Pharmacist and HMRI Heart and Stroke researcher, Joshua Bennetts, has devoted years to exploring the ways pharmacists provide meaningful support in the transition between hospital and home.  

“Many patients who have cardiovascular disease are overwhelmed by the changes to their medicines and their health status when they leave hospital.  

“They might also be managing co-morbidities that require a lot of different medications. 

“When you’re in hospital, it’s a busy environment where doctors, nurses and allied health professionals come and go. Some patients get a bit overwhelmed, so they don’t necessarily take things in at the time,” says Joshua. 

His work also looked at telehealth options where patients can speak to a pharmacist a week after they have been discharged. 

He says, “We ran a medication reconciliation telehealth trial for people with heart failure. In the trial, a pharmacist offered extra education a week after patients were discharged from hospital. There was a check-in call to see how people’s bodies were responding to the medications they had been given. The pharmacist talked through what the medications were and any potential side-effects to be aware of.” 

The patient feedback was overwhelmingly positive.  

“A lot of people liked that they were still being thought about and looked after. The phone call made them feel cared for; like they weren’t just a number,” says Joshua.  

This is one of the key strengths of joint care initiatives between hospital and home, and doctors and nurses working alongside community pharmacists.  

By expanding the scope of what pharmacists can offer in terms of services and advice, it frees up GPs and has the potential to drastically reduce the load on hospital staff. 

“Each year in Australia there are around 250,000 hospital admissions and a further 400,000 emergency department presentations due to medication-related problems,” says Joshua.  

“This is due to misuse, adverse effects or supply issues. 

“Half of these are preventable,” he says.  

Over the past few years, the laws have changed to allow pharmacists to offer UTI medications, contraceptive pill refills and the morning after pill.  

Joshua says there’s still plenty more that can be done. 

“In NSW, the guidelines only allow for patients to have a week’s supply of medication when they leave hospital. We know that people can’t always get an appointment with their GP that quickly, so the patients are then running out of their medications,” he says.  

While pharmacists aren’t the answer to everything, there are areas where they can provide much-needed support for patients.  

Joshua says, “There is a government-funded program called ‘Domicilary Medication Management Reviews’ available to patients. In short, a doctor can refer their patient to a credentialed pharmacist to arrange a home visit.  With this visit, the pharmacist reviews the patient’s medications, provides some education, and documents their findings in a report for the referring doctor.”  

“Recently this program was extended to allow hospital doctors to refer for the service in addition to GPs. This provides an important transition-of-care pharmacy service for patients to maintain continuity of care; though it is currently underutilised, and many hospital doctors don’t know it exists,” he says.  

If the workload on pharmacists does continue to increase, Joshua says this needs to be factored into staffing and remuneration.  

“Pharmacists are already offering vaccinations, one-day sick leave certificates, assisting with sleep apnea machines and providing advice on medications so if they need to do more, they need to be supported,” says Joshua.  

“If they do expand the scope of practice, it has the potential to save everyone a lot of time, money and stress. 

“As a whole, I feel really buoyant about the increased scope of practice where a pharmacist’s qualification is recognised to its full capacity. It’s a good time to be a pharmacist,” he says.  

Joshua Bennetts’ research is supported by long term HMRI supporters, Chris and Shirley Piggott.