In March 2022, the Australia government announced $350 million of funding over 4 years to employ on-site pharmacists in residential aged care, starting July 2023. In April 2023, the government made changes to the proposed on-site pharmacists, where the new program will now be delivered by and through community pharmacies. Regardless of how the model will be implemented, the goal remains the same – to improve quality use of medicines and medicines safety for aged care residents.
While it is relatively easy for pharmacists to monitor and manage some types of medicine harms (e.g., due to use of inappropriate medicines), many medicines can cause “milder” harms (e.g., poor balance, sedation) that are difficult to detect without the right tools. Left unmanaged, these “milder” harms can lead to serious adverse events such as injurious falls, according to Pharmacist Julian Soriano talking to Australian Health Journal.
In a joint project between UniSA, Tanunda Luteran Home, Flinders University and UNSW, a digital solution has been used to create an evidence-based, medicines use model to assist pharmacists (on-site aged care or community pharmacists) with actively monitoring medicine harms.
An interdisciplinary team at the University of South Australia (UniSA), University of New South Wales (UNSW) and Flinders University is currently implementing the TeleClinical Care (TCC) platform incorporating data from a suite of digital technologies to enable pharmacist at the Tanunda Lutheran Home (where Julian Soriano works) to actively monitor their aged care residents.
The ARIIA funded project is being conducted in two phases:
i) Phase 1 involves developing protocol to extract data from digital technologies (e.g. activity trackers, sleep tracking mats) into the TCC platform. The core of the existing TCC platform is a dashboard that includes longitudinal visualisations of changes in residents’ health and well-being over time. Other existing data sources collected in residential aged care will be uploaded to the dashboard, including medicine use (e.g. medicine changes, sedative load), clinical care record (e.g. bowel movement) and adverse events (e.g. falls, hospital admission).
ii) Phase 2 involves a pre-post implementation study over 12-weeks, with 30 residents recruited from the Tanunda Lutheran Home. The selected digital technologies will first be installed for all enrolled residents who provided written consent. Enrolled residents will also be asked to use an activity tracker. Prior to service provision, two weeks’ baseline data will be collected from the digital technologies; the data will serve as reference point for future changes. Pharmacists will monitor all participants using the centralised TCC dashboard.
As Soriano states, “A platform like this is going to make that job much more streamlined. And the use of sensors such as a sleep tracker and activity tracker is also going to help provide the pharmacist with more information to be able to make more informed decisions, more informed recommendations for residents, their families and their treating GPs.”
The current workforce challenges in aged care are not forgotten and Soriano expresses hope, that “this platform won’t increase the burden on residents and the staff there in terms of gathering this information. Hopefully this will be quite streamlined and automatic and there won’t be a real big service change for the already overworked nurses and residents living in aged care would just be able to live and not have to worry constantly about being poked and prodded.”
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Thyroid health into pregnancy
‘Without an adequate amount of thyroid hormone mothers can be exposed to hypertensive disorders of pregnancy, including gestational hypertension and preeclampsia or eclampsia, which affect around 10% of pregnant women and are the leading causes of maternal and neonatal mortality worldwide. Mothers who suffer from hypertensive disorders during pregnancy are at increased risk of long-term cardiovascular consequences and hypertensive disorders in subsequent pregnancies. Evidence also indicates a risk of reduced cognitive ability to their offspring.
‘Knowing if you are genetically predisposed to Hashimoto’s or Graves’ Diseases, which are both thyroid autoimmune disorders is important to be aware of, to ensure all appropriate tests are ordered. Autoimmune disorders may predispose mothers to a thyroid problem during pregnancy’, says Professor Creswell Eastman, who also serves as the ATF’s Principal Medical Advisor.
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State of private healthcare in Australia
Australia’s healthcare system is often described as a mixed system, with a combination of public and private providers. While public healthcare through Medicare provides universal coverage for essential services, private healthcare offers additional options and amenities for those who can afford them.
Private Healthcare Australia (PHA) is the Australian private health insurance industry’s peak representative body that currently has 21registered health funds throughout Australia and collectively represents 98% of people covered by private health insurance. PHA member funds today provide healthcare benefits for over 14 million Australians.
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Generosity of spirit in teaching
The Ramaciotti Medal for Excellence is considered one of the most prestigious awards in biomedical research in Australia and is highly sought after by researchers in the field.
In 2022, Professor Matthew Kiernan was the recipient of the Ramaciotti Medal for Excellence and the associated $50,000 award.
Australian Health Journal spoke with Professor Kiernan to hear about his journey in medicine and science to try and uncover and understand diseases and his generosity of spirit to pass on what he has learnt.
