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Background: A key objective of Australia's health care reform is a skilled, flexible, and well-trained workforce. To meet these requirements, the training of health professionals, including pharmacists, needs to be focused on patient care processes, and students must develop competencies in the delivery of patient care. Pharmacy graduates need to be well prepared for new and alternative career pathways through their education and training, to be a part of the future workforce. This study explores Australian intern pharmacists' perceived preparedness for practice, the match between their expectations and experience to meet the requirements of health professionals in Australia's health care reforms, and their future career intentions. Methods: Two questionnaires were sent by post to all 136 intern pharmacists in South Australia; one was sent early in their internship and the second follow-up questionnaire was sent near the completion of their internship. Results: Pharmacy graduates felt prepared for patient care, medicines information, and primary health care roles. A mismatch between expectations and actual experiences was found. By the end of the internship, 45% agree/strongly agree that they wanted to do something else other than being a practicing pharmacist. Conclusion: The current internship model no longer meets the needs and expectations of knowledgeable and skilled pharmacy graduates. An alternative internship model, which considers the expectations of graduates, is required. [ABSTRACT FROM AUTHOR]

Background Understanding why people choose to leave their professions is important to inform workforce planning to meet community needs. Poor job satisfaction has been linked to health practitioners expressing intentions to leave in other professions such as nursing, occupational therapy and medicine, but little is known about the reasons why pharmacists leave their profession. Objective To explore reasons why Australian pharmacists leave the profession. Setting As part of a survey of the Australian pharmacist workforce, a questionnaire was mailed to all registered pharmacists (n = 7,764) on the registers of the Pharmacy Boards of Victoria and South Australia; 1,627 (21 %) responded. Participants, who were registered but no longer working as a pharmacist, were asked to provide contact details if they were willing to be interviewed for this study; 89 (5.5 %) pharmacists accepted an invitation. A proportionate sample of 20 was selected for the interview. Method A semi-structured interview schedule was developed with probe options which encouraged participants to further explore their responses to questions. De-identified audio records of interviews were transcribed verbatim and thematically analysed. Main outcome measure Reasons why pharmacists leave the pharmacy profession. Results Five themes emerged: (1) Dissatisfaction with the professional environment; (2) lack of career paths and opportunities; (3) under-utilisation of pharmacists' knowledge and skills; (4) wanting a change; and (5) staying connected with pharmacy. Conclusion These findings provide insights to the pharmacy sector, previously unexplored in Australia, and informs future pharmacist workforce planning. To retain experienced, mid-career pharmacists in the profession, strategies to increase opportunities for career progression, better use of pharmacists' knowledge and skills and involvement in patient care are required to increase job satisfaction and improve retention rates. [ABSTRACT FROM AUTHOR]

This article documented the Australian community pharmacists' brand substitution practices using identical alternatives (pseudo-generics) and the patients' acceptability. A national mail survey was conducted among 500 Australian community pharmacies from different geographical areas in year 2008. The data of the first 25 original PBS prescription items dispensed on one working day and eligible for generic substitution were collected from each pharmacy. Brand substitution which involved identical alternatives of the originator medicines were identified based on the manufacturers' information stated in the Schedule of Pharmaceutical Benefits Scheme (PBS). Responses were received from 82 pharmacies for a response rate of 16.4%. The pharmacists offered brand substitution for 96.4% of the prescription items which eligible for substitution. About 10% of the substitution recommendations were involved switching of originator medicine to its pseudo-generic alternatives. A total of 10.1% of the pseudo-generic substitution recommendations were declined by the patients. This resulted in an average of AUD$4.44 per item of unnecessary extra-costs paid by the patients for purchasing the originator medicines. This indicated that the existence of pseudo-generics in the PBS market can negatively affect the consumers' welfare in terms of unnecessary extra expenditures for originator medicines that have cheaper identical alternative brands. [ABSTRACT FROM PUBLISHER]

This study evaluated Australian community pharmacists' perceptions and practices of generic substitution in response to recent changes in generic medicines policy under the Pharmaceutical Benefits Scheme reform. All community pharmacists in Australia were invited to participate in a web-based survey conducted in the year 2008 using a self-completed anonymous questionnaire. Useful responses were received from 157 community pharmacists. Of the respondents, 95.5 per cent indicated that their pharmacy had a policy that encouraged generic substitution. Most pharmacists (93.7 per cent) were willing to substitute generics for brand name medicines whenever permitted. Patient's acceptability and chronic diseases were the factors that significantly influenced the pharmacists to offer a generic substitute. Conversely, concern about patient confusion was the major barrier to generic substitution. Only 29.9 per cent of pharmacists firmly believed that substituting an originator brand with a generic would not have any effect on the therapeutic outcome. Around 13 per cent of respondents were somewhat concerned about side effects resulting from generic substitution. The majority of Australian pharmacists are highly supportive of generic substitution. There is need for an education programme to ensure pharmacists have a sound understanding of generic substitution before and following the implementation of any generic substitution policy by government. [ABSTRACT FROM AUTHOR]

Aim: To identify and evaluate the management and care of older people with multiple chronic health problems (MCHP)., Methods: Administrative health data from the Department of Veterans' Affairs and bio-social data from the Australian Longitudinal Study of Ageing are used to determine prevalence of MCHP, treatment patterns and patient outcomes. Focus groups and semistructured interviews are used to gain patient and health practitioner perspectives., Results: The prevalence of MCHP in older people is high (65%) and is associated with increased use of health services, mortality and poorer self-rated health. Australian disease-specific guidelines fail to address MCHP, and treatment conflicts with the potential to cause harm, were common., Conclusion: Improvements in the care and management of older people with MCHP requires: a multifaceted approach, across the health-care system; better coordination of holistic, patient-centred multidisciplinary care; and effective communication and education of all stakeholders. The Health reform agenda in Australia provides an opportunity for change., (© 2011 The Authors. Australasian Journal on Ageing © 2011 ACOTA.)

Objectives: This study evaluated Australian community pharmacists' rate of generic medicine substitution, patient acceptance of generic substitution and cost-savings achieved for patients from substitution., Method: A national stratified sample of 500 Australian pharmacies was randomly selected from different geographical areas. The data of the first 25 original PBS prescription items dispensed on one working day eligible for generic substitution were collected from each pharmacy., Results: Responses were received from 82 pharmacies with a response rate of 16.4%. The pharmacists recommended generics for 96.4% (1461/1515) of the prescription items which were eligible for substitution. The generic substitution recommendation rate in urban (98.7%) and rural areas (98.0%) was significantly higher than remote areas (91.6%). Conversely, patients' acceptance in remote areas (84.5%) was significantly higher than rural (78.6%) and urban areas (73.2%). Patients with chronic diseases demonstrated significantly lower acceptability (72.4%) than patients with acute conditions (81.6%). Through acceptance of substitution, the patients' medicines expenditure reduced by around 21%., Conclusion: Australian community pharmacists demonstrated a high rate of recommending generic substitution. However, to optimize the generic medicines utilization, patients' acceptance requires further improvement., (Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.)