RACGP lobbies MPs to overturn ‘shortsighted’ pharmacy prescribing trial

The RACGP has been highly critical of Queensland’s proposed state-wide trial permitting pharmacists to prescribe antibiotics for urinary tract infections (UTIs) and the contraceptive pill, warning that expanding the pool of antibiotic prescribers is unwise at a time of growing concern over antibiotic resistant ‘superbugs.’
 
In the letter sent to all Queensland MPs this week, RACGP Queensland Chair Dr Bruce Willett calls for the overturning of the ‘shortsighted’ decision made by state Health Minister Steven Miles.
 
‘The safety and care of all Queenslanders matters more than convenience, which is the proposed benefits of this trial. Future generations need antibiotics that work, and we owe it to them to do all we can to ensure they are available,’ Dr Willett wrote.
 
‘At a time when the Federal Government is seeking to restrict the use of antibiotics in hospitals and primary care, Minister Miles’ decision goes against global best practice.
 
‘Antibiotic resistance has been identified as one of the greatest threats to future human health. Already we see in our practices and in hospitals the effects of antibiotic resistant infections, colloquially known as “superbugs”.
 
‘This decision has been made outside of the national process currently underway by the Australian Health Protection Principal Committee [AHPCC] working group, resulting in a fragmented prescribing and regulatory framework.’
 
Earlier this year, the World Health Organization issued a report with dire warnings that antimicrobial resistance is a ‘global crisis that threatens a century of progress’ and could lead to 10 million deaths a year within 30 years.  
 
Dr Willett pointed out that, Australia-wide, 20% of all UTIs are already resistant to trimethoprim, the antibiotic recommended for the pharmacy prescribing trial.
 
On the contraceptive pill, Dr Willett writes that ‘there is no such thing as “just a pill script”.’
 
‘The pill is a risky medication and is no longer the first option for contraception,’ he wrote.
 
‘A prescription for the pill involves a risk assessment and health screening opportunities, including a sexually transmissible infection check, cervical screening, blood pressure check, and an opportunity to discuss new and improved contraceptives.
 
‘A retail pharmacy cannot provide these services.’
 
Dr Willett pointed out that an independent advisory committee to the Therapeutic Goods Administration warned against pharmacists dispensing the pill in 2015.
 
He wrote that allowing the trial would effectively allow Queensland pharmacists to operate outside of regulation by the Pharmacy Board of Australia and Australian Health Practitioner Regulation Agency (AHPRA) oversight of non-medical health prescribing.
 
In a separate letter directly to Minister Miles, Dr Willett wrote of his ‘deep regret’ at having to take this drastic action.
 
‘The RACGP is particularly troubled by the proposed increased availability of antibiotics for patients presenting to pharmacies complaining of symptoms that may represent a UTI,’ Dr Willett wrote to Minister Miles.
 
‘The opportunity for misdiagnosis cannot be understated.
 
‘The RACGP has been working for many years, with some success, to educate our members to prescribe fewer antibiotics. The Federal Government and governments around the world are actively working to more carefully use antibiotics.
 
‘Making antibiotics effectively an over-the-counter medication runs counter to the advice of infectious diseases experts in Australia and around the world. This is a serious issue potentially affecting antibiotic efficacy for future generations of Queenslanders, and I have thus taken the extraordinary measure of writing to MPs.’
 
The Australian Medical Association has also slammed the pharmacy prescribing trial, dubbing it ‘dangerous’.
 
The trial comes after the Queensland Government accepted all recommendations made by a parliamentary committee inquiry into pharmacist scope of practice and whether to establish a pharmacy council.
 
The Pharmacy Guild of Australia, the lobby group for pharmacy owners, welcomed the findings of that inquiry as a way for ‘pharmacists to operate to the full extent of their training’.
 
The RACGP recently praised the NSW Government for refusing to follow Queensland’s trial.

antimicrobial resistance pharmacy pharmacy prescribing Queensland