From next year, pharmacists in yet another state will be permitted to diagnose and prescribe for conditions like asthma, shingles and weight loss management.
Western Australia’s health minister has revealed the full list of conditions to be treated under an upcoming pharmacist-led prescribing trial, confirming that it will be almost identical to the now-permanent Queensland program.
The sole exception is that asthma will be part of the core range of conditions treated by pharmacists in WA; in Queensland, the asthma management component is part of a separate chronic conditions management pilot.
The announcement comes just days after the Pharmacy Guild of Australia released its 10-year strategy, one of the goals of which is to have 80% of community pharmacists qualified to prescribe by 2035.
Western Australia’s health minister Meredith Hammat said the range of conditions had been developed with “safety and accessibility front-of-mind”.
“By enhancing the skills of community pharmacists, we are reducing pressure on hospitals and GPs while giving patients safe, effective care options closer to home,” she said.
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AMA WA president Dr Kyle Hoath warned that some of the conditions had “significant complexities and difficult … sometimes even dangerous and risky treatments”.
“[The pilot] is opening a can of worms that we think we need to be very, very careful about,” Dr Hoath said.
“We call on the government to make sure that we are safe in how we manage this.”
The AMA WA’s key asks are mandatory reports to GPs following every pharmacy presentation, as well as transparent adverse event reporting.
Dr Hoath was particularly concerned about the inclusion of asthma as one of the 17 conditions to be treated.
“Oral steroids in asthma is a great example of a very dangerous treatment,” he said.
“It can’t be used for extended period of time, it has significant drawbacks – there are significant risks … that need to be monitored by a doctor who has experience in treating respiratory conditions.
“Even some of our general practice colleagues and physicians would be tentative in how they manage something like that … asthma is not simple.
“Ventolin is one thing. Oral steroids are a total other kettle of fish.”
The AMA WA president also refuted the idea that pharmacist prescribing would alleviate pressure on other parts of the health system, at least in metropolitan areas.
“We think this may even lead to more pressure [due to] delay in diagnosis or delay in the right treatment, which is only going to cause people to perhaps be more unwell and need more serious treatments,” Dr Hoath said.
“I will say, though, that I think in rural or remote areas, this is something that is an opportunity to provide better access to care … [so long as we] make sure we are doing what we can to avert adverse outcomes.”
The 16 other conditions and services which pharmacists in the WA pilot will be able to offer are:
- Smoking cessation;
- Shingles;
- Impetigo;
- Mild psoriasis;
- Mild to moderate acne;
- Mild to moderate atopic dermatitis;
- Mild, acute musculoskeletal pain;
- Allergic and nonallergic rhinitis;
- Acute otitis externa;
- Acute otitis media;
- Acute nausea and vomiting;
- Acute minor wound management;
- Gastro-oesophageal reflux and Gastro-oesophageal reflux disease;
- Hormonal contraception;
- Weight loss and management of obesity; and
- Oral health risk assessment and fluoride application.
The only other difference between the Queensland and WA programs is that pharmacists in Queensland can also offer travel health services, as well as chronic condition management for cardiovascular disease and COPD.
