The Editorial Executive Committee welcomes letters, which should be less than 250 words. Before a decision to publish is made, letters which refer to a published article may be sent to the author for a response. Any letter may be sent to an expert for comment. When letters are published, they are usually accompanied in the same issue by their responses or comments. The Committee screens out discourteous, inaccurate or libellous statements. The letters are sub-edited before publication. Authors are required to declare any conflicts of interest. The Committee's decision on publication is final.
Letter to the Editor
Editor, – The recent editorial by Andrew McLachlan (Aust Prescr 2014;37:110-1) overlooked an interesting point about reforms to the Pharmaceutical Benefits Scheme (PBS) in public hospitals. In some states, the reforms have seen patients discharged with one month's supply of their medications, in place of the traditional few days' supply currently given in hospitals not affected by the reform.1 The model of minimal supply forces patients to visit their GP and pharmacy as soon as possible after discharge.1 This has significant impacts on continuity of care - if a month is left from discharge to visiting their GP, problems due to changes in medications at discharge may not be identified.1, 2
PBS reform is intended to decrease confusion about changes to medications. However, it will not achieve this as hospitals will continue to keep only the single contracted brand of medication and there may be an increase in readmissions due to patients not being followed up by the GP after discharge.1 Further to this, the PBS reforms in public hospitals have given pharmacy departments the opportunity to profit from patients' discharge medications, causing hospital pharmacies to focus on supply rather than clinical practices.3, 4 This draws pharmacists away from important clinical roles including medication safety, counselling and education services, not to mention liaison with community services including the GP and pharmacy about the changes to patients' medication regimens.3, 4
Given that it has been shown that clinical pharmacists in hospitals reduce adverse drug events and improve patient safety, funding systems should focus on streamlining processes, community liaison and integration with community-based programs, not on increasing the burden on already short-staffed hospital pharmacy departments.3, 4
Manning Base Hospital
- Jackson JK. Analysis of the impact of public hospital pharmaceutical reforms on discharge medication supply. Aust J Hosp Pharm 2001;31:295-9.
- Morgan TK, Williamson M, Pirotta M, Stewart K, Myers SP, Barnes J. A national census of medicines use: a 24-hour snapshot of Australians aged 50 years and older. Med J Aust 2012;196:50-3.
- Department of Health and Ageing. National Medicines Policy. Canberra: Department of Health and Ageing; 2000.
- The Society of Hospital Pharmacists of Australia. Position statement: Funding for medicines used in public hospitals. Melbourne: SHPA; 2002.
- Doran E, Iedema J, Ryan L, Coombes I. Fatal rhabdomyolysis following voriconazole and simvastatin. Aust Prescr 2012;35:88-9.