The Queensland Government's decision to expand the Queensland Community Pharmacy Hormonal Contraception Pilot across the state may be good retail politics, but is unsafe health practice, according to the Royal Australian College of GPs (RACGP).
RACGP Queensland chair Dr Cathryn Hester said she worries the approach will increase the potential for adverse events.
"The Queensland Government is gearing up for a challenging election, and it is clear they are more concerned about political expediency than the safety of Queensland women.
"Prescriptions exist primarily to keep patients safe. The Therapeutic Goods Administration, or TGA, determines the rules for medicines to protect the health of Australians. Prescription medicines have potential side effects that are well beyond the scope of pharmacists' training, and a six-hour course and minor pharmacy renovation doesn't change that. This is a political decision, not an evidence-based health decision.
"Hormonal contraception is safe and appropriate for most patients, but it has many potential side effects. The TGA was asked to consider down-scheduling oral contraceptives and didn't due to the potential for adverse events. To quote that decision, 'Consumers can identify when they require (oral) contraception, but consultation with a pharmacist is not sufficient to ensure safety, particularly over extended periods of time.'
"A patient could be taking the same contraceptive pill for years, but that doesn't mean it's always right for them. The potential for risks changes over time, like if a family has a history of early age breast cancer, and new side effects can occur after many years. There could also be a better contraceptive option.
"A consult to review and issue a new prescription is not just about getting a script, it's an opportunity to discuss safe sex, ensure a patient's cervical screening is up to date and consider STI screening. Governments need to consider the second order effects of their decisions. You could have fewer unplanned pregnancies, but more people with STIs, which are already on the rise. All that is lost with this reckless approach.
"GPs do over 10 years training to be able to diagnose patients, as well as ongoing training for the rest of our working lives. There's no substitute for the care a patient receives from a GP who knows them, and you certainly can't replicate that with a short training course and a rushed discussion in a pharmacy."
Dr Hester also said she is concerned about the evaluation of the rollout.
"The evaluation for the pilot reads like market research – it's not a rigorous trial and isn't evaluating patient health outcomes. Questions put to patients as part of the evaluation were the same as you might review a pizza delivery service – was it easy to book? Was it convenient? What did you think about the cost? There are appropriate ways to evaluate health services, and this isn't it. It's a health service, and the priority should be health outcomes."
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