How local pharmacies can support NCD medication adherence

Long-term medicines are central to managing non-communicable diseases (NCDs), including diabetes, hypertension, high cholesterol and cardiovascular disease. Yet prescribing a medicine is only the beginning. People must understand why it matters, obtain repeat supplies, take the correct dose and know what to do when side effects, cost or daily routines interfere.

Local pharmacies are often the most accessible part of Australia’s primary care system. A person may see a pharmacist several times between general practice appointments, making the community pharmacy a practical setting for medication education, adherence checks and early identification of problems.

This role is especially important as Australia’s population ages and more people live with several chronic conditions at once. Multiple medicines, changing prescriptions and complex dosing schedules can create confusion, particularly after hospital discharge or a move between care providers.

The 2023 APEC Conference on Promoting Community-based Non-Communicable Diseases Integrated Care Model highlighted the value of coordinated, community-level approaches. Its focus on prevention, chronic disease management and ageing populations provides a useful framework for considering how pharmacies can work alongside doctors, nurses, allied health professionals and carers.

Why adherence is a community care issue

Medication adherence refers to how consistently a person follows an agreed treatment plan. Missed doses may occur because of forgetfulness, uncertainty about instructions, unpleasant effects, financial pressure, low health literacy or a belief that treatment is no longer necessary once symptoms improve. These factors are rarely solved by simply telling someone to “try harder”.

In Australia, the Pharmaceutical Benefits Scheme (PBS) helps make many medicines affordable, but prescription costs can still influence decisions. A person managing several medicines may delay a collection, request smaller quantities or ration tablets. Pensioners and people living on fixed incomes can be particularly exposed when medicine expenses compete with transport, food and household bills.

Community pharmacists can identify these barriers through respectful conversation. A brief question about how a medicine fits into breakfast, work, prayer, sleep or other routines can reveal practical obstacles. The pharmacist can then discuss dose administration aids, reminders, simplified regimens or a conversation with the prescriber about suitable alternatives.

The pharmacist’s place in integrated NCD care

Pharmacists contribute a medication-focused perspective to a wider care team. They can review the full medicine list, identify duplication, explain interactions and check whether a person understands the purpose of each treatment. This is valuable for conditions such as type 2 diabetes, where medicines may change as blood glucose levels, kidney function, weight or other health circumstances change.

A pharmacy medication review can also connect clinical information with everyday experience. Someone may report dizziness after taking an antihypertensive, difficulty using an inhaler or uncertainty about whether a tablet should be taken with food. Prompt communication with the GP or nurse practitioner can prevent a manageable issue from becoming treatment abandonment.

The conference’s emphasis on community-based integrated care is relevant here because adherence support works best when information travels across services. With patient consent and appropriate privacy safeguards, pharmacists can share concerns with the treating team and receive updated instructions after a hospital admission, specialist appointment or medication change.

Practical support at the pharmacy counter

A strong adherence conversation is clear, private and tailored to the individual. Pharmacists can use plain language to explain what each medicine does, when to take it, what to do after a missed dose and which side effects require prompt medical attention. Teach-back, where the person explains the plan in their own words, can identify misunderstandings without making the interaction feel like a test.

Packaging and routine can make a substantial difference. Blister packs or dose administration aids may help people who take several medicines at different times. Calendar reminders, phone alerts and linking a dose with a reliable daily activity can support consistency. These tools should be selected with the person, since an intervention that does not fit their vision, dexterity, language or lifestyle is unlikely to last.

Pharmacists can also encourage safe medicine storage and maintain an up-to-date list of prescriptions, over-the-counter products, vitamins and complementary medicines. This is particularly useful for older Australians who may obtain medicines from more than one pharmacy or travel between a city home and a regional or coastal property.

Supporting people after hospital treatment

Transitions from hospital to home are a high-risk period for medication errors. Discharge summaries may include new medicines, discontinued products or altered doses, while the patient and family are adjusting to new information. A community pharmacist can compare the discharge list with the medicines already held at home and clarify discrepancies with the hospital or GP.

The same principle applies before planned treatment. Nutrition, recovery and medicine use can interact in complex ways, and people benefit when advice is coordinated rather than delivered in separate fragments. Information about preoperative nutrition guidance illustrates why preparation and follow-up matter around major procedures, even when the pharmacist’s specific role is medication management.

After discharge, a scheduled pharmacy check-in can confirm whether prescriptions were filled, whether the person can use new devices and whether side effects have appeared. Family members or carers may need instruction too, while still respecting the patient’s independence and consent. A prompt referral to the GP is appropriate when symptoms suggest a serious reaction, uncontrolled disease or a need for clinical review.

Reaching diverse Australian communities

Australia’s pharmacy workforce serves metropolitan centres such as Melbourne, Sydney, Brisbane and Perth, as well as small rural towns and remote communities. Access can vary widely. A person in inner Melbourne may have several pharmacies within walking distance, while someone in an inland town may depend on one local service, mail delivery or a long trip to collect a prescription.

Culturally safe communication is essential in every setting. Pharmacists may need interpreter support, translated medicine information or extra time to discuss traditional remedies and family decision-making. Aboriginal and Torres Strait Islander patients may benefit from care that recognises community connections, local health services and the importance of trust built over time.

Digital systems can support follow-up through repeat reminders, electronic prescriptions and telehealth coordination, but technology should not become a substitute for accessible human care. Older people may prefer a printed schedule or a face-to-face explanation. Pharmacies can offer several communication options, including phone calls, written instructions and appointments away from the busy counter.

Connecting medicines with healthy living

Adherence does not sit apart from prevention. Regular physical activity, nutritious food, sleep, smoking cessation and social connection can influence blood pressure, blood glucose and cardiovascular risk. Pharmacists can reinforce these messages while avoiding an overly broad consultation that leaves the person feeling judged or overwhelmed.

The built environment affects whether healthy choices are realistic. Safe footpaths, nearby shops, shade and public transport can make movement easier for older adults and people living with disability. Discussion of walkable neighbourhood design helps place pharmacy-based advice within the wider conditions that shape daily activity and chronic disease risk.

A pharmacy may support this connection by referring people to accredited practising dietitians, exercise physiologists, diabetes educators, smoking cessation services or local walking groups. In Australia, participation may also involve Medicare-supported care plans, council programs or community health services. The pharmacist’s contribution is to make these options understandable and link them to the person’s treatment goals.

Using data, training and shared accountability

Adherence support should be measured by meaningful outcomes rather than the number of conversations held. Useful indicators may include timely prescription collection, fewer medication discrepancies, improved understanding, reduced preventable hospital presentations and patient-reported confidence in managing treatment. Data collection must remain proportionate and protect privacy.

Pharmacies need time, staff training and clear referral pathways to deliver this work consistently. Training can cover motivational interviewing, health literacy, cultural safety, deprescribing conversations, chronic disease guidelines and recognition of urgent symptoms. Pharmacists also need practical guidance on when to manage an issue within scope and when to escalate it.

The conference materials and speaker profiles offer a broader view of the expertise involved in community-based NCD care. Collaboration across professions can help local pharmacies move from isolated medicine supply towards coordinated support, while preserving the pharmacist’s distinct role in safe and effective medicine use.

Building a reliable local model

A sustainable model begins with defined responsibilities. The pharmacy can provide adherence counselling, medicine reconciliation, dose administration support and routine monitoring within its professional scope. General practices can respond to clinical concerns, review treatment goals and update prescriptions. Hospitals can improve the quality and timeliness of discharge information, while community organisations can address transport, food security and social isolation.

Patients should be involved in deciding what success looks like. For one person, it may mean taking a heart medicine consistently; for another, it may be understanding insulin timing or avoiding a dangerous interaction with an over-the-counter product. Shared decisions are more likely to reflect real priorities than a uniform checklist.

Local evaluation can reveal which approaches work in a particular suburb, town or remote community. A pharmacy in regional Victoria may need a different delivery arrangement from one in central Brisbane. Services should be adapted to local workforce capacity, language needs, transport patterns and the availability of nearby primary care.

When pharmacists are treated as active members of the NCD care team, adherence becomes a shared responsibility. Patients receive clearer support, prescribers gain useful feedback and medicine-related problems can be addressed earlier.

Australian health services, pharmacies and community organisations can use the APEC conference resources to strengthen local conversations about integrated chronic disease care. Download the program materials, review the practical ideas presented by health leaders and identify one pharmacy–primary care partnership that could improve medicine use for people living with diabetes, obesity or cardiovascular disease.