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Adherence In The Bush
Mark Silcock
Within Australia, there is no greater challenge than the health outcomes of patients who live in rural, regional or remote locations...

Pharmacists are perfectly placed to tailor a suite of individualised programs to patients, ensuring a holistic approach to their health and wellbeing. Western NSW-based Mark Silcock finds options for remote and regional patients are growing.

Within Australia, there is no greater challenge than the health outcomes of patients who live in rural, regional or remote locations — currently estimated to be one third of the population. In these areas, many of our national health burdens are most acute.

There is an operational and a clinical channel through which a pharmacist can support patient adherence. These two channels should not be seen as silos and in fact produce the most positive results when delivered together.

Operational route to adherence

Enrolling patients into a prescription management service and encouraging them to leave their prescriptions on file at the pharmacy are simple ways to engage directly with patients and positively impact their adherence. Prescription management services can be tailored to a patient’s preference for a simple SMS reminder service or a more functional smartphone-based app.

Patients in the bush may also benefit from an approach to engagement that involves sending letters directly to patients at home. This approach has been used extensively internationally and has been gaining traction locally as a way to develop health literacy and aid adherence.

Clinical opportunities to build adherence

The 6th Community Pharmacy Agreement has multiple programs that support pharmacists to engage with patients. By conducting MedsChecks and Home Medication Reviews, pharmacists can directly influence patients’ medicine-taking behaviour and identify any issues that may affect their adherence.

Dose Administration Aids (DAAs) offer the most practical way of supporting patient adherence daily. A simple, effective solution to patient adherence, the volume of DAAs is expected to increase significantly over the coming decade as the population continues to age. You can further enhance patient engagement by using a more patient-friendly descriptive name because not all patients understand the terms DAA or Websterpack.

Advancements in accessibility of medicines, such as recent changes to the supply of S100 products in certain states, means that medicines such as clozapine and the majority of anti-retrovirals are now available through community pharmacies. This is a positive move from a patient access perspective and once more highlights the need for the pharmacist to support and positively impact on a patient’s adherence.

All in it together

The most important lessons to consider when implementing any of these programs are to ensure that all of the stakeholders, whether that be the patient, pharmacist, doctor or pharma company (through sponsored compliance programs), have a clear understanding of how improved adherence will inevitably enhance patient health. It is also essential to remember that adherence programs do not align to a ‘one size fits all’ model and that by starting a conversation, pharmacists are perfectly placed to tailor a suite of individualised programs to patients, ensuring a holistic approach to their health and wellbeing.