special provision takes effect immediately and expires on 31 March 2020. PSA will distribute guidance to NSW pharmacists in addition to information published on the NSW Health website.

 

 

Media contact: PSA Media, 0487 922 176

 

 

Download media release here

 

Community pharmacists supporting smoke-affected Canberrans

As Canberra’s air quality is set to deteriorate again tonight, Canberrans most vulnerable to the effects of poor air quality due to the bushfire smoke blanketing the ACT can attend their local pharmacist for advice and to access one of the 100,000 Commonwealth Government supplied P2 masks delivered to every community pharmacy across the Territory this week.
 
“Around the country, pharmacists have rallied in support of their communities and are doing what they can to help as bushfires devastate so many parts of Australia,” Pharmaceutical Society of Australia ACT Vice President, Professor Mark Naunton said.
 
“In the ACT this week, pharmacists have stepped up to coordinate and provide access to protective masks for Canberrans most sensitive to smoke, such as those over 65, pregnant women and people with chronic health conditions such as asthma and cardiovascular disease.”
 
Yesterday the Commonwealth Government delivered 100,000 P2 masks to the nation’s capital and staff from the Pharmaceutical Society of Australia and the Pharmacy Guild of Australia joined forces to work with ACT Health to get them to community pharmacies as their final destination.
 
Simon Blacker, ACT President of the Pharmacy Guild of Australia reflected; “What I saw when I was delivering masks for vulnerable people to ACT community pharmacies was a mixture of joy and relief that masks were arriving that would allow the pharmacy to be able to help their local communities and their local patients. The teams of pharmacists and staff were excited to be empowered to help, and this is a common trait of all community pharmacies and those that work within them.”
 
“As we travelled around the city and visited each of Canberra’s 80 pharmacies was a network of community pharmacists eager to help out and play a part in keeping Canberrans safe from the harmful effects of pollution,” Prof. Naunton said. “This is another example of the important role pharmacists play in responding to public health issues and natural disasters.”
 
“By the time the task was completed yesterday afternoon, we believe about one-third of masks had already been provided free of charge to members of our community, showing how urgent the need in Canberra was,” Mr Blacker said.
 
Mr Blacker urged Canberrans to contact their local pharmacy for any queries regarding availability; “Access to this supply of masks is being prioritised for Canberrans whose health is at risk due to smoke. Anyone who falls in this category is encouraged to visit their local pharmacy. If your local pharmacy has run out, another nearby is likely to have some available.”

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IMPORTANT HEALTH ADVICE:

• The community are reminded that up to date health advice and further information on how to use a P2/N95 mask properly is on the ACT Health website (www.health.act.gov.au).
• The community are also reminded that use of masks is also not an alternative to avoiding exposure to the smoke outdoors.
• The best way to protect yourself and your family is to stay indoors (with windows and doors closed) when heavy smoke is around.

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Media contact
PSA Media, 0487 922 176
Pharmacy Guild of Australia (ACT Branch), Simon Blacker 0418 477 168
 

Download media release here

Bushfire Support

The current bushfires across Australia have resulted in unprecedented demand on pharmacists working in multiple settings, especially in community pharmacy.
 
PSA have heard many stories and first hand examples of pharmacists going above and beyond in their support of their communities. We have also heard of barriers to accessing and providing care in these disaster affected zones.
 
PSA have been in contact with the Commonwealth Department of Health, the office of the Commonwealth Health Minister, and the Australian Defence Force. PSA will continue to provide advice to these agencies about the requirements on the ground.
 
Members who are experiencing challenges in delivering care to their local communities can email bushfires@psa.org.au and we will pass on your requirements to the relevant State and or Commonwealth Departments.
 
These issues may be in the context of the following

• Logistical supplies of medicines
• Workforce support
• Power interruption
• Payment of medicines
• Mental health support for staff.

 
In the long term we will continue to address two major areas of concern for you and for your patients:

• The need for more flexible emergency supply arrangements, especially in disaster periods
• The need for meaningful support for community pharmacy in disaster planning and preparedness.

 
PSA are seeking advice regarding the supply of Schedule 3 medicines during this period from the relevant state health departments, and will provide advice when this available. In the absence of specific information from State health departments regarding the supply of medicines in these circumstances, including salbutamol, we urge pharmacists to exercise their professional judgment in the appropriate supply of medicines.
 
Times like this can be very hard, even for those not directly affected. If you or your staff require support, you can access the Pharmacists’ Support Service by calling 1300 244 910.
 
Beyond Blue have some good resources that you, your staff and community may find beneficial during this time, including this guide to looking after yourself in a disaster.
 
I hope and trust that you all remain safe.
 

A/Prof Chris Freeman
National President
Pharmaceutical Society of Australia