Prescription Shortcut Puts Patient Safety at Risk
10 February 2023
Urologists are warning of further misdiagnosis after a trial of pharmacists given the power to prescribe medication for urinary tract infections resulted in missed pregnancies, kidney stones, large pelvic tumours and a ruptured ovarian cyst.
South Australia’s parliament has set up a committee to explore how pharmacists could provide medication for some urinary tract infections after a similar pilot program in Queensland was made permanent with New South Wales commencing a similar trial and Victoria expected to follow suit.
“This is a knee-jerk approach that will cause far more problems than it fixes and we’re seriously concerned this will put women’s safety at risk,” says SA urologist Dr Ashani Couchman.
“We should be considering alternate options to take pressure off our health system such as more community nurses, free urine testing or drop-off boxes for samples,” she says.
“The recent trial in Queensland with pharmacists given prescription powers saw one woman told she had a UTI when in fact she was having a miscarriage,” says Dr Couchman.
“There were even cases of men being given antibiotics in the trial which was supposed to only be for women.”
“GPs are trained in the diagnosis process to ensure nothing is missed and we can’t expect pharmacists to be able to provide the same quality of care. It’s also putting them under extreme stress and pressure from a professional liability standpoint as well.”
“There are far better solutions to provide early medical access and care for those suffering from a UTI.”
“There are many serious conditions that present with symptoms similar to a UTI such as pelvic cancer, appendicitis, ectopic pregnancy and kidney stones and we’re deeply concerned these patients are the ones who will be put at risk with misdiagnosis.”
“Urine tests are critical to the management of urine infection and these need to be carefully followed up,” says Dr Couchman.
“Patients may not properly explain their past medical history to a pharmacist. They’re also unlikely to reveal deeply personal information in a busy pharmacy with other customers in earshot.”
A review of the Queensland trial by the Australian Medical Association-AMAQ found significant issues with the pilot including
- 15% of 185 doctors surveyed provided care for patients with complications following their treatment by a pharmacist
- 30% of those with complications had been given inappropriate or ineffective antibiotics
- Three male patients were treated for UTI despite the trial being only for ‘uncomplicated cystitis in non pregnant women’
- Misdiagnosis of UTI saw pregnancy, kidney stones, large pelvic tumours and a ruptured ovarian cyst missed
The Urological Society of Australia and New Zealand has made a submission to the South Australian parliamentary inquiry opposing the pharmaceutical prescription trial.
It joins the SA branch of the AMA in expressing concern over the program compromising patient safety and promoting substandard care for women.
About The Urological Society of Australia and New Zealand:
The Urological Society of Australia and New Zealand is the peak professional body for urological surgeons in Australia and New Zealand. Urologists are surgeons who treat men, women and children with problems involving the kidney, bladder, prostate and male reproductive organs. These conditions include cancer, stones, infection, incontinence, sexual dysfunction, and pelvic floor problems.
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