Australian osteopaths as non-medical prescribers: comparison of healthcare practitioner characteristics from a nationally representative survey
Brett Vaughan
A B F , Michael Fleischmann C , Kylie Fitzgerald D , Sandra Grace B , Paul Orrock B and Amie Steel E
A Department of Medical Education, Medical Building, University of Melbourne, Grattan Street, Parkville, Vic. 3010, Australia.
B School of Health and Human Sciences, Southern Cross University, Military Road, Lismore, NSW 2480, Australia.
C College of Health and Biomedicine, City Flinders Campus, Victoria University, 301 Flinders Lane, Melbourne, Vic. 3000, Australia.
D School of Health and Biomedical Sciences, Bundoora Campus, RMIT University, Plenty Road, Bundoora, Vic. 3083, Australia.
E Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, 15 Broadway, Ultimo, NSW 2007, Australia.
F Corresponding author. Email: brett.vaughan@unimelb.edu.au
Australian Journal of Primary Health 26(5) 417-423 https://doi.org/10.1071/PY19248
Submitted: 19 December 2019 Accepted: 18 June 2020 Published: 4 September 2020
Abstract
The study aimed to compare the characteristics of Australian osteopaths who definitely agree that prescribing scheduled medicines is part of their future scope of practice with those who do not. A secondary analysis of a cross-sectional survey of osteopaths from an Australian practice-based research network was undertaken. Demographic, practice and treatment characteristics were identified using inferential statistics and backward linear regression modelling. Over one-quarter (n = 257, 25.9%) of the total participants (n = 992) indicated that they ‘definitely’ agree that osteopaths should seek prescription rights. Adjusted odds ratios (OR) suggested these osteopaths were more likely to engage in medication discussions with patients (OR 1.88), frequently manage migraines (OR 1.68) and seek increased practice rights for referrals to medical specialists (OR 2.61) and diagnostic imaging (OR 2.79). Prescribing as part of the future scope of practice for Australian osteopaths is associated with patient management (medication discussions) and practice characteristics (increased referral rights for specialists and diagnostic imaging) that warrant additional investigation. Understanding of the practice, clinical and patient management characteristics of Australian osteopaths who see prescribing as part of the future scope of practice informs the case for regulatory and health policy changes for prescribing scheduled medicines.
Additional keywords: manual therapy, musculoskeletal, non-medical prescribing, osteopathic medicine, prescription medicine.
References
Adams J, Sibbritt D, Steel A, Peng W (2018) A workforce survey of Australian osteopathy: analysis of a nationally-representative sample of osteopaths from the Osteopathy Research and Innovation Network (ORION) project. BMC Health Services Research 18, 352| A workforce survey of Australian osteopathy: analysis of a nationally-representative sample of osteopaths from the Osteopathy Research and Innovation Network (ORION) project.Crossref | GoogleScholarGoogle Scholar | 29747647PubMed |
Australian Health Practitioner Regulation Agency (2017) National Boards. (Australian Health Practitioner Regulation Agency: Melbourne, Victoria, Australia) Available at https://www.ahpra.gov.au/National-Boards.aspx [Verified 19 May 2020]
Australian Health Practitioner Regulation Agency (2018) AHPRA Guide for National Boards developing submissions under the AHMAC Guidance for National Boards: applications to the Ministerial Council for approval of endorsements in relation to scheduled medicines under section 14 of the National Law. (Australian Health Practitioner Regulation Agency: Melbourne, Vic., Australia) Available at https://www.ahpra.gov.au/National-Boards/Endorsement-for-scheduled-medicines.aspx [Verified 2 July 2019]
Australian Institute of Health and Welfare (2018) ‘Australia’s health 2018.’ (Australian Institute of Health and Welfare: Canberra, ACT, Australia)
Berner ES, Graber ML (2008) Overconfidence as a cause of diagnostic error in medicine. The American Journal of Medicine 121, S2–S23.
| Overconfidence as a cause of diagnostic error in medicine.Crossref | GoogleScholarGoogle Scholar | 18440350PubMed |
Blaich R, Steel A, Clark D, Adams J (2018) Challenges and opportunities for Australian osteopathy: a qualitative study of the perceptions of registered osteopaths. International Journal of Osteopathic Medicine 30, 18–24.
| Challenges and opportunities for Australian osteopathy: a qualitative study of the perceptions of registered osteopaths.Crossref | GoogleScholarGoogle Scholar |
Borthwick AM, Short AJ, Nancarrow SA, Boyce R (2010) Non-medical prescribing in Australasia and the UK: the case of podiatry. Journal of Foot and Ankle Research 3, 1
| Non-medical prescribing in Australasia and the UK: the case of podiatry.Crossref | GoogleScholarGoogle Scholar | 20051138PubMed |
Burke SR, Myers R, Zhang AL (2013) A profile of osteopathic practice in Australia 2010–2011: a cross sectional survey. BMC Musculoskeletal Disorders 14, 227
| A profile of osteopathic practice in Australia 2010–2011: a cross sectional survey.Crossref | GoogleScholarGoogle Scholar | 23915239PubMed |
Cerritelli F, Lacorte E, Ruffini N, Vanacore N (2017) Osteopathy for primary headache patients: a systematic review. Journal of Pain Research 10, 601
| Osteopathy for primary headache patients: a systematic review.Crossref | GoogleScholarGoogle Scholar | 28352200PubMed |
Cope LC, Abuzour AS, Tully MP (2016) Nonmedical prescribing: where are we now? Therapeutic Advances in Drug Safety 7, 165–172.
| Nonmedical prescribing: where are we now?Crossref | GoogleScholarGoogle Scholar | 27493720PubMed |
Department of Veterans Affairs (2019) Veterans’ health cards. (Department of Veterans Affairs: Canberra, ACT, Australia) Available at https://www.dva.gov.au/health-and-wellbeing/veterans-health-cards [Verified 31 August 2019]
Health Professions Accreditation Council Collaborative Forum (2018) Framework for accreditation requirements for the safe and effective use of medicines. (Health Professions Accreditation Council Collaborative Forum: Canberra, ACT, Australia) Available at http://www.hpacf.org.au/wp-content/uploads/2018/10/Consultation-Paper-Accreditation-for-the-safe-and-effective-use-of-medicines-October-2018.pdf [Verified 31 August 2019]
Hosmer Jr DW, Lemeshow S, Sturdivant RX (2013) ‘Applied Logistic Regression.’ (John Wiley & Sons: New York, NY, USA)
Nissen LM, Kyle GJ (2010) Non-medical prescribing in Australia. Australian Prescriber 33, 166–167.
| Non-medical prescribing in Australia.Crossref | GoogleScholarGoogle Scholar |
Licciardone JC, Minotti DE, Gatchel RJ, Kearns CM, Singh KP (2013) Osteopathic manual treatment and ultrasound therapy for chronic low back pain: a randomized controlled trial. Annals of Family Medicine 11, 122–129.
| Osteopathic manual treatment and ultrasound therapy for chronic low back pain: a randomized controlled trial.Crossref | GoogleScholarGoogle Scholar | 23508598PubMed |
Luedtke K, Allers A, Schulte LH, May A (2016) Efficacy of interventions used by physiotherapists for patients with headache and migraine—systematic review and meta-analysis. Cephalalgia 36, 474–492.
| Efficacy of interventions used by physiotherapists for patients with headache and migraine—systematic review and meta-analysis.Crossref | GoogleScholarGoogle Scholar | 26229071PubMed |
Medicare Australia (2019) Chronic disease management – individual allied health services under Medicare – provider information. (Department of Health, Australian Government: Canberra, ACT, Australia) Available at https://www.health.gov.au/internet/main/publishing.nsf/content/health-medicare-health_pro-gp-pdf-allied-cnt.htm [Verified 4 July 2019]
Moore CS, Sibbritt DW, Adams J (2017) A critical review of manual therapy use for headache disorders: prevalence, profiles, motivations, communication and self-reported effectiveness. BMC Neurology 17, 61
| A critical review of manual therapy use for headache disorders: prevalence, profiles, motivations, communication and self-reported effectiveness.Crossref | GoogleScholarGoogle Scholar | 28340566PubMed |
Morris JH, Grimmer K (2014) Non-medical prescribing by physiotherapists: issues reported in the current evidence. Manual Therapy 19, 82–86.
| Non-medical prescribing by physiotherapists: issues reported in the current evidence.Crossref | GoogleScholarGoogle Scholar | 23669436PubMed |
Noblet T, Marriott J, Graham-Clarke E, Rushton A (2017) Barriers to and facilitators of independent non-medical prescribing in clinical practice: a mixed-methods systematic review. Journal of Physiotherapy 63, 221–234.
| Barriers to and facilitators of independent non-medical prescribing in clinical practice: a mixed-methods systematic review.Crossref | GoogleScholarGoogle Scholar | 28986140PubMed |
Noblet TD, Marriott JF, Jones T, Dean C, Rushton AB (2019a) Perceptions of Australian physiotherapy students about the potential implementation of physiotherapist prescribing in Australia: a national survey. BMJ Open 9, e026327
| Perceptions of Australian physiotherapy students about the potential implementation of physiotherapist prescribing in Australia: a national survey.Crossref | GoogleScholarGoogle Scholar | 31110095PubMed |
Noblet TD, Marriott JF, Jones T, Dean C, Rushton AB (2019b) Perceptions about the implementation of physiotherapist prescribing in Australia: a national survey of Australian physiotherapists. BMJ Open 9, e024991
| Perceptions about the implementation of physiotherapist prescribing in Australia: a national survey of Australian physiotherapists.Crossref | GoogleScholarGoogle Scholar | 31110095PubMed |
NPS MedicineWise (2019) Medicine insight. (NPS MedicineWise: Sydney, NSW, Australia) Available at https://www.nps.org.au/medicine-insight [Verified 4 July 2019]
Osborn R, Moulds D, Schneider EC, Doty MM, Squires D, Sarnak DO (2015) Primary care physicians in ten countries report challenges caring for patients with complex health needs. Health Affairs 34, 2104–2112.
| Primary care physicians in ten countries report challenges caring for patients with complex health needs.Crossref | GoogleScholarGoogle Scholar | 26643631PubMed |
Osteopathic International Alliance (2014) Osteopathy and osteopathic medicine: a global view of practice, patients, education and the contribution to healthcare delivery. (Osteopathic International Alliance: Chicago, IL, USA) Available at https://oialliance.org/resources/oia-status-report/ [Verified 10 June 2020]
Osteopathy Board of Australia (2019) Capabilities for osteopathic practice. (Australian Health Practitioner Regulation Agency: Melbourne, Vic., Australia) Available at https://www.osteopathyboard.gov.au/Codes-Guidelines/Capabilities-for-osteopathic-practice.aspx [Verified 4 July 2019]
Steel A, Peng W, Sibbritt D, Adams J (2020) Introducing national osteopathy practice-based research networks in Australia and New Zealand: an overview to inform future osteopathic research. Scientific Reports 10, 846
| Introducing national osteopathy practice-based research networks in Australia and New Zealand: an overview to inform future osteopathic research.Crossref | GoogleScholarGoogle Scholar | 31964999PubMed |
Weeks G, George J, Maclure K, Stewart D (2016) Non-medical prescribing versus medical prescribing for acute and chronic disease management in primary and secondary care. Cochrane Database of Systematic Reviews CD011227
| Non-medical prescribing versus medical prescribing for acute and chronic disease management in primary and secondary care.Crossref | GoogleScholarGoogle Scholar | 27873322PubMed |
Wilhelmsen NC, Eriksson T (2019) Medication adherence interventions and outcomes: an overview of systematic reviews. European Journal of Hospital Pharmacy, Science and Practice 26, 187–192.
| Medication adherence interventions and outcomes: an overview of systematic reviews.Crossref | GoogleScholarGoogle Scholar |
