Home' Australian Pharmacist : Australian Pharmacist March 2016 Contents Australian Pharmacist March 2016 I © Pharmaceutical Society of Australia Ltd.
The monitoring processes of pharmacists
prescribing controlled drugs were
approved by the hospital. Hospitals
were not required to specifically notify
the Pharmacy Board of these practices
because practices within the legislation
were considered routine. All staff within
the same institution accessed shared
electronic records which enabled
transparency in decision making and the
monitoring of patient care for quality
assurance purposes. Additionally, the
hospital had approval and quality
assurance review processes: these
involved interdisciplinary practice review
boards and random chart audits.
Pharmacist prescribers in
In Alberta, community pharmacists
conducted patient assessments and
could prescribe. Pharmacist prescribers
were authorised to alter medication
doses, adapt the prescription, renew
the prescription or prescribe in an
emergency situation. They also had
access to laboratory results and the
ability to order relevant laboratory tests.
At the time of the study tour, Alberta
was the sole Canadian province which
had pharmacist prescribing legislation,
but this legislation did not extend to
narcotics, benzodiazepines, barbiturates
or anabolic steroids.
Albertan community pharmacies had
three broad areas: a retail section which
sold health products; the dispensary;
and a private consultation area/
room. Patients were assessed by the
pharmacist in the private consultation
area/room. In one pharmacy I visited,
there was one full-time pharmacist with
prescribing privileges who was located
in the private consultation room; other
pharmacists managed the dispensary
and also serviced nursing homes.
In another case, I observed a rural
pharmacist who had a dual role working
in the dispensary and undertaking
patient assessments in the private area.
Patients accessed pharmacist prescriptive
services through pre-booked or walk-in
appointments at Albertan community
pharmacies. Patients were not obliged
to have their medication dispensed at
the pharmacy where the prescription
The main argument against community
pharmacist prescribing in Australia is
the perceived conflict of interest due to
competing commercial interests.
Study tour key informants highlighted
that a wide range of health
professionals, and not just pharmacists,
recommend health services or products
that could also financially benefit them.
They also explained that it was a health
practitioner’s responsibility to abide by
a professional code of ethics and make
decisions in a patient’s best interest.
Moreover, in Alberta, these concerns had
been addressed by appropriate governance
and regulation. The Albertan pharmacy
regulatory body recommended that
the roles of dispensing and prescribing
be kept separate where possible for
quality assurance; however, they also
acknowledged that this would not be
feasible in all cases such as in rural settings.
Facilitators of pharmacist
Two crucial facilitators contributed to
the evolution of prescribing roles by
community pharmacists: the first was a
private consulting area which provided
an appropriate environment to conduct
patient assessments. The other crucial
factor was the evolution of the pharmacy
technician role in community pharmacies.
This transferred almost all dispensary duties
from the pharmacist to the technician and
enabled pharmacists to prioritise their time
on patient care activities.
Challenges to pharmacist
Political and financial challenges
have presented major hurdles in the
development of pharmacist prescribing.
Some pharmacist prescribers encountered
direct resistance from some members of
the medical and pharmacy professions
which may or may not have subsided
with time. Funding challenges were
ongoing but had been partly addressed
through employer salary agreements,
organisational exchange of services,
government funding or other grants.
1. Roberts S, Gainsbrugh R. Medication therapy management
and collaborative drug therapy management. J Manag Care
Pharm. [letter]. 2010;16(1):67–9.
2. O’Connor SA, Desroches J. Should prescribing authority be
shared with nonphysicians? Yes or no. Can Fam Physician.
3. Abramowitz P, Shane R, Daigle L, Noonan K, Letendre D, Avery
T. Pharmacist interdependent prescribing: a new model
for optimizing patient outcomes. Am J Health Syst Pharm.
4. Yap D. DEA grants prescriber numbers to certain
Massachusetts pharmacists. American Pharmacists
Association; 2011 [cited 2012 Mar 20]. At: www.
5. Leslie K. Pharmacists in Ontario can give flu shots and renew
non-narcotic prescriptions. The Globe Mail; 2012 [cited 2012
Dec 19]. At: www.theglobeandmail.com/news/politics/
THE LATEST ONLINE EDITION IS AVAILABLE NOW
(online & print)
The 2016 edition of the AMH includes up-to-date drug information to help you
stay informed in your professional practice.
More than 30 new drugs have been added in the last 12 months, including sofosbuvir
and simeprevir for chronic hepatitis C and aclidinium and umeclidinium for COPD.
Advice for medicines taken during pregnancy has been reviewed and has a strong
focus on clinical relevance, and there is expanded information on the use of
Gout management has been thoroughly reviewed and updated - refresh your
knowledge and revise your practice.
There’s new information on rosacea treatment including the use of brimonidine
gel; and updated safety data such as the incidence of VTE with combined
oral contraceptives and newly reported adverse effects such as euglycaemic
ketoacidosis associated with the diabetes class SGLT2 inhibitors.
As with every edition, there are hundreds of
amendments, updates and additions in
AMH 2016 that reflect the latest
shifts in evidence and practice.
To find out more, go to www.amh.net.au
KEEP UP TO DATE
WITH THE LATEST
n Independent medicines information
prepared by our expert team of
qualified pharmacist editors
n User-friendly, concise, peer-reviewed
and evidence-based information
n Drug monographs include mode of
action, indications, precautions, adverse
effects, dosage guidelines and more
n Includes comparative information on
drugs within the same or different classes
n Highlights clinically important
interactions and provides practical
n Updates on medicine use to reflect
changes in evidence and practice
n Advice on new practice guidelines,
from local and international sources
AMH PHARMACY ULTIMATE (AMH BOOK + AMH ONLINE
[3-SCREEN] + AMH CDC [ONLINE] + AMH ACC [ONLINE])
IN AMH 2016
A selection of AMH products:
AMH BOOK +
AMH BOOK +
AMH BOOK +
AMH CDC (PRINT)
IS THE INFORMATION YOU HAVE ON DOSING
FOR CHILDREN RELEVANT & UP TO DATE?
Links Archive Australian Pharmacist February 2016 Australian Pharmacist April 2016 Navigation Previous Page Next Page