Daa Notes Flashcards
What does daa service provide
Aims to promote medicine safety and the quality use of medicines by improving adherence and medication management and reducing medication misadventure
What are the medication management services
Dispensing.
Staged supply
DAA- dose administration aids
MedsCheck, diabetes meds check
HMR review
What is the best Practice for promoting quality use of medication
-establishing patient need
-obtaining consent
-ensuring patient safety
-promoting quality use of medicines
What are the requirements of the preparation area
The preparation area needs to be
-Area of pharmacy that meets registration authority requirements
- Area should provide sufficient space to pack
-Area must have good lighting, be clean, tidy and orderly
- Area must not be accessible to public
-Area must offer freedom from interruption during packing process
What are the key factors when establishing the service
- Identify need
- Get consent
-Medication reconciliation
Describe “Identifying the need”
Pharmacist need to undertake need assessment to identify factors contributing to non adherence or medication errors to determine if DAA is useful
Patient must also be motivated and willing to use a DAA or else DAA isn’t appropriate
Patient must also have proper vision or else isn’t appropriate
Patients that may benefit from DAA service include
- Pt with medical history suggesting problems managaing medication
- pt who forget to take medication and would benefit from a visual use
-PT with a complex regime of medication with a regular dosing schedule
- Pt with signs of physical impairment
-Patient taking 5> drugs
Describe aspects of Consent
Pharmacist must obtained formed written patient consent and must be documented prior to receiving DAA service
Prior to the consent process, patient may choose not to have certain medication packed
Describe “ medicaion reconcilliation
Prior to packing a DAA pharmacist must reconcile all patient medication( prescription, non prescription and complementary medications )
Pharmacy to confirm medication profile pertaining
( brand name, generic name, form, strength, dose and dosage regime, indication, date started/ duration, prescriber)
With the prescriber or recent hospital discharge summary .
Pharmacist should reconcile frequently esp when there is medication changes, hospital admission and can use patient my health record to reconcile
PARTS of the reconciliation process include
- reviewing relevant information pertaining to patient age, cognitive state and if a carer or family member must be present
- Asking patient about any previous adverse effects ot medication
- Asking pt to bring all scripts and repeats if not already retained at pharmacy
-Assessing pt rational for treatment, attitude and adherence to the DAA service
Pharmacist should inform prescriber of any discrepancies
What is the eligibility criteria to offer DAA Service under 7cpa
Patients who are inellegible under criteria but who may still benefit from DAA can still be offered the program but pharmacy wont be paid
Eligibility Criteria includes
- Medicare card &/or DVA card holder or person who is eligible for Medicare card
- Living at home or a community setting
Current gov concession card
Difficulty managing their medication due to literacy, language, physical disability or cognitive disability
OR
Taking 5 or more medication and is having difficulty managing them
NB-
1. Aboriginal or Torres straight islander who is eligible eofr medicare who doesn’t hold a Medicare card or concession card will still be eligible
2. DAA funded under 7cpa isnt available to patients of public/private hospital, day hospital, transional care facilities to residents of a government funded age care facility or patients in a correctional facility
3. Daa funded under 7cpa only avaliable under one state/ federal/ state teritory. ie cant get &cpa funding for daa from differnt states claim can only be made under 1
How does the claiming process work
- Claim must be submitted by the end of the month
- Claim for provison of daa service= Getting paid for each week supply of pack
even if that means
-If a Patient receives a part-pack for the week after initiating a DAA or having been discharged from a hospital or facility, this is equivalent to one service - If a Pharmacy supplies a DAA that is subsequently altered or changed midweek, this is equivalent to one service
If a Patient requires multiple DAAs each week due to the volume of medicines, compatibility of medicines, the number of dosing times per day, or other factors, this is equivalent to one service
Under 7cpa
- Pharmacy gets paind $6.17 for each pt for each week of serice provided
- Participating pharmacies must keep records for 7 years
What are the processes of packing a DAA
- Risk Assessment -
( determine the medications to be packed ) - Dispensing and
storage - Packing
- Labelling
- Documentation - record details
- Checking - check patient details and contents of daa against the initial packing record
What is the risk assessment process of “Packing a DAA”
Pharmacist to weigh out the risk of packing certain medication
details of a medication that is packed and not packed should reflect on the DAA profile
What is the suitability criteria when packing medication in a DAA
- PRN MEDICATION- not to be packed as it will lead confusion and potential overuse
- Medication indicated for short term use - may be used for longer than needed
- If a medication has complicated regimen or have specific requirements around timing.
- If a decision is made to pack PRN medication these should be packed in a separate DAA
LIST of MEDICATIONS that may not be suitable to pack
-1.Effervescent tablets( effervescent forms of potassium, soluble aspirin)
2.Dispersable tablets(Piroxicam, Zactin dispersible tablets, Lansoprazole disp tablets)
3.Buccal tablets (Amphotericin b)
4.Sublingual tablets -
( GTN, Buprenorphine sublingual tablets)
5.Chewable tablets -( vitamin c
Hygroscopic tablets- Sodium Valproate
6.Tablets susceptible to light degradation ( Nifedipine, Tamoxifen
7.Tablets containing aluminium hydroxide, magnesium tricillicate
(Gavisocon, Hiprex, Omeprazole( unless packed monthly
8.Moisture sensitive tablets (ANY wafers ie olanzapine, ondansetron, Sumatriptan)
9.Medication where limited time in daa may be appropriate - ( levothyroxine can only be out of pack for upto 14 days )
10.Other medication where repacking is contraindicated from manufacturer Dabigatran
What are the requirments when retaining medication in original packaging
Not usually recommended due to risk of patient taking medication with the covering
Undertake risk of poor adherence and risk of swallowing. In consultation with prescriber can change to a drug that doesnt need to be packed in packaging ie Sodium valp, nifedipine, tamoxifen, wafers ect
Packing requirements of Cytotoxic drugs
To be packed in a separate Daa pack labelled cytotoxic away from other non cytotoxic drugs
Special handling required when dealing with thoes drugs esp pregnant women
