How do you improve a community’s use of medicines? More importantly, how do you maintain the improvements? If we are to use medicines wisely and safely in the long term, we must find answers to these questions.

The Whyalla quality use of medicines project was an ambitious project that set out to answer these questions for rural communities. In doing so, it hoped to develop a sustainable model for improving the use of medicines in regional communities throughout Australia.

Whyalla is a regional city with a population of approximately 23,000 people that lies on the western side of Spencer Gulf in South Australia. It is a major industrial centre, and a service centre for the surrounding rural Northern Eyre Peninsula and Upper Spencer Gulf regions.

The city was chosen as the site for the project because it is a clearly delineated community with a comprehensive healthcare infrastructure. The city’s population is small enough to allow close monitoring of the project’s impact, but large enough to include a broad cross-section of ages; ethnic, social and cultural backgrounds; and health status. The city also has a strong community spirit, and good communication networks between different sectors of the community.

Getting started

A huge task like improving an entire city’s use of medicines requires widespread enthusiasm and goodwill, and the development of partnerships between different sectors of the community. In addition, all sectors of the community must feel they have contributed to the project, and their contribution has been listened to and valued.

The project began by creating an awareness and understanding of the quality use of medicines. This was achieved through segments on local radio and articles in the local newspaper.

A community consultation approach was used to identify and prioritise the community’s wise use of medicines issues, and to develop strategies to deal with the priorities. The project consulted all players in the quality use of medicines arena. This ensured that it tapped into the skills, knowledge and experiences of a wide cross-section of the community, and began recognising and supporting the partnerships needed to make the project work and get results.

The process of identifying the priority issues and the strategies to implement them was conducted in four stages. Each stage built on the previous stage, and progressively refined the issues and strategies.

Project Advisory Group

A steering committee, known as the Project Advisory Group, was formed to advise the Project Team. It comprised local health professionals as well as representatives of a wide range of local organisations, including the Whyalla Secondary College, Buttlingarra Aboriginal Corporation, Lions Club, SA Ambulance, and local print and television media. Members were chosen because of their credibility in the community and their knowledge of the community and its networks. The group provided advice on a range of issues, including the best ways of reaching the community, groups to consult, and the right language for the audience.

Identifying the issues

A series of 29 community consultations was undertaken to identify the QUM issues of most concern to the community. The groups consulted represented a broad cross-section of interests: consumers, pharmacists, doctors, allied health professionals, business and government. The consumer and community groups included support, chronic illness, indigenous, ethnic, older persons, carer, sporting, service and religious groups. The total number of people consulted was 273, or about 1% of the city’s population.

Almost every local consumer and community group was invited to participate. Most were recruited through the local council’s database of community groups, and the local knowledge and networks of the Project Team and the Project Advisory Group. Members of the Project Team approached representatives of the groups by telephone and in person to discuss the project, and invite each group to participate in a consultation. Advertisements inviting the wider community to participate were published in the local newspaper. In addition, some people, such as community pharmacists and members of parliament, were approached individually.

A list of 12 questions was used to guide and stimulate the discussion of QUM issues. Participants were encouraged to draw on their own experiences when identifying their concerns. Emphasis was placed on ensuring that all participants were able to raise their concerns and be heard, and that participation was equal.

The analysis of the consultations identified 5 main and 23 sub-themes that represented the community’s QUM issues.

In order to verify the issues identified in the consultations, the Project Team went back to a cross-section of the original groups. They invited two or three people from each group to participate in one of five workshops. The workshops gave participants the opportunity to discuss the issues identified, and to develop a better understanding of their relevance to the Whyalla community. Democratic processes were then used to determine the priority issues.

The project’s distinctive logo that appeared on all project material and publicity.

Identifying the strategies

The workshops, a planning meeting, and four working parties progressively brainstormed, prioritised and refined the strategies that could be used to address the priority issues. At the end of the process, four projects were proposed: a QUM resource centre, a QUM awareness campaign, a safe medications disposal campaign, and a benzodiazepines education campaign. MedicinesTalk will feature two of these projects in future issues.

Success factors

The Project Team believe that several factors ensured the success of the project: giving the project a strong identity, letting the community take the lead in decisions, using the existing structures to promote messages and disseminate information, and supporting the community to take action.

For further information about this and other rural projects click here.