Embedded on‐site aged care pharmacists in Australia

A new study by Monash University suggests being on-site and truly embedded within the interprofessional aged care team provides pharmacists greater opportunities to support resident- and system-level improvements in quality use of medications.

In 2022 the Australian Government announced a national rollout of embedded on-site 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 of the model are yet to be finalized, it is anticipated that the phased roll-out of this new workforce model will now commence in 2024.

The new study by the Center for Medicine Use and Safety (CMUS) at the Monash Institute of Pharmaceutical Sciences (MIPS) and published in the Australasian Journal on Ageing, set out to explore the roles of early adopters of Australia's embedded on-site 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 were early adopters of the embedded onsite aged care pharmacist 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," Dr. Cross said.

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

Dr. Cross says, "This system-level knowledge broker role can 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 organizations to support quality use of medications."

Dr. Cross and colleagues at CMUS are currently working on two Medical Research Future Fund projects investigating the role of embedded on-site 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 study provides important insights into new resident- and system-level roles for pharmacists and the corresponding competencies that will be required."