Changes were made to the Extended Practice Authority ‘Pharmacists’ on 1 July. These include transition of the acute conditions services and the hormonal contraceptive prescribing service from the respective pilots to BAU activities, allowing suitably trained, educated and Queensland Health-approved pharmacists to prescribe according to their scope and prescribing approval.
The scope of practice pilot is to continue for the chronic conditions under a new Extended Practice Authority ‘Pharmacists – Community pharmacy chronic conditions management pilot’ and all pilot requirements must continue to be fulfilled for the chronic condition activities.
Pharmacists authorised to prescribe under either of the previous pilots must register their prescriber number details with Queensland Health before prescribing. A prescriber number factsheet is available to explain the requirements for existing and new prescribing pharmacists.
Prescriptions provided by prescribing pharmacists may be presented at any Queensland pharmacy, and PDL encourages dispensing pharmacists to confirm the prescribing pharmacist’s details on the Queensland community pharmacist prescriber register.
With the transition to BAU, PDL would like to remind pharmacists that the onus of responsibility for good clinical governance rests with individual prescribing pharmacists and the pharmacy owner.
PDL offers the following points for prescribing pharmacists:
- Must be qualified to provide the service and listed on the public register to prescribe.
- Consider how to maintain recency of practice for the conditions being managed.
- Maintain currency of knowledge and guidelines for each service. Consider adding any changes to EPAs or guidelines to your Learning Plan and included as CPD.
- Ensure patient records are professionally prepared, maintained and secure.
- Patient consent is gained and recorded for financial and clinical services, including physical examinations where appropriate, and sharing of information with other health practitioners.
- Patient is allowed to decide where a prescription is to be dispensed.
The Explanatory Guide – Prescribing by Queensland community pharmacists is a good summary of the current status of pharmacists prescribing in Queensland.
Medicines Management Activities
Changes also occurred on 1 July to the Medicines and Poisons (Medicines) Regulation allowing Queensland pharmacists to dispense equivalent medicines as well as expanded urgent supply arrangements. These changes apply for any pharmacist practising in Queensland; it is not limited to prescribing pharmacists. The Explanatory Guide – Pharmacists: Medicines Management Activities is a useful resource, and PDL encourages pharmacists to review this document.
PDL stresses the importance of thorough documentation for any service offered under these new arrangements. Dispensing pharmacists are reminded to take all reasonable steps to inform the original prescriber of changes they’ve made to the prescription and document this action. The dispensing pharmacist should indicate in the dispensing record and on the label that the substitution has occurred under Section 117B. For example, reference on the prescription and label could include “Substituted to ________ under S117B”.
Other considerations when providing an equivalent medicine include patient consent given and documented for non-PBS supply, review of patient allergies and drug interactions with the alternative medicine, provision of a CMI and counselling for the new medicine as well as on the substitution process. Patients are accustomed to generic substitution and need to be informed of the difference between that process and supply of a therapeutically equivalent medicine.
PDL members can call 1300 854 838 for advice and incident support from one of our Professional Officers.
