UTI prescribing now live

woman on toilet

The Queensland trial of pharmacist prescribing for simple UTIs has reached a key milestone, with the release of the Drug Therapy Protocol

Pilot and consortium lead on the Urinary Tract Infection Pharmacy Pilot – Queensland (UTIPP-Q) trial Professor Lisa Nissen, from the Queensland University of Technology, says that this is “another fantastic opportunity for pharmacists to increase their contribution to patient care in the community”.

The endorsed model of care enables eligible community pharmacists participating in the pilot to provide empirical treatment to non-pregnant women with acute uncomplicated cystitis, through the supply of antibiotics.

The protocol allows a pharmacist, for the purposes of participating in the trial, to sell and supply certain restricted drugs without the requirement for a script or purchase order, subject to the restrictions listed for it and in accordance with the treatment protocol established under the UTIPP-Q.

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

Participating pharmacists will be able to sell and supply Trimethoprim; or Nitrofurantoin if Trimethoprim is not appropriate for the patient; or Cefalexin if Trimethoprim and Nitrofurantoin are not appropriate for the patient.

Participating pharmacists are expected to have completed training to participate in the trial, to record data in the GuildCare NG UTIPP-Q recording module, and to maintain their eligibility to participate.

“The pharmacist may sell and supply a restricted drug specified in this Drug Therapy Protocol to a person without prescription only for the treatment of acute uncomplicated cystitis in a non-pregnant woman and where the pharmacist reasonably believes the sale and supply of the restricted drug is essential for the woman’s wellbeing,” the protocol states.

“Before selling and supplying a restricted drug under this Drug Therapy Protocol, the pharmacist must advise the client of the contra-indications and known side effects of the drug.

“If the supply of one of the restricted drugs specified in this Drug Therapy Protocol is not an appropriate treatment option (for example, due to contraindications), then the pharmacist has the option to supply one of the other two drugs.

“However, the pharmacist must refer the client to a medical practitioner if the referral criteria is met or all three drugs are inappropriate.”

Pharmacists may not sell and supply a restricted drug specified in this Drug Therapy Protocol in quantities that are more than a single manufacturer’s pack of the restricted drug, and drugs must be correctly labelled and appropriate records kept.

Stakeholders say the release of the protocol means another positive step forward for the historic pilot, which has already seen a large majority of community pharmacies registering to participate across Queensland.

Pharmacy Guild of Australia, Queensland, Branch President Adjunct Professor Trent Twomey thanked the Queensland Government for continuing to realise the value of community pharmacy in delivering accessible primary healthcare.

“Community pharmacists stand prepared and waiting to increase their scope of practice and deliver more health services to Queenslanderss,” he said.

“We have seen first-hand the importance of community pharmacy this year with consumers relying heavily on their trusted community pharmacy for healthcare advice and flu immunisation throughout the pandemic.”

He said that community pharmacy is well placed to reduce unnecessary hospitalisations and strain on Government resources due to uncomplicated urinary tract infections, particularly in a time when the coronavirus pandemic has impacted many GP and hospital resources.

Pharmaceutical Society of Australia Queensland Branch Manager Chris Campbell said the quality and skill of pharmacists in Queensland has been clearly demonstrated and supported by the Queensland Department of Health with the pilot.

“This brings access to Queensland women a service already successful in other countries and is welcomed with the backdrop of COVID-19, a time when pharmacists have kept the doors open to provide quality primary healthcare to Queenslanders,” he said.

“We are looking forward to evaluating the outcomes,” said Professor Nissen.

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1 Comment

  1. John Wilks

    My grave concern with this trial is that it is empirically based, and thus the wrong antibiotic will be given. The most common cause of UTIs is E. Coli and the incidence of ESBL-E. coli is increasing. I hope this blind trial will not exacerbate the ESBL issue

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