Pharmacists are calling for more prescribing powers – including Schedule 8 medications – but GP leaders are urging caution.
In the latest instalment of the to and fro over scope of practice and who should prescribe what, the Pharmacy Guild of Australia has pushed for pharmacists to have greater prescribing powers.
Earlier this month National President Professor Trent Twomey said he would like to see pharmacists be able to autonomously prescribe a wide range of medicines.
Speaking at this years APP conference he said the Guild was keen to establish a model that empowers pharmacists to work to the full extent of their training, skills and experience.
“The best model would allow qualified pharmacists to administer, obtain, possess, prescribe, sell, supply, review and/or use Schedule 2, 3, 4, and 8 medicines,” he said.
He also said prescribing needed to be included in the base registerable degree “so that every student leaving university can assess, diagnose and treat every day and long-term health conditions”.
Some pharmacists already have certain prescribing powers, dependent on state regulations.
In WA the Enhanced Access Community Pharmacy Pilot (EACPP) program allows pharmacists to diagnose and provide treatment for certain common health conditions.
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RACGP Vice President and WA Chair Dr Ramya Raman questioned what it was the Guild was trying to address with the proposal.
“What is the problem that is being solved here?” she said
“The reality is access to GPs has been a concern but things are being put in place to address this,” she said.
“ABS data shows that 67% of patients are able to see their preferred GP when they need to and 99% of patients can see a GP when they need to.
“General practice is team-based within a practice, so it may not be the preferred practitioner within the practice on that day, but there will be another practitioner available to look after that patient.
“The benefit of that is we share the same communications systems, there’s a past medical history, we have the appropriate tools to do a clinical assessment and deliver that care, and organise a follow up as well.”
Dr Raman said GP prescribing avoided the fragmentation of care and complications posed by pharmacy prescribing.
“When we talk about Schedule 8 medications, there are a significant number of adverse impacts and serious complications for patients, including drugs of dependence. How is this going to be monitored?
“There can be significant outcomes when these drugs are mixed with other drugs, that could be illicit drugs or perhaps alcohol, and the impact is ultimately for the patient.
“Another concern with pharmacy prescribing is that there is a conflict between prescribing and dispensing when there is a commercial interest.”
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In his speech, Prof Twomey suggested the Australian Pharmacy Council (APC) could offer a accredited pharmacist prescriber education program to make the increased scope of practice a reality.
However Dr Raman said any training would need to meet the same standards as those provided through medical school.
Prof Twomey’s comments follow a joint submission by Advanced Pharmacy Australia (AdPha), Pharmaceutical Society of Australia (PSA) and the Guild to the Pharmacy Board of Australia in October last year, which called for pharmacists to have increased prescribing rights.
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