‘Concerned’: dermatologists respond to NSW pharmacy trial

4 minute read

From next year, pharmacists will be able to prescribe medications for certain skin conditions as part of a statewide trial.

The Australasian College of Dermatologists has expressed “concerns” about the NSW Government’s plan to include some skin conditions in the state’s pharmacy prescribing trial. 

In a statement to The Medical Republic, a spokesperson said the risk of misdiagnosis could lead to incorrect treatment and dangerous delays to treatment. 

“The ACD fully supports pharmacists working within medically led, multidisciplinary team-based settings such as general practices and Aboriginal and Community Controlled Health Services and as part of appropriate clinically governed teams,” she said. 

“These allow the pharmacist to work collaboratively with GPs and other health professionals to support the quality and safe use of medicines through patient education and medication governance activities and can help reduce medication misadventures during transitions of care between settings. 

“However, we do have concerns about pharmacist prescribing models, particularly outside of GP-led team-based primary care setting. Some serious and malignant conditions can masquerade as common diseases of the skin.  

“Misdiagnosis can lead to incorrect treatment, dangerous delays to appropriate treatment, and result in patients experiencing significant financial burden due to ineffective treatments.” 

She said it was critical that any models of care were underpinned by appropriate clinical governance and protocols.  

“It is also important that exploration of these models is not at the expense of investment in addressing both the GP and specialist workforce shortage,” said the spokesperson. 

NSW Health Minister Ryan Park announced on Saturday that people suffering from certain skin conditions would be able to access prescription medicines through the pharmacy prescribing trial, which is due to run next year. 

The trial will see participating pharmacists authorised to supply certain medicines without a prescription, after having a consultation with a pharmacist. 

According to the government, the trial is designed to safely expand the capacity of pharmacists in order to relieve pressure on general practitioners and other primary care settings. 

In his announcement about the expansion of the trial to include some skin conditions, Mr Park said that late March next year (pending ethics approval) the trial would include treatments for impetigo (school sores) and shingles. 

Additional topical treatments for dermatitis and mild plaque psoriasis will also be included. The skin condition treatment component of the trial will run for 12 months.? 

More information about the clinical trial and for a list of community pharmacies participating in the trial, is available here.

In May, Mr Park announced the commencement of stage one of the initiative, which trialled the prescribing of treatment for uncomplicated urinary tract infection (UTI) at 100 participating pharmacies. In September, it expanded to more than 900 pharmacies and extended the trial to the prescribing of the resupply of the oral contraceptive pill (OCP). 

The trial has now expanded to more than 1100 community pharmacies, which accounts for about 60% of the state’s total pharmacies. 

Mr Park said “‘everyone knows it is sometimes difficult to get in to see our very busy GPs”. 

“And people know where to find a pharmacy and this trial offers patients who can’t see their GP another treatment pathway,” he said. 

“Through this trial, we are making it easier and more convenient for people to access the medications they need but working hard to ensure their care is not fragmented. 

“By bolstering the capacity of pharmacies, we can take pressure off other parts of our primary care system, so that those who need them can access them. 

“Where we can do things better, we should, and these are the kind of innovative initiatives that I am keen for our health system to embrace.” 

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