Free Standard AU & NZ Shipping For All Book Orders Over $80!
Register      Login
Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE

Aboriginal and Torres Strait Islander peoples' perspectives on community pharmacists prescribing: a co-designed study protocol

Cara Cross A , Vita Christie https://orcid.org/0000-0003-3887-8305 B * , Leanne Holt A , Boe Rambaldini B , Katrina Ward C , John Skinner B , Connie Henson https://orcid.org/0000-0002-7920-9821 B , Debbie McCowen D , Shalom (Charlie) Benrimoj E , Sarah Dineen-Griffin F and Kylie Gwynne B
+ Author Affiliations
- Author Affiliations

A University of New South Wales, NSW, Australia.

B Djurali Centre for Aboriginal and Torres Strait Islander Health Research and Education, Heart Research Institute, 7 Eliza Street, Newtown, NSW 2042, Australia.

C Brewarrina Aboriginal Medical Service, Brewarrina, NSW, Australia.

D Armajun Aboriginal Health Service, Inverell, NSW, Australia.

E Pharmaceutical Care Research Group, Faculty of Pharmacy, University of Granada, Spain.

F School of Biomedical Sciences and Pharmacy, The University of Newcastle, NSW, Australia.

* Correspondence to: vita.christie@hri.org.au

Australian Health Review https://doi.org/10.1071/AH24110
Submitted: 15 November 2023  Accepted: 3 June 2024  Published: 25 June 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA.

Abstract

Background

In Australia, medications can be prescribed by medical practitioners, dentists, nurses, and dispensed by pharmacists. Until recently, pharmacists have been limited to prescribing Schedule 2 and 3 medications, and optometrists, podiatrists, and nurse practitioners can prescribe medications under their scope of practice in some areas of Australia. Recently, the New South Wales (NSW) Government initiated a trial where approved pharmacists in NSW and Australian Capital Territory have an expanded scope of practice to prescribe further medications for urinary tract infections, dermatology conditions (mild to moderate atopic dermatitis, herpes zoster (shingles), impetigo, and mild plaque psoriasis), and resupply of contraceptives. This protocol is for a sub-study of the larger research trial and will explore the perspectives of Aboriginal and Torres Strait Islander peoples and communities including clinicians, healthcare services, and community members about the expanded scope of pharmacists’ practice.

Methods and analysis

Yarning circles (group) and individual yarns (semi-structured interviews) will be conducted with leaders, clinicians working with Aboriginal and Torres Strait Islander peoples (general practitioners, nurses, Aboriginal health workers, community pharmacists), Aboriginal Elders, and community members to understand perspectives of the risks, benefits, opportunities, and issues associated with pharmacists prescribing for these specific conditions. Ethics approval was obtained through the Aboriginal Health and Medical Research Council of NSW.

Conclusion

The findings of this sub-study will clarify Aboriginal and Torres Strait Islander peoples’ unique perspectives, including perception of risks and opportunities.

Keywords: Aboriginal and Torres Strait Islander, Indigenous health, pharmacy prescribing.

References

The Pharmacy Guild of Australia. Scope of Practice of Community Pharmacists in Australia. March 2023. Available at https://www.guild.org.au/__data/assets/pdf_file/0023/106178/scope-of-practice-2023.pdf

Tsirtsakis A. IMGs a ‘simple solution’ to boost GP numbers: RACGP. The Royal Australian College of General Practitioners. NewsGP page; 2023. Available at https://www1.racgp.org.au/newsgp/professional/imgs-a-simple-solution-to-boost-gp-numbers-racgp#:~:text=As%20Australia’s%20health%20system%20faces,international%20medical%20graduates%20(IMGs)

Duckett S, Breadon P, Ginnivan L. Access all areas: new solutions for GP shortages in rural Australia. Melbourne: Grattan Institute; 2013.

Famiyeh IM, McCarthy L. Pharmacist prescribing: A scoping review about the views and experiences of patients and the public. Res Social Adm Pharm 2017; 13(1): 1-16.
| Crossref | Google Scholar | PubMed |

NSW Health. Pharmacy reform to expand community health care. 13 November 2022. Available at https://www.health.nsw.gov.au/news/Pages/20221113_00.aspx

NSW Health. NSW Pharmacy Trial. 2024. Available at https://www.health.nsw.gov.au/pharmaceutical/Pages/community-pharmacy-pilot.aspx

RACGP. RACGP response to Australian Pharmacy Council Accreditation Standards for pharmacist prescriber education programs. Consultation paper one. 2023. Available at https://www.racgp.org.au/getmedia/1c0f163b-52d3-4c16-8086-2c756071cfe5/RACGP-submission-to-APC-Accreditation-Standards-for-pharmacist-prescriber-education-programs-Consultation-paper-one_1.pdf.aspx

NACCHO. NACCHO and the Aboriginal Community Controlled Health Sector oppose the proposed Queensland Community Pharmacy Trial, Pharmacy led pushes for extended, independent scope of practice threaten to erode the quality of primary health care provided to Aboriginal and Torres Strait Islander people. 3 February 2023. Available at https://www.naccho.org.au/pharmacy-led-pushes-for-extended-independent-scope-of-practice-threaten-to-erode-the-quality-of-primary-health-care-provided-to-aboriginal-and-torres-strait-islander-people/

The University of Newcastle, Dineen-Griffin S, Benrimoj S. NSW Government-Sponsored Clinical Trial: Management of Urinary Tract Infections by Community Pharmacists, College of Health, Medicine and Wellbeing, The University of Newcastle; 2023.

10  Hayman N. Improving Aboriginal and Torres Strait Islander people’s access to the Pharmaceutical Benefits Scheme. Aust Prescr 2011; 34: 38-40.
| Crossref | Google Scholar |

11  The Closing the Gap (CTG) - PBS Co-payment Program. Australian Government. 2024. Available at https://www.pbs.gov.au/info/publication/factsheets/closing-the-gap-pbs-co-payment-measure

12  SHPA. “SHPA taking action on Closing The Gap and the Voice to Parliament”. Thursday 16 March 2023. Available at https://www.shpa.org.au/publicassets/2b02b4bc-92c3-ed11-911d-00505696223b/SHPA%20media%20release%20-%20SHPA%20taking%20action%20jon%20Closing%20the%20Gap%20-%2016Mar2023.pdf

13  NACCHO. New research confirms the effectiveness of the Closing the Gap prescription measure. 6 March 2020. Available at https://www.naccho.org.au/new-research-confirms-the-effectiveness-of-the-closing-the-gap-prescription-measure/

14  Page A, Hyde Z, Smith K, et al. Potentially suboptimal prescribing of medicines for older Aboriginal Australians in remote areas. Med J Aust 2019; 211: 3: 119-125.
| Crossref | Google Scholar |

15  de Dassel JL, Ralph AP, Cass AA. Systematic review of adherence in Indigenous Australians: an opportunity to improve chronic condition management. BMC Health Serv Res 2017; 17(1): 845.
| Crossref | Google Scholar |

16  Nolan-Isles D, Macniven R, Hunter K, Gwynn J, Lincoln M, Moir R, Dimitropoulos Y, Taylor D, Agius T, Finlayson H, Martin R, Ward K, Tobin S, Gwynne K. Enablers and Barriers to Accessing Healthcare Services for Aboriginal People in New South Wales, Australia. Int J Environ Res Public Health 2021; 18: 6: 3014.
| Crossref | Google Scholar | PubMed |

17  Hoti K, Hughes J, Sunderland B. An expanded prescribing role for pharmacists – an Australian perspective. Australas Med J 2011; 4(4): 236-242.
| Crossref | Google Scholar | PubMed |

18  Australian Government, Department of Health and Aged Care. Modified Monash Model. 2023. Available at https://www.health.gov.au/topics/rural-health-workforce/classifications/mmm

19  National Health and Medical Research Council. Ethical conduct in research with Aboriginal and Torres Strait Islander Peoples and communities: Guidelines for researchers and stakeholders. Canberra: Commonwealth of Australia; 2018.

20  Gwynne K. Applying Collective Impact to Wicked Problems in Aboriginal Health. Metropolitan Univ 2017; 28: 115.
| Google Scholar |

21  Gwynne K, Rambaldini B, Christie V, Meharg D, Gwynn J, Dimitropoulos Y, et al. Applying collective impact in Aboriginal health services and research: three case studies tell an important story. Public Health Res Pract 2022; 32(2): 1-8.
| Crossref | Google Scholar |

22  Dimitropoulos Y, Holden A, Gwynne K, Do L, Byun R, Sohn W. Outcomes of a co-designed, community-led oral health promotion program for Aboriginal children in rural and remote communities in New South Wales, Australia. Community Dent Health 2020; 37(2): 132-137.
| Crossref | Google Scholar | PubMed |

23  Gwynne K, Rojas J, Hines M, Bulkeley K, Irving M, McCowen D, Lincoln M. Customised approaches to vocational education can dramatically improve completion rates of Australian Aboriginal students. Aust Health Rev 2020; 44(1): 7-14.
| Crossref | Google Scholar | PubMed |

24  Gwynne K, Flaskas Y, O’Brien C, Jeffries TL, McCowen D, Finlayson H, et al. Opportunistic screening to detect atrial fibrillation in Aboriginal adults in Australia. BMJ Open 2016; 6(11): e013576.
| Crossref | Google Scholar | PubMed |

25  Barlo S, Boyd W (Bill) E, Pelizzon A, et al. (2020). YARNING AS PROTECTED SPACE: principles and protocols. AlterNative: An Int J Indig Peoples 16(2), 90-98. 10.1177/1177180120917480

26  Payne H. Indigenous Health Orgs Oppose Pharmacy Trial; The Medical Republic. 2022. Available at https://www.medicalrepublic.com.au/indigenous-health-orgs-oppose-pharmacy-trial/63676

27  Bessarab D, Ng’andu B. Yarning About Yarning as a Legitimate Method in Indigenous Research. Int J Crit Indig Stud 2010; 3(1): 37-50.
| Crossref | Google Scholar |