‘We cannot endorse WA’s UTI pharmacy prescribing trial’: AMA (WA) and RACGP

The Royal Australian College of General Practitioners (RACGP) and Australian Medical Association WA (AMA WA) have jointly raised ongoing concerns about WA’s trial of pharmacy prescribing and are calling for it to be rigorously evaluated.

It comes after the WA Government announced that Western Australian women will be able to walk into their local pharmacy to buy antibiotics for suspected UTI, with no medical evaluation or prescription, as part of the trial.

Both the RACGP and the AMA (WA) have lobbied the trial working group in an attempt to mitigate some of the potential harms associated with pharmacy prescribing.

However, the two medical groups said it was impossible to mitigate all potential harms, in particular the risk of over-prescribing antibiotics. Overprescribing increases antibiotic resistance, one of the top 10 public health threats facing humanity, which makes infections harder to treat and increases the risk of severe illness and death.

RACGP WA Chair Dr Ramya Raman said it was important to have a seat at the table to try to make the trial safer.

“While we cannot endorse this trial due to the potential harms, we want to make sure it’s as safe as possible for all of the patients involved,” she said.

“Not all the risks can be mitigated. This is largely because there is no such thing as a simple diagnosis – GPs train for over 10 years before they diagnose patients and do ongoing training for their entire working life. Pharmacists aren’t trained to diagnose or prescribe.

“The best practice for UTI diagnosis involves urine dipstick testing as a minimum to determine if it actually is a UTI. This is one of the recommendations the RACGP and AMA WA put forward for this trial and any future trials.”

AMA (WA) President Dr Michael Page said there are still questions that remain unanswered about the trial, and rigorous evaluation of patient health outcomes is essential.

“We cannot support increased use of antibiotics in the community, when increasing antibiotic resistance is one of the biggest global health threats that we face,” he said.

“But we want to make sure it’s as safe as possible for the women in the trial, and that’s why we are involved. We’re glad that they accepted our expert advice and changed the first-line antibiotic for the trial to one that is likely to actually work in the Western Australian setting.

“There are still questions yet to be answered about the trial, one of the critical ones being how will it be evaluated? A rigorous evaluation of patient health outcomes is essential to ensure patient safety and the best health outcomes possible, and Western Australians shouldn’t settle for anything else.”

The RACGP and the AMA (WA) welcome the opportunity to discuss their ongoing concerns and recommendations with the Western Australian Government, Department of Health, and other stakeholders to make the WA trial as safe as possible for Western Australians.