Prescribing path for pharmacists

A clear pathway for pharmacist prescribing is shown in the Pharmacy Board of Australia’s position statement released this week, according to the Pharmacy Guild.

This view was echoed by Pharmaceutical Society of Australia President Chris Freeman, who said: “PSA is pleased that the Pharmacy Board has concluded under the National Law there are no regulatory barriers in place for pharmacists to be able to prescribe collaboratively under two of the three models outlined in the Health Professionals Prescribing Pathway [HPPP].”

The statements from the Guild and PSA follow the board’s extensive work in examining the issue of pharmacist prescribing, including competency mapping and broad stakeholder engagement, a forum and the release of a discussion paper on pharmacist prescribing.

In conclusion, the board found there were no regulatory barriers in place for pharmacists to prescribe under a structured prescribing arrangement and prescribing under supervision, but that autonomous prescribing required additional regulation via an endorsement for scheduled medicines.

This would require the board to make an application to the Ministerial Council for approval of endorsement, and to develop a registration standard.

The Guild believes the board’s statement outlines a clear pathway and process to achieve autonomous pharmacist prescribing and is urging the board to proceed towards this objective in the interests of Australian healthcare consumers.

In a response to the board’s original paper on pharmacist prescribing, the Guild restricted comments to autonomous prescribing, saying: “We see this as the only feasible option for improving medicines access and management.”

This week, Guild National President George Tambassis said: “Quite clearly, autonomous pharmacist prescribing would improve access to treatment options for conditions that can be managed by a pharmacist – including after hours and on weekends when access to other healthcare professionals is limited or non existent.

“If pharmacist prescribing is to contribute to the delivery of sustainable, responsive and affordable access to medicines, then it has to be autonomous, and we should proceed with the work required to achieve this.”

In the PSA statement, Mr Freeman said: “Collaborative prescribing agreements within general practice, aged care, hospitals and community pharmacy can address concerns about patients not reaching treatment goals, improve the monitoring of adverse events, and in aged care could go a long way to reducing the medication related misadventure that occurs in this setting.

“It is incumbent now upon state and territory jurisdictions with their medicines and poisons legislation to review their legislation to remove any unnecessary barriers to pharmacists ‘prescribing via a structured prescribing arrangement’ and ‘prescribing under supervision’.”

Pharmacy Board Chair Brett Simmonds says the board’s position statement addressed the competence of pharmacists in Australia to prescribe under the models of non medical prescribing defined by the HPPP.

While the board’s work in exploring pharmacist prescribing hasn’t resulted in any regulatory proposals, the board hopes it will facilitate further exploration by stakeholders on the potential role of pharmacists in prescribing that may contribute to the healthcare needs of the public.

“Developments leading to changes to how pharmacists further contribute to the delivery of health services requires input from a broad range of stakeholders and government, and importantly, the public receiving such services,’ Mr Simmonds said.

The board’s position statement also includes several important considerations that would inform any development of pharmacist prescribing models.

“I urge stakeholders to consider these issues, to reach a common understanding of the ways in which pharmacists can further contribute to public healthcare and to collaborate on any future proposals,” Mr Simmonds said.

The board welcomes further engagement on proposals for pharmacist prescribing, including further discussions on the issues raised in its position statement, available on its website at: www.pharmacyboard.gov.au.

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