Community pharmacies already deliver essential services to older Australians, both in residential aged care homes and in the community
Some of those services include:
- medication management, including medication checks and reviews
- medication adherence such as dose administration aids, and
- clinical governance and quality use of medicines, supporting safe and effective medication use.
Research shows 99 percent of residential aged care homes have access to at least one pharmacy within 2.5 km radius in metropolitan areas, while 93 percent have that access in regional areas.
Community pharmacies currently supply medicines and medication management services to more than 3,000 aged care homes nationwide. These services work well when underpinned by a strong relationship with the aged care provider together with a commitment to patient safety and continuity of care.
However, in some cases, the model’s application can be fragmented: medicine supply is often separated from other clinical services, and this can lead to inefficiencies, duplication, and an increased risk of medication misadventure.
Funding mechanisms can also exacerbate the issue. Under the Australian National Aged Care Classification funding model, aged care homes have discretion over how medication management funding is applied, and this risks de-valuing and de-prioritising the pharmacy’s dose administration aids service.
This needs to be rectified by ensuring the medication supply service and medication adherence service are separated.
Towards 2035
The PGA’s new 10-year plan sets out a bold vision: to make community pharmacy the first point of contact for healthcare in Australia. It is structured around focus areas with clear strategies and measurable outcomes.
There are several common links between the Towards 2035 strategic plan, the National Aged Care Reforms, and the Scope of Practice Review led by Professor Mark Cormack.
These common themes do present a national strategic alignment in health reform to modernise healthcare delivery, optimise workforce capabilities, and improve patient outcomes — especially for older Australians.
Theme | Towards 2035 | Aged Care Reforms | Scope of Practice Review |
|---|---|---|---|
| Workforce Optimisation | 80% of pharmacists qualified to prescribe by 2035 | Develop a strong workforce strategy for aged care | Remove barriers to full scope of practice for health professionals |
| Patient-Centered Care | Think pharmacy first for healthcare | Place older Australians at the center of care | Improve access and outcomes for marginalised groups |
| Strategic Planning | 10-year strategic roadmap with clear focus areas | Strategic plans reviewed periodically for continuous improvement | 18 recommendations across workforce, education, regulation, funding |
| Collaboration and Integration | Advocacy and partnerships to strengthen pharmacy’s role | Engage stakeholders including consumers and providers | Promote multidisciplinary team-based care |
Aged-care solution providers
Community pharmacies can offer real solutions for older members of their communities, including outreach services and residential care.
Outreach services
Where community pharmacists, based at a local community pharmacy, travel to external health facilities or homes—offer a compelling solution. These models allow community pharmacies to act as both suppliers and clinical service providers, reducing fragmentation and improving continuity of care.
Residential care
Outreach pharmacists can provide oversight and ensure all medication services are coordinated. In home care, outreach enables older Australians to receive high-quality medication management in the home, aligning with recommendations from the Royal Commission into Aged Care Quality and Safety.
Aged care and digital health
The Electronic National Residential Medication Chart (eNRMC) is a conformant electronic medication management system which allows for the prescribing, supply, and administration of medicines in residential aged care settings without the need for paper prescriptions.
The eNRMC systems are being updated to meet electronic prescribing conformance requirements with the aim of enhancing medication management in aged care homes. This transition aims to improve safety, reduce administrative burden, and streamline pharmacy dispensing processes.
The eNRMC proposes significant benefits to community pharmacies, particularly those providing dose administration aids to patients living at home and in aged care homes.
The eNRMC has several key advantages
Streamlining dispensing workflow
Chart-based electronic prescriptions are accessible via the National Prescription Delivery Service (NPDS), eliminating the need for manual transcription from paper charts 1.
Scan a token or barcode
Pharmacists can retrieve prescriptions directly into their dispensing software, reducing errors and saving time 1.
Extended chart duration
eNRMC charts are valid for six months (up from four months), reducing the frequency of chart renewals and associated administrative burden 1 2.
Improved coordination and communication
Real-time access to medication charts enhances collaboration between pharmacies, prescribers, and aged care staff 3. Clinical Information Systems (CIS) and My Health Record (MHR) Integration supporting data sharing and continuity of care 3.
Enhanced safety and accuracy
Reducing transcription errors and supporting timely medication administration 3.
Single source of truth
For medication records, improving visibility and reducing risks associated with polypharmacy 2.
Support for PBS/RPBS claiming
Fully conformant eNRMC systems support PBS/RPBS claiming directly from the chart, removing the need for separate paper prescriptions 2.
Remote access and flexibility
Pharmacists can access live eNRMC charts remotely, which is especially useful for supplying DAAs to patients at home or during temporary leave from aged care 2.
For these benefits to be fully realised, several issues must be addressed, including community pharmacies bearing the brunt of implementation costs — software licensing and upgrading, training, data entry, and verification.
Moreover, prescriber reluctance and a misalignment with pharmacy workflows will introduce inefficiencies and reputational risks. Pharmacies also often find themselves mediating between prescribers and the RACH, advocating for safe practices while absorbing the operational burden.
Collections of information
The Department of Health, Disability and Ageing has a collection of information about electronic National Residential Medication Chart (eNRMC) products. It includes specific information for residential aged care providers, prescribers, software vendors and pharmacists and can be accessed via here: https://www.health.gov.au/resources/ collections/enrmc-transitional-arrangements-collection
Pharmacy first for aged care
Community pharmacies are already indispensable to aged care. With the strategic direction set by Towards 2035, they are poised to become even more central—delivering accessible, innovative, and patient-centred care that meets the complex needs of older Australians.
This future is not just aspirational — it is achievable. Through bold policy, empowered practitioners, and a commitment to healthier communities, PGA’s vision will ensure older members of our communities and those in aged care residents receive the best possible pharmacy care, wherever they live.
| Key eNRMC transition dates | |
|---|---|
| End of September 2025 | All eNRMC software vendors must have met electronic prescribing conformance. |
| From October 1 to February 28 2026 | Transitional arrangements apply for conformant systems. |
| From March 1 2026 | Only fully conformant eNRMC systems can be used for prescribing; non-conformant systems may be used for administration only1. |
Ace in the deck: Why dose administration aids matter
Medication adherence in older Australians is a complex and persistent challenge, driven by factors such as polypharmacy, cognitive decline, physical limitations, and fragmented healthcare systems.
Dose administration aids – often referred to as DAAs – can improve medication adherence in older Australians by simplifying complex regimens and reducing unintentional non-adherence, particularly among those with cognitive or physical limitations. They really are community pharmacy’s ace in the deck for aged care medication adherence.
However, there is a caveat – a DAA’s effectiveness does depend on individual factors such as motivation, cognitive capacity, and the stability of the medication regimen
These aids are most beneficial when used as part of a coordinated, multidisciplinary approach to medicines management. These devices, facilitated and packed by pharmacists, organise medications according to the days of the week and times of the day.
They are particularly effective for patients who take multiple medications, as they help to ensure that the right dose is taken at the right time. They are pre-packed by pharmacists and come in various forms, including weekly or monthly packs.
Medication use amongst older people in Australia
High prevalence of medication use
- Nearly 98% of Australians aged 75 and over were dispensed at least one PBS medication in 2022. On average, they were dispensed 8 different medication types 1.
Polypharmacy is common
- 71.5% of people aged 75+ were dispensed five or more medications.
- 32.6% were dispensed 10 or more 1.
- Polypharmacy increases the risk of adverse drug events, interactions, and medication-related harm 2.
Medication management reviews (MMRs)
- Only 5.4% of people aged 75+ had at least one MMR in 2018–19, despite high rates of polypharmacy 2.
Common medication types
- Cardiovascular, nervous system, and gastrointestinal medications are among the most frequently dispensed 1.
Widespread medicine-related problems
- Over 95% of aged care residents have at least one medication-related issue; most have three or more 3.
Inappropriate medication use
- * Over 50% of aged care residents are prescribed medications considered potentially inappropriate for older people.
- 20% of unplanned hospital admissions are due to such medications 3.
Common safety concerns
- * Sedating medications, antipsychotics, and benzodiazepines are often used for too long.
- Administration errors and altering medications (e.g., crushing tablets) are also prevalent 4.
Community pharmacy fast facts
Highly accessible
- There are more than 6,000 community pharmacies across Australia.
- 97% of people in capital cities live within 2.5 km of a pharmacy.
- Nearly 40% of pharmacies offer after-hours services 4.
Frequent contact
- Australians visit a community pharmacy 18 times per year on average.
- For many older adults, especially those living alone, pharmacy staff may be their only regular face-to-face contact 4.
Social connection role
- Pharmacies are increasingly recognised for their role in addressing loneliness, which is linked to increased medication use, including opioids and benzodiazepines 4.
Understanding dose administration aids
Dose administration aids have a multitude of benefits and are the most prominent of medication adherence tools
The use of DAAs has been shown to have a positive impact on patient outcomes. Improved medication adherence leads to better management of chronic conditions, which in turn reduces hospitalisations and healthcare costs.
Patients using DAAs report higher satisfaction with their medication management and a greater sense of control over their health.
How effective are they?
Recent studies have provided valuable insights into the effectiveness of DAAs. For instance, a study conducted by the University of Sydney found that patients using DAAs had a 20% higher adherence rate compared to those who did not use them 5. Another study published in the Journal of Clinical Pharmacy and Therapeutics reported that DAAs significantly reduced medication errors in elderly patients 6. Additionally, a nationwide cohort study highlighted that DAAs were associated with a 25% reduction in hospitalizations due to medicationrelated issues 7.
Research and funding
Several studies have highlighted the effectiveness of DAAs in improving medication adherence and patient outcomes. For example, a study conducted by The University of Sydney found patients using DAAs had a 20 percent higher adherence rate compared to those who did not use them.
Another study published in the Journal of Clinical Pharmacy and Therapeutics reported DAAs significantly reduced medication errors in elderly patients.
The Australian Government, under the 8th Community Pharmacy Agreement (8CPA), subsidises a weekly DAA service for up to 90 pharmacy patients who live in the community. However, this funding is not available to permanent residents of Aged Care homes.
This type of research shows dose administration aids play a crucial role in supporting the quality use of medicines. They offer numerous benefits, including improved adherence, reduced medication errors, enhanced safety, and convenience.
However, challenges such as cost, accessibility, and the need for patient education must be addressed to maximize their effectiveness. Overall, however, DAAs have a positive impact on patient outcomes and are a valuable tool in the management of medication regimens.
References
- Pharmacist Fact sheet: Electronic National Residential Medication
- Electronic National Residential Medication Charts (eNRMC) and My Health
- eNRMC Integration — emphn.org.au
