Yet, medications have the potential for unwanted effects.[1] Therefore, it is important for

healthcare providers to assist consumers or patients in managing their use of medications. Medication management is a complex Ibrutinib process that involves a range of healthcare providers. Figure 1 illustrates the nine major ‘steps’ identified in the medication management ‘pathway’.[2] In Australia, provision of medication services is complicated by the division of regulatory aspects of healthcare delivery between the Commonwealth (national) Government and state/territory governments. Currently, the Commonwealth Government oversees registration of healthcare practitioners (including scopes click here of practice), subsidy of pharmaceuticals under the Pharmaceuticals Benefits Scheme (PBS) and the implementation of the National Medicines Policy.[3,4] On the other hand, the state/territory governments manage regulatory aspects relevant to drugs and poisons and healthcare providers not licensed under the national

registration of healthcare practitioners (e.g. paramedics, Indigenous health workers).[4,5] The division of responsibilities and funding, including for public health services, between the Commonwealth and state/territory governments further complicates the delivery of healthcare services, including medication services.[4] The medication pathway is further compromised in rural areas, with consumers’ access ID-8 to healthcare services restricted due to limited health workforce capacity as well as geographical, professional and social isolation.[4,6,7] This essentially challenges the existing rural healthcare providers to consistently fulfil the ‘steps’ in the medication pathway and to provide the necessary medication support to consumers. This is of concern in rural areas where there is a lack of services offering alternative or adjunct therapy, which could lead to

increased reliance on medication therapy. Rural healthcare also does not provide a favourable environment to comply with key objectives outlined in the National Medicines Policy, specifically (1) timely access to affordable medications, (2) responsible and quality delivery of medication services with best-practice regulatory systems in place and (3) Quality Use of Medicines (QUM), which encompasses judicious, appropriate, safe and efficacious use of medications.[3,4,6,7] The dynamics of rural health have been shown to foster changing or extended clinical roles or skills and differential healthcare models to cope with rural health demands.[6] However, few studies have explored the effect of rural location on the medication pathway in Australia and how rural healthcare providers are coping with the medication needs of consumers or patients. The majority of published studies reviewing rural QUM processes have been limited to individual professions (e.g.