Rub shoulders with Kerri Barwick MPS (centre) and other members of team PSA at CPC24[/caption]
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]
Case Scenario
Kiet, a 45-year-old man of Thai ethnicity, presents to your pharmacy with a prescription for allopurinol. He has been prescribed this to treat his frequent gout flares, for which he usually takes ibuprofen. Kiet is worried, as he recalls his brother having a ‘bad reaction’ to a gout medicine in the past, and because he has never had to take any regular medicines before. You look in the Australian Medicines Handbook and note that Kiet’s ethnicity may increase his risk of having the HLA-B*58:01 allele, which significantly increases the risk of hypersensitivity reactions with allopurinol. You ask Kiet, but he does not recall having had any genetic tests in relation to this.
Introduction
Medication-related problems have a significant impact on individuals and Australia’s healthcare system, costing $1.4 billion annually and causing 250,000 annual hospital admissions.1 Half of medication-related harm is believed to be preventable.1 Consequently, medicines safety is Australia’s 10th National Health Priority Area, and the work of pharmacists is integral to its achievement.2
Pharmacogenomic testing is a tool that can be used to personalise medicine management. It has been shown to reduce adverse events, healthcare utilisation and healthcare costs.3-6
Learning objectivesAfter reading this article, pharmacists should be able to:
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