Black hole swallows pharmacist prescribing trial
The evaluation did not include urine cultures .
Georgia head 20pt here 3 dk
PAGE 9 ruffles the move to expand pharmacists ’ diagnosing and prescribing roles . Perhaps that is a little unfair . But , based on leaked documents about the evaluation , which has now ended , it seems pharmacists were asked to contact their patients themselves seven days after the UTI consult to find out what the treatment outcomes were and whether they had to seek further advice from another healthcare provider .
Patients were also asked to complete a clinical service evaluation survey , with the answer options ranging from ‘ very satisfied ’ to ‘ very dissatisfied ’, although there seemed to be no mechanism for them to explain their response .
Maybe Dr Mildenhall ’ s patient responded .
But more fundamentally , again as Australian Doctor has previously reported , no urine cultures were used to determine whether any of the 7000 pharmacist-written prescriptions were clinically appropriate .
The UTI trial will run for another six months , with the expectation that it will become a permanent fixture of the Queensland health system .
However , the issue of transparency remains .
The final evaluation report has been written . The author was Professor Lisa Nissen , whose previous research a decade ago into pharmacy vaccinations is the main reason why pharmacists are now administering flu vaccines and much else across Australia .
DERMATOLOGIST
RECOMMENDED *
However , the pharmacy academic ’ s report has yet to be released . It is still in the hands of Queensland Health , which has still not stated if , or when , it will be made public .
GPs in north Queensland are not happy .
Last month , they presented a petition to the Queensland Parliament asking some basic questions — like how many women were referred to a GP ; how many women were misdiagnosed by a pharmacist ; how much money did the
NEW & IMPROVED FORMULAS
INTRODUCING NEXT LEVEL
SENSITIVE SKIN CARE
ENHANCED WITH INGREDIENTS TO IMPROVE SKIN QUALITY
+ GLYCERIN Help Prevent Dryness
Powerful humectant that pulls in moisture to hydrate the skin 1 – 5
+ NIACINAMIDE Strengthen Skin Moisture Barrier
Widely known for its ability to strengthen skin barrier integrity 1 – 5
+ PANTHENOL Soothe and Restore Dry Skin
Hydrating ingredient that soothes and restores dry skin 1 – 5
CETAPHIL REFORMULATED PRODUCTS HAVE BEEN :
Studied IN VITRO 6
Evaluated across 23 CLINICAL STUDIES 6
* Cetaphil AUS HCP Recommendation Research , Galderma , Dec 2021 . References : 1 . Galderma Data on File [ Claims Master Reference ]. 2 . Galderma Data on File [ RD . 27 . SPR . 203918 ]. 3 . Galderma Data on File [ RD . 27 . SPR . 203917 ]. 4 . Galderma Data on File [ RD . 53 . SPR . 203908 ]. 5 . Galderma Data on File [ RD . 53 . SPR . 203914 ]. 6 . Galderma Data on File [ Clear Project deck _ Final ]. AU-CET-2200040 . CET-003023-02 / ADG . March 2022 .
Tested on nearly 1000 PATIENTS 6
® pharmacy , which charged a private fee to dispense any script , make per patient ?
Professor Nissen , who is head of the school of clinical sciences at Queensland University of Technology , defended her evaluation ’ s methodology , saying it was appropriate ( even if it was unclear what the exact methodology was ) given the challenges of taking a more scientific approach .
“ It ’ s not as though we had the funding to run a randomised controlled trial ,” she told Australian Doctor .
“ If we ’ re prepared to have a group of people who are never treated for UTI , we ’ ll set that up , but it ’ s just not happening .”
She acknowledged there was always a possibility of misdiagnosis , as in the case of Dr Mildenhall ’ s patient , given pharmacists ’ treatment decisions were made on the basis of reported symptoms without the use of urine tests .
On top of that , she admitted a “ small number of people ” had been inappropriately prescribed multiple courses of antibiotics , adding there was no way for pharmacists to know if patients had been treated before if that information was not volunteered during the consult .
But she added : “ The amount of people who were treated twice , as a proportion of the 7000 in the total study population , you could almost count on one hand . It ’ s tiny .
“ What we do know is that we make a good attempt to follow people up seven days later , and we have been able to capture a very good percentage given the nature of the pilot .”
“ It ’ s shown this has been a very successful measure . Patients were happy ; they ’ ve received treatment . It ’ s worked .”
Meanwhile , it is still not known if the much more ambitious , and potentially dangerous , pharmacy diagnosing and prescribing trial being considered for north Queensland will go ahead . It is still in draft stage .
But five members of the expert steering committee tasked with helping to devise , implement and evaluate the experiment have already quit .
The latest was the chair of the Northern Queensland Primary Health Network , who withdrew to avoid any “ conflict of interest ” because it turned out he was a pharmacy owner and director of a company called Alive Pharmacy Warehouse .
Judging by the rhetoric , it seems pharmacy antibiotic prescribing for UTIs will survive in Queensland — even if clear evidence that it is not harming women is unlikely to emerge , leaving the community in the dark about its safety , efficacy or whether it is even worth the $ 20 consult .