The use of insulin, considered a high-risk medication with APINCHs classification,5 Ms Barwick notes, provides justification for a Home Medicines Review (HMR). ‘There’s an advantage to going into the home to observe the patient’s diet, consider potential interactions, and educate patients on the best effects and outcomes,’ she says.
Advice around cleaning blood glucose level (BGL) monitors to ensure accuracy can also be provided. ‘Pharmacists can explain how to put test drops through and clean blood spills on the monitor, common in pregnancy due to higher blood volume,’ says Ms Barwick.
With only 50% of women diagnosed with GDM receiving tests for heart disease and type 2 diabetes post-pregnancy,6 HMRs can be beneficial at this stage of the journey, too.
‘Along with conversations around diet choices, exercise regimes and sleep, I also explain how often testing is required over the next 5–10 years, and how to monitor for signs of the development of diabetes,’ Ms Barwick advises.
Nausea and vomiting in pregnancy
The presence of iron in pregnancy multivitamins may exacerbate symptoms of nausea and vomiting in some pregnancies, according to Ms Barwick.
‘Pharmacists can recommend a trial cessation of the iron component of pregnancy vitamins, often unnecessary in pregnancy,’ she says.
In 2020, photographer Bobbi Lockyer created a Birthing on Country project to highlight and create awareness around birthing issues and outcomes in Aboriginal women. For more, see 
Suzanne Nielsen MPS[/caption]
Artificial barriers that prevent pharmacists in Queensland from caring for their patients should be removed, PSA has argued in the lead-up to the 2020 state election this month.
The election was the perfect time for legislators to commit to new reforms that would help pharmacists improve the health of Queenslanders, PSA Queensland Branch President Shane MacDonald said.
This includes allowing pharmacists to administer more routine medicines, such as injectable buprenorphine, enoxaparin (Clexane), denosumab (Prolia), risperidone, insulin or vitamin B12, to improve the management of complex health conditions.
‘Pharmacists are skilled in administering subcutaneous and intramuscular injections,’ he said. ’However, Queensland law currently limits the medicines which can be administered to some vaccines and adrenaline.’
‘Amending regulations will remove the barrier artificially preventing pharmacists from providing safe, convenient and timely healthcare to Queenslanders and be at no cost to the Queensland government.’
With PSA’s Medicine Safety: take care report revealing that more than 90% of patients have at least one medicine-related problem on leaving hospital, PSA has also asked the elected party to establish and fund transition-of-care pharmacists in all Queensland tertiary hospitals to avoid preventable readmissions.
Transition-of-care pharmacists would work with a patient’s care team to provide services that could reduce medicine harm.
‘[This could be] through reviewing medicines for patients who have experienced a heart attack, phoning patients to help safely wean doses of steroid medicines or coordinating medicines for patients with complex medicine profiles,’ Mr MacDonald said.
Pharmacists shouldn’t be forgotten
The state also needs a Chief Pharmacist to provide strategic leadership in improving medicine safety for Queensland and to drive coordination and rapid implementation of public health measures during emergencies.
This was made clear during the COVID-19 pandemic, with pharmacists overwhelmed not only by demand for medicines but by patients seeking guidance.
‘The absence of a Chief Pharmacist in Queensland during COVID-19 saw delays in implementing vital initiatives to support continuing medicine supply, such as digital image prescriptions and electronic prescriptions,’ Mr MacDonald said.
‘A Chief Pharmacist is needed to provide advice and leadership for timely government responses to emergencies as they occur and to deliver on Queensland’s commitment to Australia’s 10th National Health Priority Area: The Safe and Quality Use of Medicines.’
The PSA has provided pre-election submissions to the Queensland Labor and Liberal National Parties.
