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Long-Term Care Pharmacy
Published in William N. Kelly, Pharmacy, 2018
Consultant pharmacists work in various settings: An independent or chain store pharmacy that provides limited LTC servicesStand-alone LTC pharmaciesPharmacies that provide no drugs but consult on the proper procedures and therapies in the facilityPharmacies located in nursing homes There are increasing numbers of consultant pharmacists making their living by working for assisted living facilities and skilled nursing facilities on a full-time basis. They have a contract with the pharmacy provider or with the facilities themselves. Major LTC pharmacy companies include Omnicare/CVS, PharMerica, and Guardian.
Unique Aspects in the Nursing Home Setting
Published in Thomas T. Yoshikawa, Shobita Rajagopalan, Antibiotic Therapy for Geriatric Patients, 2005
Chesley L. Richards, Joseph G. Ouslander
Finally, most nursing homes have on their staff or through contract consultant pharmacists who can assess the quality of care regarding medication prescriptions and provide consultation regarding drug therapy issues. In most long-term care facilities (LTCFs), consultant pharmacists perform mandatory medication reviews and provide feedback to the LTCF administrator and medical director. Consultant pharmacists may offer an important on-site perspective and expertise in improving the management of a wide range of medications, including antimicrobials, and should be seen as a potential resource for clinicians and medical directors regarding antimicrobial management (16). During disease outbreaks in nursing homes, consultant pharmacists may also provide valuable resident and family counseling regarding medication side effects or support regarding distribution of prophylactic antimicrobials (e.g., oseltamivir) (17).
Australian Consultant Pharmacists’ Potential Roles in Sleep Health Care: Exploring a New Avenue for Improving the Management of Insomnia
Published in Behavioral Sleep Medicine, 2022
Mariam M. Basheti, Minh Tran, Keith Wong, Christopher Gordon, Ronald Grunstein, Bandana Saini
Pharmacists have specialist education in medications and commonly work in community settings in Australia. A growing proportion of Australian pharmacists undertake specialty training to become “accredited” for specialized medication review services. This training requires completion of a Stage 1 Preparatory Module, followed by a stringent Stage 2 Clinical Assessment, and finally, triennial assessment with annual continuing professional development requirements that need to be met (AACP, (n.d)). This training process up-skills accredited pharmacists to systematically interview patients, check the patient’s understanding and usage of medications (prescribed/over-the-counter/complementary), understand lifestyle issues that may impact therapeutic outcomes (diet/exercise/alcohol/smoking) and review treatments for regimen appropriateness, drug-interactions, therapeutic duplication, missing therapy or potentially inappropriate medication use. Consultant pharmacists work collaboratively with GPs and other health professionals to improve safe and effective use of medicines through making pertinent regimen change recommendations post-review (Chen, 2016). Australian consultant pharmacist practice consists of providing Medication Management Review (MMR) services (Health, 2014), commonly known as Medication Therapy Management in the US and Clinical Medication Review/Medicines Use Review in the UK (Blenkinsopp et al., 2012; Pellegrino et al., 2009). In Australia, MMRs consist of two types; Home Medicines Review (HMR) and Residential Medication Management Review (RMMR) (Health, 2014). The procedural steps underpinning both HMR and RMMR services are showcased in Figure 1. Both the HMR/RMMR services are reimbursed by the Australian universal health insurance system (Medicare) (Chen, 2016; (Government, (n.d))), and involve a GP or medical practitioner (MP) identifying a patient who meets set criteria and referring the patient to a consultant pharmacist, or the patient’s own pharmacist (Administrator, 2020). The latter may be a consultant themselves, employ consultants within their pharmacy, or contract consultant pharmacists (Health, 2014). MMR services have shown positive results, improving prescribing outcomes and reducing patient exposure to inappropriate medications, all leading to improved patient well-being (Castelino, Bajorek et al., 2010; Castelino, Hilmer et al., 2010; Nishtala et al., 2009).