Quality Use of Medicines

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Background

The Department of Veterans' Affairs (DVA) provides services to entitled veterans, war widows/widowers and their dependants under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004. Approximately 300,000 Gold and White Card beneficiaries are entitled to treatment services.

During 2005/06, over fifteen million dispensings under the Repatriation Pharmaceutical Benefits Scheme (RPBS) were approved at a cost of $465 million. With an average age of 79 years, the rapidly ageing veteran community typically have more health problems, more complex medical conditions and tend to be more reliant on medications than younger populations. They are therefore, more likely to be at risk of medication related adverse events.

Medication error is one of the most common causes of unintentional harm in Australia which results in an estimated 140,000 hospital admissions every year. DVA has programs in place designed to reduce medication misadventure in the veteran community, improve their wellbeing, keep them at home and avoid preventable admissions to hospitals due to medication mismanagement.

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DVA's pharmacy initiatives

Veterans' medicines advice and therapeutics education services (Veterans’ MATES)

Veterans’ MATES is a consortium of prominent institutions including the University of South Australia’s Quality Use of Medicines and Pharmacy Research Centre, the University of Adelaide, the National Prescribing Service, the Australian Medicines Handbook, the Drug and Therapeutics Information Service and the Repatriation General Hospital Daw Park. Through its Veterans’ MATES program, DVA has enlisted the help of doctors and pharmacists to ensure veterans and war widows/widowers receive the best medication for their condition.

The Veterans’ MATES program replaces the very successful Prescriber Intervention and Feedback Program (PFP) which was delivered from 1998 to 2003, and is designed to improve the health and wellbeing of veterans by assisting them to manage medicines wisely. As of October 2006, the Veterans’ MATESprogram has delivered eight clinical modules since its inception in June 2004.  A further eight modules are planned to be delivered before June 2009.  The modules will provide feedback, evidence-based materials and practice visits for selected medical practitioners for whom the module material is relevant.

The program draws on RPBS data to identify and address potential medication-related problems among veterans. Modules include resource materials for veterans, prescribing doctors, pharmacists and other health professionals such as nurses. All module material is made available on-line at the Veterans' MATES pages

The Department is supporting a close working relationship with Local Medical Officers (LMOs), to alert them to potential medication problems that have been identified with their veteran patients and to seek their co-operation in investigating and resolving any problems. LMOs are encouraged to review medication profiles, make any necessary changes in treatment or arrange a medication review for the veteran.

Community-based medication review program

Under this program an LMO can refer a veteran or war widow/widower to an accredited consultant pharmacist. These pharmacists are specially trained to conduct medication reviews, to identify potential medication problems and to produce reports for LMOs. The accredited pharmacist will visit the veteran or war widow/widower at home on appointment for a medication review. The aim of this program is to ensure that all medications are used correctly, and that there is no drug duplication or potential for adverse effects such as drug interactions or contraindications.

The Department's Veterans’ MATES program will identify those veterans and war widows/widowers who may have a medication problem and will alert the LMO by letter. The Department wishes to build a closer working relationship between LMOs and pharmacists by providing information on potential medication mismanagement to alert the LMO. The LMO may then work with the patient to address the issue.

Medication reviews will only be conducted with the approval of the veteran's or war widow’s/widower’s LMO, and with the consent of the veteran or war widow/widower.

Veterans, war widows/widowers and their dependants are also eligible to receive a MBS item 900 Home Medicines Review (HMRs) which are arranged through their treating LMO and are conducted by an accredited pharmacist.  There is no requirement for pharmacists to register with DVA prior to providing a HMR service for a veteran. For more information on HMRs, see http://www.medicareaustralia.gov.au/providers/incentives_allowances/pharmacy_agreement/hmr.htm

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Other DVA pharmacy initiatives

MediWise - DVA sponsors kits produced by the Pharmaceutical Society of Australia (PSA) which are then used by pharmacists as the basis for providing presentations on the appropriate use of medicines. These kits include MediList and Health Record cards that allow veterans and war widows/widowers to record all their medicines and instructions for taking them.

Self care fact cards - DVA sponsors the development of several Fact Cards by the Pharmaceutical Society of Australia (PSA). These Fact Cards provide information on a range of health matters and suggestions for self managing common medical conditions. These cards are available to community pharmacies and general practices, and present peer-reviewed information to the community in easy-to-understand terms. They are available for distribution by community pharmacists and are available to reinforce counselling messages by LMOs and pharmacists. Fact Cards that are sponsored by the Department cover topics including falls prevention; the wise use of medicines; gout; depression; anxiety; sleeping problems; complementary medicines; and post traumatic stress disorder.  Copies of these fact cards are also available from the Department.

Wound care resources- DVA has contracted Monash University to develop resources for health professionals to assist them in the management of wounds in both the veteran, and wider community. 

See: Wound identification resource kit 

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Enquiries

Director
Medication Management
Department of Veterans' Affairs
PO Box 9998
Canberra ACT 2606

DVA state office pharmacists

QLD - (07) 3223 8652
NSW - (02) 9213 7510
VIC - (03) 9284 6442
TAS – (03) 6221 6631
SA - (02) 9213 7510
WA - (08) 9366 8337

Veterans’ MATES enquiries

The prescriber helpline- 1800 500 869
The veteran helpline- 1300 556 906

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