UTI prescribing and risk

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PDL says it has flagged some risk considerations for pharmacists participating in the Queensland UTI trial

In an update for Queensland members, PDL outlines a number of issues relating to the trial.

The UTIPP-Q is a research pilot program aimed at investigating the supply of specified antibiotics, without a prescription, by pharmacists working in Queensland QCPP-accredited pharmacies.

The trial has been implemented as part of the Queensland Government’s response to the inquiry into the establishment of a pharmacy council and transfer of pharmacy ownership in Queensland.

It was approved by Queensland Health to commence on 19 June 2020 under a Drug Therapy Protocol.

“The treatment protocol and DTP must always be followed,” PDL notes.

“The service must be managed and recorded in full through the GuildCare NG UTIPP-Q module, even if supply is not provided, alternative therapy recommended, or if a referral to a medical practitioner is offered.”

The organisation points out that the GuildCare NG GuildCare NG UTIPP-Q module is available at no cost for all QCPP-accredited pharmacies in Queensland  and is unrelated to other GuildCare subscriptions.

Service can only be provided by registered pharmacists who have successfully completed the training and consented to the pilot guidelines: interns and pharmacy students are excluded.

The service is only available from Queensland pharmacies with current QCPP accreditation.

“Individual pharmacists must successfully complete the online module available from the PGA or PSA websites,” PDL notes. “These are available irrespective of membership of the organisations. Once registered, pharmacists can provide the service only at a UTIPP-Q registered pharmacy.

“The service can only be provided face to face i.e. not via a telehealth service model.

“As part of the registration process, individual pharmacists must confirm their indemnity insurance policy covers this service. The PDL Master Policy automatically provides cover for this service. Members do NOT need to advise PDL of participation in the pilot program.”

PDL also notes that community pharmacies must be QCPP accredited and be registered with the pilot program and that pharmacy owners must confirm their business insurance policy provides cover for this service.

Risk management

PDL also noted that it has flagged some risk management considerations:

  • Review or develop appropriate policies and procedures before commencing the service
  • The service must only be provided by a UTIPP-Q registered pharmacist. Allocation of tasks to other staff members is not appropriate.
  • Privacy and confidentiality are vital, and discretion should always be used.
  • Ensure the patient understands that the follow-up call may be from the pharmacist providing the initial service or another UTIPP-Q registered pharmacist.
  • Discuss the service fee and cost of medicine prior to supply, and explain the service fee will apply in cases when the pharmacist decides medicine supply is not appropriate.
  • Ensure all contraindications to therapy e.g. allergy or previous reactions, drug interactions, etc. are confirmed during the consultation process.
  • Referrals to a GP should be completed in a professional and clinical manner.
  • Accuracy and security of electronic transmission of referrals or records is vital.
  • Clear communication with clients is needed to ensure:
    • Participants are fully informed and can provide informed consent for participation in the research evaluation of the service;
    • The responsibilities of the pharmacist are clearly explained;
    • Participants are appropriately counselled, including provision of CMI;
    • Ensure participants comprehend all advice given including duration of therapy, reasons for non-supply and referral; and
    • The follow-up service is explained.
  • Comprehensive documentation of all aspects of the pharmacist’s activities is vital:
    • As with any clinical service, appropriate records should be kept. This includes completing the recording process as per the protocol even if supply is not provided. All data is beneficial for the pilot irrespective of the outcome of the service scenario.
    • Any incident or complaint should be reported to PDL as soon as possible.

More information

PDL Director for QLD and Deputy Chair, Gilbert Yeates joined PDL Professional Officer, Gary West, to discuss the new Urinary Tract Infection Pharmacy Pilot in Queensland.

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