How Do Pharmacists Practice in Aged Care? A Narrative Review of Models from Australia, England, and the United States of America

Ibrahim Haider, Mark Naunton, Rachel Davey, Gregory M. Peterson, Wasim Baqir and Sam Kosari
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Ibrahim Haider: Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia
Mark Naunton: Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia
Rachel Davey: Health Research Institute, Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia
Gregory M. Peterson: Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia
Wasim Baqir: NHS England and NHS Improvement, London SE1 6LH, UK
Sam Kosari: Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia

IJERPH, 2021, vol. 18, issue 23, 1-17

Abstract: Medication management in residential aged care facilities (RACFs) is complex and often sub-optimal. Pharmacist practice models and services have emerged internationally to address medication-related issues in RACFs. This narrative review aimed to explore pharmacist practice models in aged care in Australia, England and the USA, and identify key activities and characteristics within each model. A search strategy using key terms was performed in peer-reviewed databases, as well as the grey literature. Additionally, experts from the selected countries were consulted to obtain further information about the practice models in their respective countries. Thirty-six documents met the inclusion criteria and were included in the review. Four major pharmacist practice models were identified and formed the focus of the review: (1) the NHS’s Medicine Optimisation in Care Homes (MOCH) program from England; (2) the Australian model utilising visiting accredited pharmacists; (3) the Centers for Medicare and Medicaid (CMS) pharmacy services in long-term care from the USA; and (4) the Medication Therapy Management (MTM) program from the USA. Medication reviews were key activities in all models, but each had distinct characteristics in relation to the comprehensiveness, who is eligible, and how frequently residents receive medication review activity. There was heterogeneity in the types of facility-level activities offered by pharmacists, and further research is needed to determine the effectiveness of these activities in improving quality use of medicines in the aged care setting. This review found that in some models, pharmacists have a limited level of collaboration with other healthcare professionals, emphasising the need to trial innovative models with integrated services and increased collaboration to achieve a holistic patient-centred approach to medication management.

Keywords: pharmacists; models of practice; medication review; medication management; residential aged care facilities; long-term care; nursing homes; England; Australia; USA (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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