EXPANSION of pharmacists' scope of practice to include antibiotic prescribing will see general practice become a "back-up service" managing treatment failures, a leading GP warns.
In an article published on the Royal Australian College of General Practitioners' (RACGP's) newsGP website, the College's former Expert Committee Quality Care Chair, said the decision to extend the Urinary Tract Infection Pharmacy Pilot - Queensland (UTIPP-Q) suggested a move to pharmacists prescribing "appears to be a fait accompli - regardless of the results of this 'trial'".
"Pharmacies may be convenient and accessible, but pharmacists aren't," he said.
"They are busy too, with usual workload involving prescription dispensing.
"From a health management perspective, we also have no idea of the backgrounds, workloads or competency of the pharmacists who are making these clinical decisions.
"What we do know, is that with non-prescription medications counselling is not often provided or is of poor quality.
"There are also high rates of over-treatment and overselling of medication, with pharmacists ignoring eligibility criteria and not complying with legislation or clinical protocols, nor having appropriate medical referral practices.
"The retail environ of pharmacy is not a location where judicious use of antimicrobials is made. History shows that Australian pharmacy sales of vaginal antifungals and chloromycetin eye drops increased dramatically when the prescriptions were made pharmacist-only.
"If the promotion of pharmacy antibiotic sales and services under the guise of convenience is prioritised over good healthcare, then antimicrobial stewardship as a national priority is dead.
"GPs will be stuck between a rock and a hard place.
"They will be forced to collaborate with a business-oriented pharmacy model of which they do not approve.
"They will be the clinical back-up service, managing the over-diagnosis, misdiagnosis, and treatment failures.
"Whilst governments have a mandate to govern as they see fit, it is important that consumers and national health priorities are not sacrificed for business benefit.
"Drug and antibiotic sales under the guise of convenience is poor health policy with little societal or professional benefit, other than pharmacy business."
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