Queensland’s pharmacy trial would mean a conflict of interest similar to that found by the banking Royal Commission, says a leading doctor
GPs continue to criticise moves towards pharmacist prescribing, with RACGP Queensland Chair Dr Bruce Willett telling newsGP that the prescribing trial – which is to see a statewide pilot of pharmacist prescribing of low-risk emergency and repeat prescriptions for the contraceptive pill and antibiotics for UTIs – would cause a similar conflict.
The Royal Commission into the Banking and Financial Services Sector highlighted numerous instances where trustees believed they could “manage” conflicts of interest.
Commissioner Kenneth M Hayne said that in regard to the banking commission findings, conflicts should not be “managed” but “eliminated”.
Dr Willett told newsGP that the Queensland trial would constitute “creating exactly that situation in the pharmacy sector”.
“We’re looking at an area where this situation has been disastrous, and now it seems we’re replicating the disaster.”
He said that a recent study, by researchers from QUT’s Business School and Faculty of Health School of Clinical Sciences made the pharmacy trial “redundant before it starts”.
The study involved mystery shopper patients performing two patient scenarios – one requesting emergency hormonal contraception, and the other bacterial or viral conjunctivitis.
The researchers found that of the 205 Brisbane-area pharmacies mystery shopped, 57.6% of pharmacies followed dispensing behaviour compliant with the protocol, while 31.3% involved some form of overtreatment or overselling of medication.
At the time, PSA CEO Dr Shane Jackson said that the study actually suggests that “consumers receive focussed and cautious care from pharmacists in response to the simulated case studies”.
“While the sample size is relatively small, the results suggest consumers would benefit from a remuneration structure which supported longer patient-pharmacist interactions, particularly in more complex cases,” he said.
“This would allow pharmacists more time with patients and provide more targeted treatments tailored to each consumer’s specific health needs.”
Dr Willett, however, told newsGP that the QUT study’s results were “really worrying”.
He said that the likelihood of encouraging antibiotic resistance and “future ‘super-bugs’” is raised by the dispensing of oral antibiotics.
“We really expect to see the same behaviour as displayed in the study,” he said.
The comments are only the latest in a series of attacks on the Queensland pharmacy trial by leading doctors representing the RACGP or AMA.
Doctors from both groups have repeatedly claimed that pharmacist prescribing of antibiotics will encourage antibacterial resistance.
The comments also follow criticism this week of moves towards pharmacist prescribing in Western Australia by AMA WA president Dr Andrew Miller, who made several claims on ABC Radio which were refuted by the Pharmacy Guild’s Matthew Tweedie.
Dr Miller is critical of the recommendations arising out of a WA Government review into the pharmacy sector, which included carefully watching initiatives like the Queensland trial to determine whether a similar program could be instituted in WA.
Dr Miller continues to speak out on social media on the subject.
I said many nice things about pharmacists on the ABC this morning! Evidence is here at around 3:02:16 on the timeline https://t.co/Aa7p4kdvnn
— Andrew Miller (@drajm) July 22, 2019
You continue to tweet instructions to me! I am not a Guild member under your ancient model of ownership control & the AMA responds to Qs on diagnostics, conflicts & upsell in pharmacy as & when we see fit – we have a culture of openness & transparency – but sure, happy to visit. https://t.co/337roWzvXy
— Andrew Miller (@drajm) July 24, 2019