The Royal Australian College of General Practitioners (RACGP) has spoken out against expanded pharmacy prescribing powers in South Australia.
It comes following the Government today announcing that from March next year, women aged 18 to 65 suffering from a urinary tract infection (UTI) will be able to access antibiotics from pharmacists. Women will also be able to obtain a resupply of their oral contraceptive pill from their pharmacy.
The decision coincides with World Antimicrobial Awareness Week, which runs from 18 to 24 November.
Earlier this year, the RACGP President Dr Nicole Higgins and RACGP South Australian Chair Dr Sian Goodson spoke out at a Parliamentary Select Committee hearing on why expanding pharmacy powers is not the right call. The College's submission (see no. 23) also outlines the many risks to patient safety.
RACGP President Dr Nicole Higgins urged the state's leaders to reverse course.
"This pharmacy prescribing expansion may well seem like a convenient option; however, patient safety and wellbeing must come first," she warned.
"Ask any GP and they will tell you the same thing, there is no such thing as an 'uncomplicated' UTI that can be easily managed by a pharmacist. GPs and practice teams have nothing but respect for the vital role that pharmacists perform in communities across Australia; however, they simply do not have the training and expertise to diagnose and prescribe these drugs and the retail setting is not a suitable environment for these consultations. Governments must keep in mind that all GPs in South Australia and across the country complete over a decade of training to diagnose and manage patients and treat conditions such as UTIs."
RACGP South Australia Chair Dr Sian Goodson backed the President's comments.
"The fact that this week is World Antimicrobial Awareness Week highlights just why this decision is not in the best interests of patients," she said.
"WHO has declared that antibiotic resistance is a global health emergency. As the College warned today, the Australian Commission on Safety and Quality in Health Care has urged judicious prescribing of antibiotics for a range of health conditions including urinary tract infections. So, with this decision in South Australia we are heading in exactly the wrong direction, because introducing more non-medical prescribers of antibiotics through pharmacies risks undercutting our efforts to fight antimicrobial resistance.
"We have known for some time that pharmacy prescribing runs counter to antimicrobial stewardship goals. To take just one example, a 2021 study here is Australia found a huge increase in topical chloramphenicol prescribing after it was rescheduled to pharmacist only in 2010. So, at a time when we are facing one of the great public health challenges of this century, there has never been a worse time to expand antibiotic prescribing.
"Expanding pharmacy prescribing also runs the risk of disrupting continuity of care, because your GP will not know what your pharmacist is prescribing you and vice versa. This is another example of fragmentation of care rather than targeted funding to support pharmacists being part of multi-disciplinary teams within general practices.
"If the Government is determined to press ahead, we recommend they consult closely with medical groups, including the RACGP, to make pharmacist antibiotic prescribing as safe as possible. In Western Australia, for example, we were able to provide crucial feedback on antibiotic choice, exclusion criteria, record keeping and mandating that the dispensing record be transmitted to My Health Record. It's far from ideal, but it is certainly better than nothing."
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