Pharmacist prescribing claims of pressure relief ‘ludicrous’, says RACGP


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Pharmacist prescribing would put vulnerable patients at risk and won’t take pressure off GPs and hospitals, the RACGP claims

Following the announcement of a review into the pharmacy sector in Queensland, the Royal Australian College of General Practitioners (RACGP) has expressed concern about the proposal that pharmacists be able to write prescriptions, saying this would fragment health care and put patients at “serious risk”.

The review will look into a range of issues affecting the pharmacy sector in Queensland, from the ownership rules to pharmacist prescribing. Mainstream media reports suggested that this could see pharmacists prescribing medicines including asthma preventers, oral contraceptives or Viagra.

Dr Bruce Willett, chair of the RACGP, says that it is “vital” specialist GPs and their health care teams manage prescriptions in a general practice setting.

“GPs, as specialists in patients’ medical histories are uniquely placed to be able to deliver high quality care to Australians through a thorough understanding of their patients’ overall health,” Dr Willet says.

“There is abundant proof that fragmenting care worsens health outcomes.

“Patients want to spend more time with their GP, and it’s important that the Queensland State Government understands and supports the community to see their GP and experience better health outcomes.”

When a patient receives health care in a pharmacy instead of in general practice, they miss out on important preventive health care services, Dr Willett says.

“This could result in a delayed diagnosis and in turn, delayed care,” Dr Willett says. 

“For example, limited repeats on medications for the treatment of oral contraceptives and cardiovascular disease ensure patients can continue to be monitored while receiving treatments and medications, ensuring the right medication is prescribed at the right time.

“Through prescribing contraceptives through a doctor’s appointment a GP is able to review if the right method is being used through a review of symptoms, ensuring side effects do not have dangerous consequences.

“Removing this opportunity takes away from ensuring vital tests such as cervical screenings and STI tests are completed and women have a full picture on the potential use of options such as LARCs.

“The argument that pharmacists issuing low-risk medications would take pressure of GPs and emergency departments is ludicrous,” Dr Willett says.

“Allowing anyone other than a patient’s regular GP or other medical specialist to prescribe medications, fragments continuity of care and results in their medical records no longer displaying the full picture.

“This puts vulnerable patients at serious risk and must be avoided.”

Earlier this week Pharmacy Guild Queensland branch president Trent Twomey told 4BC1116 News Talk’s Chris Smith that such fragmentation was “no longer the case”.

Mr Twomey pointed out that Cairns, where he practises, was one of the trial sites for the opt-in My Health Record.

“So all of my pharmacies have access to patients’ history through the My Health Record,” he said.

“This national rollout happens in October this year. So 97%, 98% of Australians will have an electronic record by Christmas this year, and that provides the perfect opportunity for pharmacists, with informed information, working in conjunction with general practitioners and other allied health providers and hospitals, to be able to do more to keep people healthier.”

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4 Comments

  1. PharmOwner
    26/05/2018

    “Allowing anyone other than a patient’s regular GP or other medical specialist to prescribe medications, fragments continuity of care and results in their medical records no longer displaying the full picture.”
    So, Nurse practitioners, diabetes educators et al with prescribing rights fragment patient care? Quite often it seems as though GPs and specialists don’t communicate patient’s medical histories to each other, so we already have fragmented care. My Health Record should assist in keeping track of such examples of disparate episodes.

  2. Michael Inglis
    26/05/2018

    There are pros and cons on both sides of the argument as to whether pharmacists should have prescribing rights or not. It might be better to only have a pharmacist who works in or with a medical practice to have these rights. Anyone with enough knowledge can opt out or block info from MHR so there are risks involved. I do believe that the scope of vaccinations that we can do should be widened though. Keep up the good work Trent

  3. Kevin Hayward
    26/05/2018

    If pharmacist prescribing is to occur it should be done collaboratively with safeguards, as in the UK, using appropriately trained Pharmacists working with GPs under a structured patient group directive PGDs, or again, working with GPs as appropriately trained dependent prescribers. The physical location of the Pharmacists will influence the degree of collaboration, PGDs seem to support the needs of Pharmacists based in community pharmacy, whilst specialist primary or secondary care Pharmacist led clinics may prefer prescribing rights.

  4. Kevin Hayward
    26/05/2018

    If pharmacist prescribing is to occur it should be done collaboratively with safeguards, as in the UK, using appropriately trained Pharmacists working with GPs under a structured patient group directive PGDs, or again, working with GPs as appropriately trained dependent prescribers. The physical location of the Pharmacists will influence the degree of collaboration, PGDs seem to support the needs of Pharmacists based in community pharmacy, whilst specialist primary or secondary care Pharmacist led clinics may prefer prescribing rights.

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