WA, Qld expand pharmacists' scope
Wednesday, 14 August, 2024
Western Australia has expanded the role of community pharmacists following the success of uncomplicated urinary tract infection (UTI) treatment program that is said to have helped 7000 patients across the state.
The decision is a practical and logical next step towards a new network of pharmacists, who are appropriately trained and authorised to deliver care to more Western Australians for a broad range of acute specific conditions such as mild to moderate shingles, acne, dermatitis, musculoskeletal pain and inflammation, nausea and vomiting, and wound management, said a statement issued by the Western Australian Health Minister Amber-Jade Sanderson.
鈥淒esign, development and implementation will take place over the next two years, with the aim for pharmacists to deliver advanced care by 2027,鈥 the statement said.
The announcement follows the commencement of the Queensland Community Pharmacy Hormonal Contraception Pilot aimed at improving access to hormonal contraception in order to reduce barriers to reproductive health care.
The welcomed the pilot reminding participating pharmacists that they can now enrol in PSA鈥檚 Sexual and Reproductive Health Contraceptive Service 鈥 Queensland training program. Once completed, they can immediately begin offering the service to Queensland women.
PSA鈥檚 CEO Adjunct Associate Professor Steve Morris said, 鈥淧SA has worked closely with Queensland Health to certify our training program which uses case-based learning powered by artificial intelligence聽鈥 a world first in pharmacist education. The simulated clinical environment uses the most life-like patient simulations possible to hone pharmacist communication and clinical skills in providing more timely and safe access to hormonal contraception.鈥
criticised the pilot saying that the move 鈥渕ay be good retail politics, but is unsafe health practice鈥.
RACGP Queensland Chair Dr Cathryn Hester said, 鈥淧rescriptions exist primarily to keep patients safe. The Therapeutic Goods Administration, or TGA, determines the rules for medicines to protect the health of Australians. Prescription medicines have potential side effects that are well beyond the scope of pharmacists鈥 training, and a six-hour course and minor pharmacy renovation doesn鈥檛 change that. This is a political decision, not an evidence-based health decision.
鈥淗ormonal contraception is safe and appropriate for most patients, but it has many potential side effects. The TGA was asked to consider down-scheduling oral contraceptives and didn鈥檛 due to the potential for adverse events. To quote that decision, 鈥楥onsumers can identify when they require (oral) contraception, but consultation with a pharmacist is not sufficient to ensure safety, particularly over extended periods of time.鈥
鈥淎 patient could be taking the same contraceptive pill for years, but that doesn鈥檛 mean it鈥檚 always right for them. The potential for risks changes over time, like if a family has a history of early age breast cancer, and new side effects can occur after many years. There could also be a better contraceptive option.
鈥淎 consult to review and issue a new prescription is not just about getting a script, it鈥檚 an opportunity to discuss safe sex, ensure a patient鈥檚 cervical screening is up to date and consider STI screening. Governments need to consider the second order effects of their decisions. You could have fewer unplanned pregnancies, but more people with STIs, which are already on the rise. All that is lost with this reckless approach.
鈥淕Ps do over 10 years of training to be able to diagnose patients, as well as ongoing training for the rest of our working lives. There鈥檚 no substitute for the care a patient receives from a GP who knows them, and you certainly can鈥檛 replicate that with a short training course and a rushed discussion in a pharmacy.鈥
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