On 4 August 2023, the WA Government announced the implementation of treatment of urinary tract infection (UTIs) by pharmacists. WA Health has issued a Structured Administration and Supply Arrangement (SASA) that authorises trained pharmacists working in community pharmacy to supply antibiotics for the treatment of urinary tract infections in eligible women aged between 18 and 65 years.
Important note
This is not a trial. All pharmacists who meet the criteria outlined in the Pharmacist Initiated Treatment of UTI SASA have been authorised to supply the approved medicines from 4 August 2023. Note that pharmacists must have completed competency-based training prior to offering the service.
Checklist before providing the service
| Confirm insurance cover | PDL continues to support the profession and members in the provision of professional services. For pharmacists considering providing the service, PDL is pleased to state that the PDL Master Policy automatically includes professional indemnity cover for members providing this service in line with the approved guidelines. This is also the case for PDL proprietor members who have a Guild Insurance Pharmacy Business Insurance Policy. |
| Complete all training required | Pharmacists must complete one of the accredited training programs before offering the service. Training is available through the Australasian College of Pharmacy and the Pharmaceutical Society of Australia.
This service is only permitted to be provided in WA by pharmacists who hold unconditional general registration with the Australian Health Practitioner Regulation Agency (Ahpra). Intern pharmacists and those pharmacists with conditions on their registration are not permitted to provide the service under the SASA. Pharmacists must complete cultural safety and gender diversity training relevant to their place of practice to ensure they provide the service in ways that are inclusive, culturally safe, sensitive and responsive. This training may already be a component of a pharmacy’s training protocol and quality assurance program. |
| Facilities are appropriate to ensure privacy | Pharmacists must meet professional practice standards and ensure that the consultation is conducted in an area that protects the patient’s privacy and confidentiality. It is particularly important to ensure that the patient is comfortable disclosing sensitive information that may be critical to the diagnosis and treatment plans. |
| Transfer to My Health Record is enabled | The SASA mandates that the dispensing record is transmitted to My Health Record. The purpose of the mandate is to ensure that relevantpatient details were obtained, and the pharmacist’s HPI-I is linked to the dispensing record to allow the transmission to occur.
Prior to offering the service, pharmacists should ensure that their dispensing software has been configured correctly so that this transfer occurs automatically. For dispensing software-specific information, pharmacists should consult their software vendor. Note: Some people may have opted out of using My Health Record or have recently arrived in Australia. It is important to note that people without My Health Record are not excluded from accessing treatment. |
| Ensure policies and procedures are in place | Ensure that your pharmacy has completed a comprehensive risk assessment and review of the new service to be implemented. Policies and procedures to support workflow, procedures for handling requests appropriately, fees and charges, incident management and referral pathways are in place and understood by all pharmacy staff. |
Providing the service
| The consultation | Ensure proper history taking during the consultation. Pharmacists should ensure the approved medicines are only supplied for patients aged between 18 and 65 years with anatomical female urinary tract, presenting to a community pharmacy with symptoms indicative of uncomplicated UTI, and meeting all clinical inclusion criteria.
WA Health has published supplementary information for pharmacists which should be read and understood by all pharmacists providing the service in conjunction with the training and treatment protocol. |
| Medicine choice and dispensing
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The WA pharmacy UTI program recommends nitrofurantoin as the first line antibiotic and trimethoprim as the second line option. The most recent urine E. coli antibiograms indicate that nitrofurantoin is the most effective antibiotic for empirical therapy in community acquired UTIs.
All medications supplied following consultation should be dispensed and labelled in accordance with standard dispensing procedures. |
| Record keeping | The pharmacist must keep a clinical record of the consultation and provide a service summary to the patient and, if appropriate, to the patient’s usual GP. This can be done using a pharmacy practice software, or the pharmacist may choose other forms of digital or paper record keeping methods. |
| Service limitations, referral pathways and follow up | Pharmacists providing the service must ensure that they are familiar with the exclusion criteria. Recurrent UTIs should be referred to a medical practitioner. They are defined as two or more episodes in the last six months, or three or more episodes in the last 12 months. Patients must not be supplied with another course of antibiotics for unresolved symptoms. Patients must be referred to a medical practitioner when required, or if the pharmacist is in doubt of the safety and appropriateness of the treatment.
Patients supplied with antibiotics should be provided with follow-up advice on when they should seek an assessment from a medical practitioner. In cases where patients are unsuitable to be treated in the pharmacy based on the consultation, or the treatment provided has failed, a referral and service summary should be provided to take to their GP. |
If you have questions regarding this material or the provision of this service, please contact the PDL Professional Officers on 1300 854 838.
