UTI pharmacy pilot recommended for expansion despite GP concern

Tasmanian pharmacists provided 6534 episodes of care during the state’s 12-month urinary tract infection (UTI) prescribing pilot, with 91% of patients supplied antibiotics.
 
An evaluation of the pilot, which allowed pharmacists to assess and treat uncomplicated UTIs in Tasmanian women from 1 March 2024 to 28 February 2025, found 88% of patients surveyed said they felt better after receiving treatment from a pharmacist.  
 
However, with just 120 patients responding to this survey, the RACGP says this is not a strong enough evidence base to ‘assess safety and patient outcomes or guide major changes to healthcare’.
 
The evaluation revealed that on average, pharmacists spent 10 minutes with each patient, and 25% of those surveyed reported needing follow-up care, mostly with their GP.
 
During the pilot, there were no formal reports of adverse outcomes and no increases in reports to the Therapeutic Goods Administration of increased medication-related adverse reactions.
 
Overall, the evaluation found the trial likely reduced cost for patients and pressure on GP and hospital-based services.
 
It recommends UTI treatment becomes part of ongoing service provision in Tasmanian pharmacies, and that ‘routine mandatory follow-up should not be required for all pharmacy UTI consultations’.
 
‘Instead, pharmacists should provide clear safety advice at the time of consultation, including expected symptom improvement, red flags, and when and where to seek further medical care,’ the evaluation concludes.
 
But the report has drawn the ire of GPs, with RACGP President Dr Michael Wright saying the evaluation was not robust enough to determine whether the model delivered safe and effective care. 

‘Counting consultations and prescriptions tells us how much care was delivered. It doesn’t tell us whether patients got better or whether the care was safe,’ he said. 

‘UTI symptoms can overlap with other conditions. If the diagnosis is wrong, patients risk receiving antibiotics they don’t need while the real cause of their symptoms is missed or treatment is delayed. 

‘Every unnecessary antibiotic prescription contributes to the growing threat of drug-resistant superbugs. If we don’t use antibiotics carefully, we risk returning to a time when a simple cut or infection could become life-threatening.’

RACGP Tasmania Chair Dr Toby Gardner echoed the President’s calls, saying the evaluation also highlights problems with continuity of care, with more than one-third of pharmacists surveyed being unable to communicate with a patient’s GP following treatment. 

‘When a patient’s usual GP doesn’t know what treatment or antibiotics they have received, care can become fragmented and important information can be missed,’ he said.

‘The evaluation also found some pharmacies had to close temporarily to provide private consultations, while pharmacists reported workforce pressures and difficulty providing other services at the same time. 

‘These findings raise important questions about whether this model can work at scale, particularly in rural communities already dealing with workforce shortages.’
 
Log in below to join the conversation.

pharmacy prescribing scope of practice Tasmania