Avoid Amcal stroke service: surgeons

The AMA and Stroke Foundation are urging Australians to avoid a stroke screening service available through Amcal

Screening and risk assessment activities in community pharmacy must be evidence-based, meet unmet needs in the community, be appropriate for a pharmacy setting and provided by an appropriately-trained pharmacist, the peak national body for pharmacists, PSA says.

PSA responded to media reports criticising the new “Strokecheck” screening service offered through the Amcal pharmacy banner group.

According to Fairfax Media, there have been reports that the service produces many “false positives” and is unnecessarily frightening participants.

Screening and risk assessment – which is within the scope of all pharmacists’ practice in Australia – is a key component of Australia’s strategy to reduce the burden of preventable disease, PSA says. There is strong evidence screening and risk assessment targeted at preventable conditions such as diabetes, cardiovascular, chronic kidney disease and osteoporosis, is cost-effective and improves population health.

“The opportunity is obvious in that it represents another avenue for highly accessible community pharmacies to embed themselves as important contributors to our healthcare system,” PSA National President Joe Demarte says.

“However the responsibility, on the other hand, is to remember that this is a preventive health service and deserves to be treated as such. With this in mind, PSA has a new position statement on screening and risk assessment to help pharmacists with this important issue.”

PSA’s statement outlines five principles that should underpin pharmacy-based screening and risk assessment services. These principles are informed by the World Health Organization’s Principles of early disease detection.

The principles include:

  • Principle 1: Screening and risk assessment services should target conditions associated with a significant burden of disease, and populations where interventions provide greatest value.
  • Principle 2: Interventions must be evidence-based and appropriate for the pharmacy setting.
  • Principle 3: Pharmacists need to obtain and document informed consent.
  • Principle 4: Pharmacists must facilitate appropriate follow up, including referral for patients with a positive screening test.
  • Principle 5: Pharmacists must be appropriately trained and equipped to provide screening and risk assessment services.

Mr Demarte says: “Screening and risk assessment activities in community pharmacy must not only be evidence-based and appropriate for the pharmacy setting, they must only be provided by an appropriately trained and equipped pharmacist using validated screening and risk assessment tools.”

Previous Forum: Who wants Phosphorus Pentachloride?
Next Waste water analysis reveals drug use

NOTICE: It can sometimes take awhile for comment submissions to go through, please be patient.


  1. Jarrod McMaugh

    As much as AMCAL is copping some flack for this service, it should be noted that this service is supplied by GPs.

    Very little condemnation from medical groups for the GPs involved in the service…. but pharmacy remains the punching bag.

    Reinforces the need to ensure that every service implemented in pharmacy is above reproach

  2. Drugby

    I have just returned from attending an iPACT meeting (International Pharmacists for Anticoagulation Care Taskforce), an international group of pharmacists developing guidelines for pharmacists on anticoagulation care. Pharmacists have many roles in stroke prevention, including screening amd medication review.

    Patients with AF with a high-risk of stroke often have sub-optimal anticoagulation or no antithrombotic treatment at all. It is estimated that only 40% to 60% of older patients likely to benefit from anticoagulation actually are prescribed anticoagulants. Numerous observational studies have demonstrated underuse of anticoagulants in Australia.

    The balance of risks and benefits of anticoagulant therapy should be assessed and discussed with the patient, with consideration given to patient preference.

    One of the members of that group runs an anticoagulation clinic and has just released a video and fact sheet for patients: http://www.weahsn.net/news/starting-anticoagulation-jack/

    • Jarrod McMaugh

      I can only agree with you that stroke risk in AF is under-managed in Australia. The NPS information on anticoagulation in AF clearly demonstrates 2 extremely relevant and easy-to-implement tools for assessing the indication and risks associated with anticoagulation in AF… yet the uptake is still too low.

      Pharmacists could easily apply this information as a starting point for discussions with their patients, and refer them to their doctor for consideration of the most appropriate anticoagulant.

      This is an intervention in stroke-risk-reduction that should be undertaken by pharmacists everywhere.

  3. Karalyn Huxhagen

    I have been presenting on Heart failure in the elderly as part of QuM of late. The attendees at my lectures have so many personal stories of poor management of cardiac issues. My lectures go an hour over while I sort personal questions. In hMR I see a considerable amount of sub optimal management of stroke prevention and AF. Patients entering QH end up with a cardiologist as part of their post discharge and they also have a private cardio as part of their care plans. It becomes a messy medication plan with the ultimate controller being the cardiac care clinical nurse.
    Pcsts have a large array of roles that we can provide to asssit patients manage stroke risk.

Leave a reply