Ensuring the line between prescribing and dispensing is maintained
BY DR RICHARD KIDD, CHAIR, AMA COUNCIL OF GENERAL PRACTICE
Imagine your patients understood their prescribed medications, what each one does and why compliance with the dosage regime is important. Imagine your patients understood what over the counter complementary medicines might be contra-indicated. Imagine reducing the adverse drug events experienced by your patients. Imagine patients’ access to vital medication could be improved.
The AMA understands the importance of these things to quality patient care, and in 2015 released the AMA’s General practice pharmacists – improving patient care proposal. Evidenced-based and developed in consultation with the Pharmaceutical Society of Australia (PSA), this proposed a funding program for integrating pharmacists into general practices and outlined the economic benefits as well as the potential for improved patient outcomes.
Our advocacy for this proposal successfully resulted in the Federal Budget 2018-19 announcement that general practices, regardless of location, would be supported to employ allied health professionals, such as non-dispensing pharmacists within general practice. The changes, under the new Workforce Incentive Program (WIP), will commence early in 2020. From February 1, general practices will be able to access subsidies to further support them to build their multidisciplinary healthcare teams. While this is a good start, the policy is limited by the retention of current caps on incentive arrangements and the lack of indexation that has eroded the value of these types of subsidies. This needs to change if we are to fully realise the benefits of multidisciplinary care with general practices.
More recently, the AMA has been working on an advocacy strategy to promote the role of pharmacists in general practice, while providing patients with enhanced convenience, safety and quality care in access to medications. Coupled with this has been the AMA’s ongoing efforts to ensure patient safety and quality prescribing. In October, we released the 10 Minimum Standards for Prescribing. Developed by the AMA Council of General Practice and approved by the AMA Federal Council, the Standards are consistent with medical ethics and frameworks for the quality use of medicines.
These Standards put the interests of patients first and provide strong evidence to reject attempts by unauthorised or inappropriately skilled practitioners who may seek prescribing rights outside of their scope of practice. With the release of the Pharmacy Board of Australia’s Position Statement on Pharmacist Prescribing that same week, it was reassuring to see patient safety trumping pecuniary interest with the Board taking a position to not pursue a model of autonomous prescribing by pharmacists.
There are simple changes that Government could make now that would provide patients more convenience and enhance affordability of medications. Most predominantly, enabling pharmacies to dispense up to three months’ worth of a medication at a time where deemed safe to do so by the prescribing medical practitioner. Other reforms that will be explored in an AMA discussion paper in the coming year will include deregulation of pharmacy ownership, innovative models of dispensing utilised overseas, and the use of enabling technology to facilitate medication dispensing that is safe, timely and convenient.
The discussion paper will highlight that GPs want to improve patient access to medications in a safe manner. A key principle will be ensuring the line between prescribing and dispensing is maintained.
So, while the new year will no doubt hold some hot debate on the above-mentioned issues, now I’d like to take this opportunity to wish you all a happy and safe holiday season.
Published: 02 Dec 2019