Pharmacy Daily | Doctors urge NSW to drop UTI trial

MEDICAL groups are urging NSW Health Minister, Brad Hazzard, to abandon plans to introduce a trial of pharmacists prescribing for uncomplicated urinary tract infections (UTIs) (PD 05 Oct).

Both the Australian Medical Association (AMA) and the Royal Australian College of General Practitioners (RACGP) have warned against expanding pharmacists scope of practice.

Speaking at the General Practice Crisis Summit yesterday, AMA Federal President, Professor Steve Robson, described the proposal as a "dangerous experiment", and voiced concerns about Queensland's decision to make pharmacist prescribing for UTIs a permanent part of pharmacists' scope of practice in the sunshine state (PD 04 Oct).

"Governments need to come to the table with viable solutions to support general practice and build collaborative models of care - not changes that completely undervalue the quality of care that is provided through general practice and fragment patient care," he said.

"We know from the Queensland trial that it did not relieve pressure on emergency departments, but instead resulted in women waiting longer for treatment for conditions that are easily mistaken for UTIs, including pregnancy, pre-cancerous conditions, and sexually transmitted infections that can lead to infertility."

RACGP Expert Committee - Quality Care member and NSW-based GP, Dr Michael Tan, also raised concerns about the proposed pilot, saying the description of it being a "prescribing" trial would be problematic.

"People don't present with a diagnosis of a UTI," he said.

"They present with symptoms that might be due to a UTI, but it may well be due to another diagnosis that will need treatment.

"One wonders, for instance, how many STIs have been missed in the Queensland trial.

"This transactional and unintegrated approach to primary care worsens care quality.

"Specifically in this situation, it seems to throw out the principle of antimicrobial stewardship."

An economic analysis of the expected financial benefits of pharmacists in NSW being able to treat UTIs, presented at the Guild's Pharmacy Industry Roadshow last month, estimated that it would generate savings of $297.2 million over a 10-year period.