Regulatory morass putting patients & pharmacists at risk

Patients are potentially at risk from inconsistent interstate prescription-related requirements, Australian experts say

Pharmacists and GPs are also in danger of unwittingly breaching differing jurisdictional requirements relating to prescribing rules and regulations, they add.

A review of Australian state and territory Acts and Regulations relating to medicines prescribing and provision has revealed a large number of inconsistencies between jurisdictions.

Despite more than a decade and a half having passed since the 2000 Galbally Review recommended uniform national drugs, poisons and controlled substances legislation – an approach endorsed by the Health Ministers’ Advisory Council – “little progress has been made” toward uniform legislation, say the reviewers.

This jurisdictional variation has “the potential to impact the legal or ethical practice of a pharmacist,” say the authors who include academics from Griffith University’s  School of Pharmacy and a community pharmacist.

“Pharmacists practising in an unfamiliar jurisdiction may fail to recognise an invalid prescription or refuse to supply a valid prescription due to differences in legislative requirements.”

As an example of the complexity of these differences, they say even highly regulated S3 medicines supply varies greatly. Age restriction, recording, labelling and identification requirements vary for pseudoephedrine.

Supply of these products is not permitted in South Australia without appropriate photo identification, recording of patient details and recording of the transaction on Project Stop: requirements not required in Victoria or Tasmania at the time the review was conducted.

Patients are also impacted, especially if travelling interstate, with differing requirements for age provision of emergency contraceptives, adrenaline auto-injectors and other medicines in Queensland listed as an example.

“Previous research conducted on Queensland pharmacists practising near a state border revealed that ‘lack of awareness of medicines legislation could translate to refusal of dispensing of otherwise legal prescriptions’…. Potentially disrupting the continuum of patient care and bringing the profession into disrepute,” the authors say.

“Ideally medicines legislation should be uniform,” they conclude. “Whenever medicines legislation is updated the opportunity to progress toward legislative harmony should be addressed.”

The study was published in the Journal of Pharmacy Practice and Research.

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