Push for pharmacists to dispense more medicines without script

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As GPs and hospitals come under increasing pressure from COVID-19, it “just makes sense” for pharmacists to do more, says Guild… but RACGP labels it a “cynical ploy”

Pharmacists should be allowed to dispense more medicines and provide more vaccinations so patients can avoid a GP visit, the Pharmacy Guild has told mainstream media amid the COVID-19 outbreak.

“The last thing you want to do in a pandemic is create a cluster where sick people congregate with people with the virus,” Pharmacy Guild vice president and Queensland branch president Trent Twomey told the Sydney Morning Herald and The Age on Tuesday.

“Frankly, state and federal governments can’t afford not to utilise the pharmacy workforce.”

The Guild reiterated its call for pharmacists to dispense medicines like the contraceptive pill, preventative asthma inhalers, blood pressure tablets and antibiotics for urinary tract infections.

A Queensland trial set to roll out this year will allow pharmacists to dispense the oral contraceptive pill and antibiotics for urinary tract infections without the need for a prescription.

In the vaccination space, pharmacists have made regular gains in most states and territories. Over the past month, it was announced that QLD and NSW pharmacists will be able to administer influenza vaccination for those aged 10 and up.

Queensland Health has announced that trained pharmacists in the state will be able to administer cholera, diphtheria, tetanus and pertussis (dTpa); diphtheria, tetanus, pertussis and poliomyelitis (dTpa-IPV); Haemophilus influenza type B; hepatitis A; meningococcal ACWY; poliomyelitis; and measles, mumps, rubella (MMR) vaccines to people aged 16 years and above.

The Pharmacy Guild also wants access to all travel vaccinations to 10 years of age.

Pharmacists were “the second largest health workforce in the country, behind nursing”, Mr Twomey told Fairfax media, with 35,000 pharmacists and 65,000 pharmacy assistants giving patients “unparalleled accessibility”.

However the RACGP has labelled the calls as “a cynical ploy from the Pharmacy Guild to exploit COVID-19 to achieve long sought after changes that will hand greater power to retail pharmacies.”

“It is yet another example of the pharmacy sector trying to place financial gains ahead of patient care and safety,” said RACGP President Dr Harry Nespolon.

“Ensuring a patient’s continuity of care with their GP is vital. We don’t just hand out medicines, we talk to our patients about preventative care, provide a check-up and carefully record their medical history.”

A spokesperson for the Pharmacy Guild told AJP: “It just makes sense as GPs and hospital emergency departments come under increasing pressure, including through the emergence of COVID-19, that pharmacists should be authorised to practise to their full scope.

“This is not an intrusion into doctor territory, but a legitimate recognition that pharmacists in comparable countries are able to do more within their existing training, and Australian patients should benefit from the expertise of pharmacists to take pressure off a stressed health system,” said the spokesperson.

“For example, if a patient was self-isolating because of COVID-19 concerns, and that patient ran out of their prescription medicines – we believe a local pharmacist should be able to dispense and deliver that medicine under continued dispensing provisions, without requiring that patient to sit in a doctor’s waiting room for a script.”

The RACGP President said that there were other avenues available to fight coronavirus.

“If the Pharmacy Guild was serious about helping Australians during a pandemic, they would stop their opposition to an easing of dispensing restrictions. This would enable people to access two-month supplies of commonly prescribed medicines,” he said.

Commenters on the Fairfax article were split on the issue.

“Look at all these doctors who are more worried about protecting their turf than the public welfare,” said one.

“Any move from the protective pharmaceutical mob to gain more power must be ruled out,” added another.

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  1. Karalyn Huxhagen

    At the meeting I attended yesterday about emergency planning for aged care in pandemic it was clearly identified that there are not enough hospital beds or GPs to cover the population in full pandemic. We are already using tools under TEMSU such as skype and IT functionality to access GPs without exposing them to the residents that are infected.
    We have an RSV outbreak and some related respiratory illnesses already in aged care.
    If the RACGP does not realise that in Pandemic and natural disaster planning that they need the pharmacist workforce as well as our ability to supply medications in a diversity of locations than they have not paid attention since the Floods, cyclones and bushfires in past yrs.
    extended prescribing qtys has no place in this conversation as it is not relative . Applies to medications that are often not vital at time of huge shortages.
    In Pandemic you need a workforce that can triage , diagnose, supply medications and manage comorbidities. To dismiss phcy from the health workforce at this time of imminent crisis is a really stupid stance.
    Our role of maintaining supply of medications at the patient level has been seen time and time again during crisis.
    Get a grip RACGP

  2. Michael Ortiz

    The corona virus has the potential to swamp the Australian healthcare system. It is disappointing that the RACGP and the AMA seem to be more interested in protecting their turf than minimising the impact of the Corona virus in the community. Pharmacists are the most accessible of health professionals and are trying make a contribution to managing the corona virus pandemic. Instead of working together, the leadership of the peak medical organisations seem to be more interested in blocking expanded professional roles for Community pharmacists. Their attack on the financial motives of the Pharmacy Guild seems misinformed as the Pharmaceutical Society also supports similar calls to expanded Pharmacist professional roles.

    It was not that long ago that these medical organisations were telling the media that it was dangerous to let pharmacists give immunisations. The reality is that pharmacist immunisations has been a public health success which is still limited by Pharmacists’ inability to access NIP free vaccinations and to bulk bill immunisations through the MBS. The value of Pharmacist immunisation programs is obvious and healthcare administrators have acknowledged this by expanding the range of approved conditions for pharmacist immunisations. This should include immunisation when a corona virus vaccine becomes available.

    There has been a lack of recognition of the contribution of community pharmacists following natural disasters like the recent bushfires. The Parkinon’s NSW newsletter recently highlighted how a community pharmacist on the NSW South Coast opened his pharmacy out of hours so that an older Parkinson’s Disease patient could get his essential medication lost during the bushfire. This highlights how pharmacists should be able to continue medications in patients with stable chronic diseases and it seems reasonable that pharmacists should also be able to order medical tests to monitor control of chronic medical conditions (like diabetes and high cholesterol). Pharmacists and GPs need to work together to benefit t the Australian population particularly in rural and remote areas. That being said, it is important that pharmacists be adequately trained for expanded professional roles.

    If you look at the panic buying of toilet paper, then what will happen if patients can’t access to medical care if there is an explosion of corona virus infections. Pharmacists and GPs need to work together to benefit the Australian population particularly in rural and remote areas. That being said, it is important that pharmacists communicate appropriate prevention behaviours like frequent hand washing and that protocols be developed for managing patients presenting at a community pharmacy with flu-like symptoms. If we want to avoid medical services being swamped, then we need to develop protocols for an expanded role for Community Pharmacists.

    It is time for the medical and pharmacist organisations put their vested interests aside and work together to minimise the impact of the Corona virus in Australia. It is likely that a proportion of patients infected with the corona virus will present at a community pharmacy. If we want to reduce the spread of the virus to other patients, then we need be able to isolate these patients early. It may not be enough to refer these patients to a swamped hospital which seems to be the current recommended response.

    Lets hope that the medical profession leadership stops complaining about other health professionals and that they can work more closely with allied health professionals to minimise the impact of the Corona virus in Australia.

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