Autonomous pharmacist prescribing ruled out

Australian Medical Association/AusMed

The AMA has welcomed the Pharmacy Board of Australia’s decision not to pursue autonomous prescribing by pharmacists.

The Pharmacy Board recently released its Position Statement on Pharmacist Prescribing and said it would not seek to chase a model whereby pharmacists could prescribe medications without medical supervision.

The Pharmacy Board’s statement said autonomous prescribing by pharmacists would require additional regulation, changes to State and Territory legislation, and an application to the Ministerial Council, which could only proceed following the development of a registration standard.

The Board said it was not making an application at this time.

Health Minister Greg Hunt has ruled out any changes, despite the Pharmacy Guild of Australia campaigning for them.

AMA President Dr Tony Bartone said the Pharmacy Board had put patient safety first.

Dr Bartone met with the Pharmacy Board before it released its Position Statement. He applauded the Board’s position.

“Pharmacists are not doctors, and they should not be allowed to undertake autonomous prescribing,” Dr Bartone said.

“The Pharmacy Board has highlighted that significant issues remain with any model of pharmacist prescribing including evidence of need, conflicts of interest, and the importance of separating the prescribing and supply of medicines – all issues that were raised by the AMA.”

Dr Bartone said the Pharmacy Board had strongly endorsed the appropriate scope of practice of health professionals. He added that that the AMA highly values the professional role of pharmacists in working with doctors and patients.

The Pharmacy Board’s Position Statement was published a day after the AMA released its 10 Minimum Standards for Prescribing document.

In that document, developed by the AMA Council of General Practice and approved by the AMA Federal Council, the AMA seeks to ensure patient safety and high-quality health care.

The 10 Minimum Standards for Prescribing are:

  • Standard 1: Prescribing by non-medical health practitioners should only occur within a medically led and delegated team environment in the interests of patient safety and quality of care.
  • Standard 2: There must be no pecuniary or non-pecuniary benefit to the prescriber related to the choice of medicines prescribed or the dispensing of those prescribed medicines.
  • Standard 3: Before prescribing establish a therapeutic relationship with the patient and perform a comprehensive medicines assessment to identify what other medicines, including complementary medicines, the patient is taking and consider any implications to the patient’s treatment plan.
  • Standard 4: Prescribers ensure they:
    • a) consider the necessity and appropriateness of medications in managing the patient’s health care needs,
    • b) choose the most suitable and cost-effective medicines when medicines are considered appropriate, taking into account the efficacy, potential for self-harm and the ability of the patient to adhere to the dosage regimen,
    • c) advise patients are aware of the relevant side effects of prescribed medications as well as relevant interactions between medications, and
    • d) report any adverse reactions to the TGA.
  • Standard 5: Prescribers must maintain clinical independence.
  • Standard 6: Prescribers must operate only within their scope of practice and comply with state, territory and legislative requirements including restrictions under the Pharmaceutical Benefits Scheme.
  • Standard 7: Prescribers work in partnership with the patient to set therapeutic goals and with other health professionals as appropriate to select medicines and to tailor and implement a treatment plan.
  • Standard 8: Prescribers provide clear instructions to delegated prescribers within the health care team and to other health professionals who dispense, supply, or administer the prescribed medicines.
  • Standard 9: Prescribers with the patient consent communicate with other health professionals within the patients’ health care team about the patient’s medicines and treatment plan.
  • Standard 10: Prescribers monitor and review the patient’s response to treatment and adjust the treatment plan as appropriate.

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