Quality Use of Medicines in Practice

This paper critically analyzes a case study on quality use of medicines, focusing on the health of Mr. T. It discusses the key issues and provides recommendations based on the Australian healthcare system. Subject: Medicine

Quality Use of Medicines in
Practice
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Introduction
The primary purpose of the paper is to critically analyse the case study related to quality use of
medicines. Based on the case study it will summarise the key issues that may create a negative
impact on the health of Mr. T. It will discuss the importance of the principles of quality use of
medicines for older Australians. Moreover, from the key issues, the paper will select two issues
and provide recommendations to address the issues. The recommendations will be entirely based
on the healthcare policy related to the Australian Healthcare system. The recommendations will
help Mr. T to mitigate the issues efficiently and effectively.
Critical analysis of the case study
Mr. T is an 84-year old widower who lives at home on his own. From the case study, it can be
seen that Mr. T has been suffering from hyperlipidemia, arthritis, hypertension, and heart failure.
Whereas, eight and two years previously he has a history of two myocardial infarctions. On the
other hand, he has been admitted in the hospital for a DVT due to an acute episode of GORD.
Followed by this his daughter him to the general practice clinic. Based on this condition of Mr. T
the significant issue is that Mr. T’s daughter was worried as over the last few months he had
several falls and mentally he is not as sharp as he was earlier. Another issue is that Mr. T remains
ambulatory with a cane where he reports of not needing assistance with his regular activities.
It has been observed that Mr. T prefers drinking on Friday and Saturday night and had quit
smoking ten years ago. As per his prescribed medications, it has been noticed that he has to take
eight medicines daily to remain healthy and fit. While questioning Mr. T related to his
medicines, he stated that he does not forget to take the doses. Whereas, the significant issue is
that he finds it difficult to name as well as identify the medicines. However, he identifies the
medicines by their shape and color, which may result in the inappropriate intake of medicines.
He also states that due to blood pressure when he gets a headache, he takes an extra dose of
metolol. From the case study, another significant issue that has been identified is Mr. T
complains several times that how he feels like a pill bottle due to the intake of eight medicines
per day. According to him, he did not want to spend his pension money on purchasing the pills
every month.

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It has also been observed that Mr. T comprise of a medicine box that has been brought by her
niece from his kitchen, which he uses when he needs them. According, to Mr. T some of the
medicines were recommended by a pharmacist, some were given to him by his neighbors as they
did not need them anymore and few of the medicines were brought from the supermarket. The
consumption of these medicines may be harmful to his health as he is unaware of the use of
medicines. As a result, it will create a negative impact on the health and wellbeing of Mr. T.
Recommendations to address the two selected issues
From the case study, various issues have been analysed; out of these issues, the two selected
issues are as follows:
Most of the time, Mr. T complains that he feels like a pill bottle, and he did not want to spend his
entire pension money in order to buy medicines. Based on this issue, it is highly recommended
that Mr. T must be provided with incentives for improving the quality use of medicines by the
Australian healthcare system. For the older Australians like Mr. T, who is 84 optimising quality
use of medicines will help in using the strategies (Titov et al., 2015). The strategies will help Mr.
T to adopt the new or existing Medical Benefits Scheme (MBS) items, promoting deprescribing
of medicines, and more proactive review based on quality use of medicines. The Medical
Benefits Scheme (MBS) will save the pension money of Mr. T that is spent on buying pills. He
must implement the strategies that provide access to regular feedback and reporting to quality
indicators along with non-pharmacological therapies (Hubbard et al., 2015). In order to address
this particular issue, the Australian healthcare system must make efficient use of digital resources
that can be utilised for non-pharmacological management and medication review
(Theuretzbacher et al., 2015). To facilitate a comprehensive medication review, the new MBS
items must be formulated. These strategies will help Mr. T to utilise better the new and existing
MBS items, non-pharmacological interventions, and quality use of medicines that are taken
regularly. It will also minimise the usage of irrelevant polypharmacy as well as improve the
quality of life and health of Mr. T.
Sometimes Mr. T makes use of medicines that have been given by his neighbors, recommended
by the pharmacist, and some of them were brought from the supermarket that could be harmful
to him. It is strongly recommended that the Australian Health care system, such as the Australian
Therapeutic Goods Administration (TGA) must examine the presence of compulsory heading to

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the sanctioned Consumer Medicine and Product Information of all medicines (Westbrook et al.,
2015) This will help Mr. T and other older Australians to gather relevant information regarding
the use of medicine before consuming it as well as how to cease and safely withdraw the
medicine. Moreover, it is also recommended that the Australian National Medicines Policy
(1999) and National Strategy of Quality Use of Medicines 2002 must be updated to guide older
people like Mr. T regarding the use of medicines (Scott et al., 2015). To address this issue, the
national document must be updated that should lead to prioritisation and involvement in
appropriate national professional organisational standards of practice and jurisdictional
government guidelines (Waring, Allen, Braithwaite & Sandall, 2016).
Moreover, to mitigate this issue, the Australian healthcare system must review the current
Australian policies. It is also recommended that there is a requirement to serve integrated and
multidisciplinary patient-centered pharmaceutical care to Mr. T across the funding bodies,
healthcare professionals, and public and private hospitals (Wimmer et al., 2017). In order to
enhance the quality use of medicines, it is significant to develop a system map that helps in
understanding the complex pathways of Mr. T and facilitates integrated patient-centered and
multidisciplinary care. The older Australians like Mr. T must be provided with relevant tools and
education to improve quality use of medicines. The healthcare professionals must follow the
principles of quality use of medicine that includes medicines management (Qi et al., 2015). Such
principles will help Mr. T to recognise the medicines and will be able to make appropriate use of
them. Translation and synthesis of research into educational, tools, and guidelines opportunities
to guide relevant deprescribing and prescribing in older adults with multimorbidity are required.
The healthcare professional’s guidelines and tools such as the Australian Medicines Handbook
must be provided that consist of current sources of medicines information (Jokanovic, Tan,
Dooley, Kirkpatrick & Bell, 2015).
Furthermore, the Australian Healthcare system must implement the National strategic plan to
minimize inadequate polypharmacy. Systems to facilitate coordination, communication, and
collaboration are needed. It is also required to create systems to maintain appropriate up to date
records of medicine for older adults living in Australia (Gebel et al., 2015). On a community
level, the process markers, economic outcomes, associations with patient outcomes, and high-
risk medicines use is required to be monitored nationally.

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Conclusion
The paper critically analysed the case study related to Mr. T, who is dealing with hyperlipidemia,
arthritis, hypertension, and heart failure. It also summarizes the key issues related to the case
study. Out of various key issues, two issues had been selected; they are, Mr. T feels stresses out
of taking eight pills regularly. He states that to purchase the pills, he has to spend his entire
pension money. However, it is recommended that the Australian Healthcare system must provide
an incentive to Mr. T in the form of Medicine Benefits Scheme (MBI) to buy medicines without
spending his pension money. Thus, it is required to formulate the MBI items to help Mr. T to
utilise the new and existing MBI item better.
Another issue that has been identified from the case study is that sometimes Mr. T takes
medicine recommended by the pharmacist, provided by the neighbors and purchased from the
supermarket. It can be seen that the consumption of such medicine is harmful as Mr. T is
unaware regarding the use of these medicines. Hence, it is recommended that the Australian
Healthcare system must provide information on the approved medicines for the convenience of
older Australians. The Australian Healthcare system must also provide Australian Medicines
Handbook to Mr. T that possess relevant information regarding medicine.

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References
Gebel, K., Ding, D., Chey, T., Stamatakis, E., Brown, W. J., & Bauman, A. E. (2015). Effect of
moderate to vigorous physical activity on all-cause mortality in middle-aged and older
Australians. JAMA internal medicine, 175(6), 970-977.
Hubbard, R. E., Peel, N. M., Scott, I. A., Martin, J. H., Smith, A., Pillans, P. I., ... & Gray, L. C.
(2015). Polypharmacy among inpatients aged 70 years or older in Australia. Medical
Journal of Australia, 202(7), 373-377.
Jokanovic, N., Tan, E. C., Dooley, M. J., Kirkpatrick, C. M., & Bell, J. S. (2015). Prevalence and
factors associated with polypharmacy in long-term care facilities: a systematic
review. Journal of the American Medical Directors Association, 16(6), 535-e1.
Qi, K., Reeve, E., Hilmer, S. N., Pearson, S. A., Matthews, S., & Gnjidic, D. (2015). Older
peoples’ attitudes regarding polypharmacy, statin use and willingness to have statins
deprescribed in Australia. International journal of clinical pharmacy, 37(5), 949-957.
Scott, I. A., Hilmer, S. N., Reeve, E., Potter, K., Le Couteur, D., Rigby, D., ... & Jansen, J.
(2015). Reducing inappropriate polypharmacy: the process of deprescribing. JAMA
internal medicine, 175(5), 827-834.
Theuretzbacher, U., Van Bambeke, F., Cantón, R., Giske, C. G., Mouton, J. W., Nation, R. L., ...
& Kahlmeter, G. (2015). Reviving old antibiotics. Journal of Antimicrobial
Chemotherapy, 70(8), 2177-2181.
Titov, N., Dear, B. F., Ali, S., Zou, J. B., Lorian, C. N., Johnston, L., ... & Fogliati, V. J. (2015).
Clinical and cost-effectiveness of therapist-guided internet-delivered cognitive behavior
therapy for older adults with symptoms of depression: a randomized controlled
trial. Behavior therapy, 46(2), 193-205.
Waring, J., Allen, D., Braithwaite, J., & Sandall, J. (2016). Healthcare quality and safety: a
review of policy, practice and research. Sociology of Health & Illness, 38(2), 198-215.
Westbrook, J. I., Li, L., Lehnbom, E. C., Baysari, M. T., Braithwaite, J., Burke, R., ... & Day, R.
O. (2015). What are incident reports telling us? A comparative study at two Australian

7
hospitals of medication errors identified at audit, detected by staff and reported to an
incident system. International Journal for Quality in Health Care, 27(1), 1-9.
Wimmer, B. C., Cross, A. J., Jokanovic, N., Wiese, M. D., George, J., Johnell, K., ... & Bell, J. S.
(2017). Clinical outcomes associated with medication regimen complexity in older
people: a systematic review. Journal of the American Geriatrics Society, 65(4), 747-753.