Dineen-Griffin Sarah, Benrimoj Shalom I, Garcia-Cardenas Victoria
PhD, GradCertPharmPrac, MPharm, BBSci. University of Technology Sydney. Sydney, NSW (Australia).
PhD, BPharm (Hons). University of Granada. Granada (Spain).
Pharm Pract (Granada). 2020 Apr-Jun;18(2):1967. doi: 10.18549/PharmPract.2020.2.1967. Epub 2020 May 15.
There is evidence that the Australian Government is embracing a more integrated approach to health, with implementation of initiatives like primary health networks (PHNs) and the Government's Health Care Homes program. However, integration of community pharmacy into primary health care faces challenges, including the lack of realistic integration in PHNs, and in service and remuneration models from government. Ideally, coordinated multidisciplinary teams working collaboratively in the community setting are needed, where expanding skills are embraced rather than resisted. It appears that community pharmacy is not sufficiently represented at a local level. Current service remuneration models encourage a volume approach. While more complex services and clinical roles, with associated remuneration structures (such as, accredited pharmacists, pharmacists embedded in general practice and residential aged care facilities) promote follow up, collaboration and integration into primary health care, they potentially marginalize community pharmacies. Community pharmacists' roles have evolved and are being recognized as the medication management experts of the health care team at a less complex level with the delivery of MedChecks, clinical interventions and medication adherence services. More recently, vaccination services have greatly expanded through community pharmacy. Policy documents from professional bodies highlight the need to extend pharmacy services and enhance integration within primary care. The Pharmaceutical Society of Australia's Pharmacists in 2023 report envisages pharmacists practising to full scope, driving greater efficiencies in the health system. The Pharmacy Guild of Australia's future vision identifies community pharmacy as health hubs facilitating the provision of cost-effective and integrated health care services to patients. In 2019, the Australian Government announced the development of a Primary Health Care 10-Year Plan which will guide resource allocation for primary health care in Australia. At the same time, the Government has committed to conclude negotiations on the 7th Community Pharmacy Agreement (7CPA) with a focus on allowing pharmacists to practice to full scope and pledges to strengthen the role of primary care by better supporting pharmacists as primary health care providers. The 7CPA and the Government's 10-year plan will largely shape the practice and viability of community pharmacy. It is essential that both provide a philosophical direction and prioritize integration, remuneration and resources which recognize the professional contribution and competencies of community pharmacy and community pharmacists, the financial implications of service roles and the retention of medicines-supply roles.
有证据表明，澳大利亚政府正在采用一种更具综合性的健康照护方法，推行了诸如初级卫生保健网络（PHNs）和政府的“医疗之家”计划等举措。然而，社区药房融入初级卫生保健面临挑战，包括在初级卫生保健网络中缺乏切实可行的整合，以及来自政府的服务和薪酬模式方面的问题。理想情况下，需要在社区环境中建立协同工作的跨学科团队，鼓励而非抵制技能拓展。在地方层面，社区药房的代表性似乎不足。当前的服务薪酬模式鼓励采用按量计费的方式。虽然更复杂的服务和临床角色以及相关的薪酬结构（如认证药剂师、全科医疗和老年护理机构中的药剂师）促进了跟进、协作以及融入初级卫生保健，但它们可能会使社区药房边缘化。社区药剂师的角色已经演变，并且在提供药物检查、临床干预和药物依从性服务等不太复杂的层面上，正被认可为医疗团队中的药物管理专家。最近，通过社区药房提供的疫苗接种服务大幅扩展。专业机构的政策文件强调了扩展药房服务以及加强在初级保健中整合的必要性。澳大利亚药学会2023年的药剂师报告设想药剂师充分发挥其能力范围，提高卫生系统的效率。澳大利亚药剂师公会的未来愿景将社区药房视为健康中心，为患者提供具有成本效益的综合医疗服务。2019年，澳大利亚政府宣布制定一项初级卫生保健十年计划，该计划将指导澳大利亚初级卫生保健的资源分配。与此同时，政府承诺就第七份社区药房协议（7CPA）进行谈判，重点是允许药剂师充分发挥其能力范围，并承诺通过更好地支持药剂师作为初级卫生保健提供者来加强初级保健的作用。7CPA和政府的十年计划将在很大程度上塑造社区药房的业务和生存能力。至关重要的是，两者都应提供一种理念方向，并优先考虑整合、薪酬和资源，以认可社区药房和社区药剂师的专业贡献和能力、服务角色的财务影响以及药品供应角色的保留。
