A leading pharmacist and a lawyer go head-to-head in the debate over pharmacist prescribing
“Pharmacist prescribing should be implemented in Australia, without delay,” argues PSA vice president Shane Jackson in the February issue of the Journal of Pharmacy Practice and Research, in a section entitled ‘A Matter of Opinion’.
Arguing the case ‘for’ prescribing, Dr Jackson says pharmacist prescribing would increase access to care, improve safety and reduce variability in care delivery, making better use of a highly trained workforce and building flexible multidisciplinary teams.
“As the custodians of medicines safety, pharmacists must be tasked with increased responsibility and accountability to be more actively involved in the decision‐making processes at the commencement and review of medications,” he says.
“Why do we need pharmacist prescribing? Because we need optimisation in the use of medicines, we need quality use of medicines and we need safe use of medicines.
“Without the ability to prescribe (or deprescribe), pharmacists are fighting in a wet paper bag against the huge issue of medication safety we have in this country.”
Three safe prescribing models that have been identified are autonomous prescribing, prescribing under supervision and prescribing via a structured prescribing arrangement, Dr Jackson explains.
“There is a growing body of evidence supporting pharmacist prescribing,” he adds.
Opposing the suggestion that pharmacists should prescribe without delay is Sarah Bartholomeusz, Founder and Principal at You Legal.
Ms Bartholomeusz argues that “it would be reckless to suggest that we should simply implement pharmacist prescription laws without delay.
“Australians could benefit from pharmacist prescribing, but only following a thorough consideration of the clinical, financial and legal consequences.”
The model adopted in Australia will need to address the types of diseases the pharmacist is authorised to treat, the drugs or categories of drugs and the prescriptions permitted, she says.
All this needs to be done within the existing legislative framework, she adds, before looking into the current legislation in more detail as well as medicolegal liability considerations.
There will also be a change to training and standards of care, as “encouraging pharmacists to extend their practice to prescribing will result in a significant change in the way they conduct their practice and manage their risk,” argues Ms Bartholomeusz.
In A Matter of Opinion, the JPPR identifies potentially contentious matters and invites experts in the field to contribute a brief piece outlining their opinion on the matter. In each case, a commentator is invited to advocate in favour of the proposition under consideration, and another contributor argues the opposing point of view. The contributions are not comprehensive reviews but rather brief expressions of opinion, backed up by some succinct supporting information.