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]
Last month, I had the pleasure of meeting many of you at our annual PSA22 flagship conference in Sydney, where we also launched our Medicine safety: disability care report, the fifth in our series of Medicine Safety reports.
Approximately 4.4 million Australians are living with a disability, many requiring complex medical care. Safety problems with medicines are very common, and mainly relate to timely access to health professionals, inappropriate prescribing, difficulty in taking medicines, and inadequate access to medicine management review services.
Overuse of chemical restraint is a significant problem – 74% of people with intellectual disability in a residential facility have been chemically restrained for more than 5 years.
In 2020, the NSW Poisons Information Centre received 11,197 calls from disability service providers about medicine safety issues, many of which could have easily been resolved by better access to pharmacist care.
Medicine safety problems often go unreported for those living independently, with family in-home or residential care, meaning that reported data is only the tip of the iceberg!
The PSA has been working hard to bring medicine safety to the forefront of conversations on disability care – as we have done with aged care over the past 18 months.
There is a clear and pressing role for pharmacists to be engaged in medicine safety for people with disability. Pharmacists must be recognised as an essential service provider for people with special medicine needs and should be embedded everywhere that medicines are used.
A greater focus on medicine safety is needed to help address the health and life expectancy gap for people with disability. This Medicine Safety report into disability care offers four core recommendations that will ensure Australians with a disability get the best care possible.
Pharmacists are the key, and we look forward to working with state, territory and federal governments, the disability sector, patients, and their families to improve the provision of care to Australians living with a disability.
The Medicine safety: disability care report is available on the PSA website – I encourage all members with an interesting disability care to have a read. The overuse of chemical constraint is a significant challenge that pharmacists and the wider health care profession must work together to address. We can all do better to support our patients who live with a disability.
DR FEI SIM FPS BPharm (Hons) PhD FHEA GAICD FPS: Follow Dr Fei Sim FPS on Twitter at @drfeisim and connect on LinkedIn via Dr Fei Sim.
