Grattan Institute backs pharmacist prescribing for chronic patients
The Grattan Institute in Melbourne has come out on favour of community pharmacists prescribing repeats of long-term medications for patients with stable conditions.
The institute's health program director, Professor Stephen Duckett, says patients are missing out because highly-trained pharmacists have a far more limited role in Australia than in other countries.
In a submission to a discussion on pharmacist prescribing, the institute says all three models proposed by the Pharmacy Board should be implemented to improve healthcare access and medication management.
These are: autonomous prescribing within hospitals; prescribing under supervision in group medical practices; and prescribing under a structured prescribing arrangement.
The institute says there is evidence that pharmacists can safely provide repeat prescriptions to people with simple, stable conditions, and work with GPs to help patients manage chronic conditions.
Apart from medication management, packing and patient education, this could include:
- Adjusting doses and discontinuing or altering the medication in consultation with a GP.
- Helping to treat acute conditions in chronic care patients, while avoiding adverse interactions with their existing medication.
- Informing GPs and other health practitioners of any relevant information about the patient’s care plan.
People have to wait longer and travel further to see a GP for a service that their local pharmacist could just as easily provide, says Professor Dutton.
“Sometimes people get sicker in the interim, which increases costs on the individual and the health system.”
In the community, pharmacist prescribing should occur only within the context of documented, structured prescribing arrangement with each GP.
“In this form of prescribing authority, the pharmacist would negotiate with each GP on what the arrangements are, and what authority the pharmacist has,” Professor Duckett says.
Prescribing under supervision, where a pharmacist has limited prescribing rights determined by legislation or their employer, should be restricted to group practices and hospitals.
Otherwise, it would allow a pharmacist under the supervision of one GP to change the medications prescribed by a different doctor or initiate medications for a patient not managed by the supervising GP.