Consumers seeking and receiving health care have evolved over the last two decades.4 They have better access to information (and advertising) via the internet and online networking groups, and rightly expect to be more informed and involved in their own health. People expect to receive high-quality, safe and effective health care that is tailored to their needs while reducing their out-of-pocket costs.5
People are living longer. They have more chronic health conditions and so are taking multiple concurrent medicines. The use of complementary and alternative therapies continues to be high.6 In addition to polypharmacy, other challenges that have escalated over the past 20 years include poor outcomes for people living with mental illness7 (especially indigenous Australians),8 antimicrobial resistance, and the continuing burden of medication-related harms. These place a considerable strain on
healthcare systems, policies and budgets with effects rippling towards the community through social and welfare services.
Healthcare professionals now see a wider spectrum of people4 and are more cognisant of the gap in the health and well-being of vulnerable members of the community. This includes indigenous Australians, frail older people, people living with mental illness as well as migrants and refugees.
Healthcare professionals are more aware of people’s literacy and health literacy levels, their social determinants of health and their beliefs and opinions about treatments. There is also now a wider range of health professionals involved in prescribing, with an important need for consistent and rigorous training and credentialling to ensure the quality use of medicines. The healthcare provider has also changed with expanding scopes of practice, which in some cases may be seen as blurring of the traditional boundaries of practice.