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Call to integrate pharmacists within Aboriginal Community Controlled Health Services to fight chronic disease

Joseph Guenzler -

The Queensland Aboriginal and Islander Health Council's submission to the recent House of Representatives Inquiry into Diabetes centers on the impact of social, environmental, and health system factors that create additional challenges for Aboriginal and Torres Strait Islander communities in preventing the illness and its associated complications.

As the peak body representing Aboriginal Community Controlled Health Organisations (ACCHOs) in Queensland, the Queensland Aboriginal and Islander Health Council (QAIHC) stresses that improving access to culturally sensitive primary healthcare services can have a significant impact on health outcomes.

QAIHC's chief executive Cleveland Fagan said ACCHOs provide most primary health care services to the Aboriginal and Torres Strait Islander population across Australia, and are best placed to help prevent diabetes, identify and intervene early, and help patients to navigate health system challenges.

"When people can access this support, people's health outcomes and quality of life is considerably improved," Mr Fagan said.

QAIHC's Public Health Physician Associate Professor Sophia Couzos said diabetes can be a complex condition for patients to manage.

She noted that many patients cannot access the quality primary health care they need, and when they access this care it can be difficult to adhere to treatment, especially medications.

"And medications can't work if patients don't take them," she said.

A/Prof. Couzos played a pivotal role as the lead researcher in the Integrating Pharmacists within Aboriginal Community Controlled Health Services to Improve Chronic Disease Management (IPAC Project).

This nationwide trial, conducted in collaboration with QAIHC, JCU, the National Aboriginal Community Controlled Health Organisation (NACCHO), and the Pharmaceutical Society of Australia (PSA), aimed to integrate non-dispensing pharmacists into the clinical teams of 18 ACCHOs in Queensland, Northern Territory, and Victoria.

The research outcomes revealed Aboriginal and Torres Strait Islander people dealing with chronic conditions such as diabetes experienced notable advantages when they received support from both their physician and a healthcare team that included an on-site pharmacist.

This comprehensive approach led to improvements in diabetes management, a reduction in cardiovascular disease risk factors, a decrease in medication errors, and enhanced medication understanding, ultimately resulting in improved medication adherence among the patients.

Mr Fagan said pharmacists working in ACCHOs made a significant difference helping patients take their medicines, help doctors deliver better care, and help our people lead healthier lives.

"There were improvements in diabetes, blood pressure, and kidney function, more medicine reviews by doctors, far fewer medication prescribing errors, more patients took their medicines as they needed to, and patients felt healthier as a result," Mr Fagan said.

The Medical Services Advisory Committee, an independent body established by the Australian government, supports the value of the IPAC Project.

On June 12, MSAC advised funding to expand the integration of non-dispensing pharmacists into Aboriginal Community Controlled Health Organisations more widely, reflecting the positive impact observed in the project's outcomes.

A/Prof. Couzos said the research was significant as the largest dataset of Aboriginal and Torres Strait Islander individuals with chronic disease ever enrolled to study the use of medicines, with 1,456 participants.

"The IPAC Project's integrated approach to primary health care is also significant because of the benefits we see on a system level," she said.

"It's good for diabetes patients, but also for those with chronic cardiovascular disease, and it slowed down kidney disease deterioration that is often linked with diabetes.

"Pharmacists can take the strain off doctors when they work together as better medication means better management, and better management means fewer hospitalisations and doctor visits."

In the wake of these findings and MSAC's recommendations, QAIHC calls on the Albanese Government to provide more and targeted funding so interested ACCHOs can integrate pharmacists into their own operations.

"It's safe, improves chronic disease indicators, and costs a similar amount to existing medication review programs but has demonstrated improved outcomes for our people," Mr Fagan said.

"This should be rolled out Australia-wide as a measure for Closing the Gap."

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