Pharmacy prescribing made permanent without adequate evidence
The Queensland Government’s decision to make pharmacy prescribing ‘business as usual’ without evidence is disappointing and dangerous.
The Queensland Government’s decision to make pharmacy prescribing ‘business as usual’ without evidence is disappointing and dangerous.
AMA Queensland recognises access to essential healthcare services is declining after years of government neglect, particularly in rural and regional communities, but short-term political objectives should never over-ride safety or quality.
“We need solutions that will genuinely improve community health,” AMA Queensland President Dr Nick Yim said.
“This announcement is extremely disappointing, especially considering the pilot is yet to be evaluated.
“The Crisafulli Government was elected on a promise that they would listen to the experts, yet this decision is another in a growing list not supported by doctors or the evidence.
“Independent evaluation is the only way we can ensure patients aren’t harmed through programs that prioritise politics over safety.
“We are concerned that even if the results of the evaluation show it risks patient health, the government will ignore them.
“This is what they have done by refusing to follow the evidence about our world-leading drug diversion, pill testing and alcohol harm reduction programs.
“It is also what they did when deciding to scrap the health workforce incentives we desperately need to attract the doctors and nurses required to run our hospitals and general practices.
“AMA Queensland has long opposed the pharmacy prescribing program due to lack of independent evaluation, increased costs to the health system and fragmentation of care.
“It is an approach to medicine that has no input or support from doctors on the ground who work with other health practitioners every day to ensure the best and safest health outcomes for their patients.
“The program is also not the answer to overcrowded emergency departments and hospitals around Queensland – we need more staff, with proper qualifications, and better resourcing.
“We have actively worked with Queensland Health to develop collaborative care models that allow doctors, nurses, pharmacists and other allied health professionals to work in teams to safely care for patients, so it is disappointing to see a quick political fix overrule these efforts.
“Once again, we have been given another political announcement that does nothing to protect or improve the health of Queenslanders.
“We call on the government to act in the interests of the community with evidence-based strategies.”
Background
- In 2020, the Queensland government began the Urinary Tract Infection Pharmacy Pilot – Queensland (UTIPP-Q), which allowed pharmacists to undertake a brief online training course and then prescribe and diagnose UTIs in women.
- There was no mechanism for the 6,751 women who took part in the trial to report adverse outcomes, other than directly to the pharmacist.
- AMA Queensland surveyed more than 1,300 doctors across the state in 2022 and found 240 cases where doctors had to treat patients who experienced complications as a result of participating in the pilot.
- The most common misdiagnosis was having a sexually transmitted infection rather than UTI.
- At least six pregnant patients were misdiagnosed with UTI and sold antibiotics that are unsafe in the first 12 weeks of pregnancy, including one patient with a potentially life-threatening ectopic pregnancy.
- The UTIPP-Q evaluation, carried out by QUT, found that one in two participating pharmacists said they would have found it difficult to not sell antibiotics after charging patients the $20 consultation fee.
- The planned North Queensland Scope of Practice Pilot, allowing pharmacists to diagnose and sell medications for 23 serious conditions for the 630,000 people living to the north and west of Mackay, became public in early 2022.
- All medical groups withdrew their participation when the scale of the proposal became apparent.
- In September 2023, with no consultation with medical groups, the Queensland Government announced the North Queensland pilot would be expanded to the entire state from March 2024
