The SAX Institute this morning released a report raising serious questions about the lack of evidence underpinning the ongoing roll out of pharmacist prescribing in all Australian states and territories.
The “Community pharmacist prescribing outcomes in Australia and beyond” report was prepared by the Leeder Centre for Health Policy, Economics and Data and commissioned by the Royal Australian College of GPs (RACGP) in response to a growing concern for patient safety amid rapid changes to prescribing for over 20 different health conditions.
RACGP President Dr Michael Wright said the results of the report were troubling to read, particularly after ongoing but unfounded claims the initiatives across the country were evidence-based.
“The RACGP supports increasing access to healthcare; however, this should never be at the expense of patient safety,” he said.
“Coordinated care is vital, but GPs across Australia are seeing patients with adverse health outcomes or diagnoses missed after forgoing a GP appointment in favour of a pharmacy prescription.
“This can look like a patient getting prescribed treatment for a urinary tract infection and then presenting to a GP down the track with chlamydia, gonorrhoea, pelvic inflammatory disease or even an ectopic pregnancy. We cannot take these risks lightly.
“All states and territories have announced or commenced pharmacist prescribing for around 20 common and minor conditions, but the independent report shows the bulk of these conditions have never been formally evaluated in robust clinical trials internationally, let alone in Australia.
“These initiatives must be grounded in evidence to avoid putting patients at risk. The RACGP commissioned the report after patient safety concerns were consistently ignored by State Governments and repeated assertions by the Pharmacy Guild that the treatments were “evidence-based”.
“We looked for high-quality clinical evidence that might support safe autonomous pharmacist prescribing but couldn’t find it. Then we asked State Governments to give it to us, but they declined. So, our last resort was to commission this independent report in case we were missing something. As it turns out, the evidence doesn’t exist and what does exist is limited or of very low quality.”
Dr Wright challenged State Governments and the Pharmacy Guild to publicly release full details of any robust clinical evidence or peer-reviewed trials and evaluations demonstrating that autonomous pharmacist prescribing is safe.
“While improving access to medicines is important, putting measures in place without assessing the risk to our patients is dangerous and could lead to poorer health outcomes, particularly for women who are targeted in these initiatives.
“This new report identified some evidence that pharmacist prescribing may improve access to medicines, but the evidence largely measured service uptake and prescribing activity rather than patient or health system safety outcomes.
“Rolling out major changes to our health system without evidence that they are safe and effective is reckless.
“We need our health system to be evidence-based not lobbyist-led. Governments are putting policy ahead of safety and it is the Australian people who will pay the price.
“We all want to see better access to medicines for patients around Australia, but not when it puts their health at risk.”
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