A new report highlights an urgent need to address medication safety as part of disability care, according to a new report from the Pharmaceutical Society of Australia (PSA).
The report makes four key recommendations aimed at improving equity of access and support for people with a disability to use the medicines they need safely and effectively, according to Dr Fei Sim, National President of the PSA.
On 31 August, the PSA is hosting a webinar for members on the role of pharmacists in disability care.
Fei Sim writes:
Australians living with a disability face significant and systemic problems when accessing medicines and a greater focus on medicine safety is needed within the disability sector, according to a report recently released by the Pharmaceutical Society of Australia, ‘Medicine Safety: Disability Care’.
Approximately 4.4 million Australians live with a disability, with many of those on complex medicine regimes. In PSA’s 2019 Medicine Safety: Take Care report, we estimated that 250,000 hospital admissions are a result of medicine-related problems each year, with an annual cost of $1.4 billion.
Access to healthcare should be equal for all Australians; however, people with disability report experiencing many challenges when accessing health services.
Barriers commonly identified by people with disability or their carers include physically inaccessible buildings, discrimination by healthcare professionals, long waiting times, high costs, and a lack of communication between the health professionals who treat them.
These barriers may also affect the decision of when to access healthcare, as one in 12 people with disability report delaying or not seeing a GP when needed. This compares to one in 25 people without disability.
Approximately 2.5 million people (60 percent of people with disability) required assistance in their daily life, most commonly with healthcare. Of those who needed assistance with healthcare, one in two (49 percent) received assistance from informal providers such as a partner, their child or their parent.
Geographical location may affect access to healthcare with more people with disability who live in outer regional and remote areas reporting difficulties accessing health services compared to people with disability living in major cities.
Further, we found that many medicine safety problems are likely unreported, as existing data tends not to include people with disability living independently, with family in home care, or in residential care, and very few Australian studies have been conducted on medicine safety issues experienced by people with disability.
The result in a health system that is failing Australians with a disability.
While developing the Medicine Safety: Disability Care report, we spoke with people with a disability, as well as their carers and families. All reported barriers to safe medicine use, and at all stages of the medicine management cycle process. There were reports of significant problems ranging from accessing prescribers like a GP, access to pharmacists, to difficulty reading and understanding information about the medicine and opening and administering the medicine itself.
For example, one patient with low or impaired vision told us that “Off-the-shelf medicine instructions are unreadable on both the packaging and the instruction leaflets,.
Another said that they weren’t able to open their medicine without help, saying “you have to pull it open, which costs a huge effort. I also have to turn this… So, my cleaning lady comes every Wednesday, and then I ask her in case a bottle needs to be opened.”
These challenges pose serious risks to people with disability, inhibiting their access to the medicines they need. Each of these examples are opportunities for a trained pharmacist to step in and support the patient to understand and use their medicines effectively.
As the peak body representing the pharmacy profession, we have made four key recommendations that could ensure equity of access and support for people with a disability to use the medicines they need safely and effectively.
Firstly, to ensure disability service providers have access to quality use of medicine (QUM) service by funding on-site pharmacists’ roles in disability provider organisations. This would ensure that all Australians who engage a disability service have access to a pharmacist who can support their medicine management.
Secondly, to enable pharmacists to register as providers under the National Disability Insurance Scheme (NDIS) to increase access for people with disability to medication management services tailored to their needs, referred by suitably qualified NDIS service providers. The Federal Government must ensure that the skills and expertise of pharmacists are available to all patients, including those who are house-bound or cannot access a community pharmacy.
Thirdly, to allow suitably trained pharmacists to administer vaccines and other injectable medicine to people with a disability in a setting of their choice, including their own home. This would improve equitable access to vaccinations for people living with a disability and limit the severity of preventable disease.
Lastly, to enhance the set of quality indicators for disability care to facilitate continuous improvement of medicine safety initiatives.
There is a clear and pressing role for pharmacists to be engaged in medicine safety for people with disability. Pharmacists must be recognised as an essential service provider for people with special medicine needs and should be embedded everywhere that medicines are used.
We need to focus on medicine safety to help address the health and life expectancy gap for people with disability. Pharmacists are the key, and we look forward to working with state, territory and federal governments, the disability sector, patients, and their families to ensure the best quality care for all Australians living with a disability.
See Croakey’s extensive archive of articles on safety and quality in healthcare.