Shifting the debate


prescription

When it comes to pharmacist prescribing, the focus is too heavy on initiation and not enough on deprescribing, argue two pharmacy researchers 

The ongoing discussion about pharmacist prescribing rights in Australia focuses on initiation of medicines and not enough on deprescribing, say Lisa Kouladjian O’Donnell and Mouna J Sawan in the latest issue of the MJA. 

“Prescribing is a process,” they say, adding that one of the steps of “good prescribing” is to monitor and stop treatment. 

“Given inappropriate polypharmacy is increasing in older people, collaborative deprescribing (defined as the supervised withdrawal of inappropriate medications) with pharmacists, medical practitioners and patients should therefore be given equal priority within this debate.” 

Pharmacists are experts in pharmacotherapy and growing evidence shows the effectiveness of pharmacist prescribing roles that include medication cessation, says Dr O’Donnell and Dr Sawan from the University of Sydney’s Faculty of Medicine and Health. 

“All the steps that underpin prescribing (initiation to withdrawal) are equally important to ensure patient safety,” they explain. 

“The proposal of expanding the pharmacists’ prescribing role needs to encompass all aspects of the prescribing process. 

“If initiation and continuation of a medication is emphasised, in the context of pharmacists’ prescribing rights in Australia, we may lose focus on patient care and safety.” 

The Pharmacy Board of Australia released its position statement on pharmacist prescribing in October last year, following extensive consultation. 

See the full letter in the MJA here 

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