Doctors and chemists clash over treatments

A controversial 18-month-long trial has found pharmacists have appropriate skills to sell antibiotics for uncomplicated urinary tract infections.

The Pharmacy Guild of Australia, Queensland branch, said pharmacists had followed the same UTI protocols as doctors.

A turf war between Queensland doctors and chemists will intensify after results from a controversial 18-month-long trial found pharmacists have appropriate skills to sell antibiotics for uncomplicated urinary tract infections.

An unreleased 126-page draft report, obtained by The Australian, is overwhelmingly supportive of the trial, which began in June 2020 and enabled pharmacists to diagnose and prescribe drugs to 6751 women.

Despite strong push back from the Queensland arm of the Australian Medical Association, the trial is being expanded to enable pharmacists to diagnose and treat more than 20 other serious conditions including heart problems, dental issues and asthma.

The evaluation of the Queensland Health trial comes after the AMAQ released a survey of its doctors which alleged more than 200 patients had to seek treatment from doctors after being misdiagnosed by pharmacists.

But the draft report of the UTI trial, authored by Professor Lisa Nissen, clinical sciences head at Queensland University of Technology, found pharmacists delivered safe and appropriate care when prescribing the antibiotics.

“Overall, both patients and pharmacists reported that the (trial) was of significant value because of improved accessibility and convenience,” Professor Nissen wrote.

Her report found only 36 per cent of the almost 7000 patients who were prescribed antibiotics were able to be contacted for follow-up questions by a pharmacist after their treatment.

Of the 2409 who were able to be contacted, 87 per cent reported their UTI symptoms had resolved after the antibiotic treatment.

Of the remaining patients, 184 had no resolution of their symptoms but had already sought other care and another 86 were verbally referred to their GP by the pharmacist.

Four patients visited an emergency department after being prescribed antibiotics by a pharmacist. The first had an allergic reaction, the second was diagnosed with a “superbug”, a third given IV antibiotics, and the fourth was admitted to hospital with appendicitis.

The four patients who presented to emergency were reviewed by clinicians from the trial’s steering committee who concluded the pharmacists followed treatment protocol.

The Pharmacy Guild of Australia, Queensland branch, said pharmacists had followed the same UTI protocols as doctors.

“Not every community has access to GPs – and even in those that do, sometimes women have to wait weeks before getting an appointment,” a spokesman said.

The AMAQ met with Health Minister Yvette D’Ath on Monday afternoon to raise concerns about the pilot and to continue to oppose the expansion of the trial.

“We hope the report will be made publicly available so that doctors and all Queenslanders can see the outcomes of this pilot,” AMAQ president Chris Perry said.