Having practised as a hospital pharmacist by day and a residential aged care pharmacist by night, Dr Lisa Pont naturally began to think about how pharmacists could work differently as part of her research.
Having practised as a hospital pharmacist by day and a residential aged care pharmacist by night, Dr Lisa Pont naturally began to think about how pharmacists could work differently as part of her research.
This story is part of our 10 of the Best - fourteenth edition. 10 of the Best is an annual NHMRC publication, showcasing 10 NHMRC-funded health and medical research projects. See more 10 of the Best.
As a clinician-researcher, she understood the challenges at the patient level and knew data-driven research could help.
'I always say I have one foot in the clinical camp, but I have one foot in the research camp, and it means that I see things from both perspectives,' says Dr Pont, who is now at University of Technology Sydney.
In 2016, Dr Pont received a Translating Research into Practice Fellowship to lead a research program exploring potentially harmful medicine use in Australian nursing homes and trialled strategies to reduce prescribing of these medicines.
Polypharmacy, the use of multiple medicines, is commonly defined as the concurrent use of five of more medicines by the same person.
According to the Australian Commission on Safety and Quality in Health Care, prevalence of polypharmacy ranges between 43% and 95%, with people in hospitals and aged care homes at the higher end.1
Many aged care residents experience medicine-related problems, such as incorrectly prescribed doses, use of unnecessary or harmful medicines, or use of medicines which interact with each other.2
During the program, Dr Pont used data sourced from community pharmacies supplying the nursing homes in question. This data is collected and updated, and captures details of medicines delivered within the facility.
'It takes it out of a clinical trial setting and it allows us to start understanding what is happening with medicines in the actual population', Dr Pont says.
'That's something I can't get with a traditional data collection method.'
Dr Pont worked with independent not-for-profit NPSMedicineWise to bring the findings back to the aged care facilities, alongside the tools they needed to make a change.
'By bringing that data in, we were giving people feedback on what was happening in their facilities, but also giving them support about things that they might use to change', Dr Pont says.
'It was all about empowering the facility, which is again, commonplace these days. But at that time, that was something quite different … people saw medicines as the domain of the doctor.'
Dr Pont’s research highlighted the systemic need for better use of medicines in aged care, which formed part of the evidence base of the Australian Royal Commission into Aged Care Quality and Safety’s recommendations on pharmacists and residential aged care.
The research highlighted the potential to use routinely collected health data to monitor for the use of unnecessary or harmful medicines in aged care facilities.
Dr Pont now sits on an expert advisory group for the Australian Pharmacy Council, where the integration of data analysis, non-drug therapies and multidisciplinary teams in pharmacy education is being mapped out.
'At the moment, it's you're a data analyst, or you're a pharmacist', she says.
'But I think that's changing … the use of data is becoming much more essential in healthcare delivery.'
Equipped with these additional skills, pharmacists will be able to interpret real data to understand a facility’s medicine usage, informing and evaluating clinical practice. They will be able to work more collaboratively with other health professionals to incorporate non-drug therapies within the facility.
Next steps
The research identified significant variations between facilities in the frequency of usage for certain types of medicine. Dr Pont is now investigating the variation to better understand its drivers.
As the incoming President of the International Society of Pharmacoepidemiology#, Dr Pont is collaborating with colleagues around the globe on the use of real world data in pharmacy research.
#Pharmacoepidemiology is the study of the uses and effects of drugs in well-defined populations.
1 Australian Commission on Safety and Quality in Health Care, The Fourth Australian Atlas of Healthcare Variation, 6.1 Polypharmacy, 75 years and over
2 Kaur S, Roberts JA, Roberts MS. Evaluation of medication-related problems in medication reviews: a comparative perspective. The Annals of pharmacotherapy. 2012;46(7-8):972-982.