Progressing Safely in OTC Switch. Dr Natalie Gauld ASMI presentation Nov 2015

Transcription

1 Progressing Safely in OTC Switch Dr Natalie Gauld ASMI presentation Nov 2015

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4 Outcomes of progressive switches considered in NZ & Australia in New Zealand doi: /journal.pone g001 Australia

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6 Gauld N, et al. Journal of Health Services Research & Policy, (4): p

7 Pharmacy policed their profession very, very effectively and self-managed their profession very, very effectively, in a way that certainly makes me more confident that other things can go down in the same way.... Regulatory participant, NZ their perception of the commitment of the pharmacy profession to the management of schedule 3 and schedule 2, has a huge bearing on decisions of further rescheduling. Committee member, Australia

8 with the correct training there was no reason why pharmacists could not manage patients who present for the first time with a urinary tract infection. pharmacist sale of trimethoprim may be more in line with best practice than the prescribing habits of general practitioners. MCC minutes May 2012 this rate of misdiagnosis was unlikely to differ significantly whether it was a pharmacist or a GP doing the diagnosis NDPSC record of reasons Oct 2009 on chloramphenicol

9 Progressive Switches in NZ Year Medicine Company Features Mandated training 2009 Chloramphenicol (eye infections) Famciclovir tablets (cold sores) Zolmitriptan nasal spray (migraines) 2010 Calcipotriol (psoriasis) 2011 Cholera & ETEC vaccine (traveller s diarrhoea) Novartis AstraZeneca Algorithm Algorithm Screening tool Algorithm Algorithm 2012 Influenza vaccine Screening tool Yes Trimethoprim (cystitis) Screening tool Yes 2013 Meningococcal vaccine Screening tool Yes Tdap vaccine (pertussis) Screening tool Yes Shingles vaccine Screening tool Yes 2014 Sildenafil (erectile dysfunction) Douglas Screening tool Yes

10 Widening consumer access to medicines through pharmacists has involved mandatory training elsewhere

11 Screening tools/ algorithms

12 It works pretty well, I talk to the patient with open questions, then quickly go through the list so I don t miss anything. I like the forms they are amazing, you can t miss something. You learn it today but forget it tomorrow. You know you re doing the right thing. It s taking pharmacy to new places

13 Gave pharmacists more complex switches Increased trust in pharmacists Tools, organisations on-board, enthusiasm in pharmacy Pharmacists rose to the challenge (evidence)

14 82% response rate 42% not immunized the previous year The commercial environment of a community pharmacy did not appear to detract from the professional role Evidence

15 What about Australia? Source: The Australian Government, the Treasury CHF survey: most respondents believed that pharmacists have a larger part to play in providing primary care services We are facing significant challenges in maintaining the sustainability of our health system Hon Sussan Ley above all, I am about ensuring that Australians have access to information, choice and affordable health care Hon Sussan Ley

16 What about Australia? New models for reclassification to maximise the benefit/risk equation Reclassify by product and/or have market exclusivity Learn from other countries Work together to make it work Collect evidence

17 We are all very comfortable with supplying sildenafil. Quite a few men we see haven t had it before, so it s providing a useful service. Female pharmacist qualified <10 yrs On New Year s Day there was a 3 hour wait and $105 cost to see the doctor. The medical centre was referring women with cystitis to us for treatment. Pharmacist from a tourist town

18 Thank you