Denosumab for erosive hand osteoarthritis
References
Favero M, Belluzzi E, Ortolan A, et al. Erosive hand osteoarthritis: latest findings and outlook. Nat Rev Rheumatol 2022;18(3):171–83.
Kloppenburg M, Kroon F....
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[post_content] => Despite vaccination rates dropping, pharmacists continue to be vaccinators of choice for COVID-19 and influenza vaccinations. But more needs to be done to reach vulnerable groups.
These key insights, and more, were revealed at the 2024 Queensland Immunisation Symposium, held on Friday (18 October).
Pharmacists continue to lead COVID-19 and influenza vaccination
The COVID-19 vaccine rollout was the largest immunisation program Australia has seen as a country, with pharmacists delivering over 12.5 million COVID-19 vaccines alone in a 3-year period, said Genevieve Donnelly Assistant Secretary, Access, Engagement and Compliance Branch at the Department of Health and Aged Care.
‘Pharmacists have consistently delivered close to 50% of the COVID-19 vaccinations in primary care,’ she said.
‘It speaks quite considerably to the trust that people have in you as a profession as to how to access care and where they see that they can easily access it’
Furthermore, while influenza vaccination rates are declining nationally, Ms Donnelly said pharmacists were the only channel that not only held the number of vaccines administered this year for influenza, but increased it.
‘In an environment where people aren't taking the opportunity to go elsewhere, they will come to the pharmacy,’ she said. ‘That's where the trust is, and that's where the access is.’
Childhood vaccination continues to drop below the critical 95% mark
The fluctuating community sentiment about healthcare, spurred on by COVID-19, is driving vaccination rates down, said Ms Donnelly.
‘I don't think I've ever seen anyone so engaged in a medicine as what we saw during COVID-19 … on such a scale,’ she said. ‘[But] unfortunately, we’ve seen a sustained decline in childhood immunisations in this country.’
[caption id="attachment_27970" align="alignnone" width="2096"]
Source: Queensland Health Immunisation Program[/caption]
The decline in childhood vaccination for children under 5 continued in 2024, moving Australia further from the 95% coverage target it held prior to the pandemic.
The vaccination rate of First Nations people is below the national average – particularly in the 1–2 years age cohort, said Sarah Risdale from the Queensland Health Immunisation Program.
‘The biggest risk for us is that some of these diseases rely on herd immunity, so the more we drop off, the more risk that previously eradicated diseases will return,’ warned Ms Risdale.
Because many vaccine-preventable diseases, such as polio and measles, were under control for many years – a key challenge is that many people don’t know the health impacts they can wreak.
‘It's really hard to sell something to someone when they don't really understand or have never seen what the impact could be,’ she said. ‘Particularly off the back of COVID-19, everyone is hesitant to believe what the government is telling them, and they seek their own healthcare advice and information.’
But because pharmacists have always been trusted healthcare professionals who the community comes to for advice, patients will be willing to trust that advice on vaccination, Ms Risdale advised.
‘It's a big responsibility for pharmacists when they're engaging with people [about] healthcare,’ she said.
Long way to go on meningococcal B protection
Pharmacists should also prioritise meningococcal B vaccination – with outbreaks of the deadly disease occurring in far North Queensland among other regions recently, said Ms Risdale.
‘This year in Queensland, we have a state-funded meningococcal B program for infants under 2 and adolescents 15–19,’ she said. ‘Unfortunately, we haven't seen the uptake we thought we would see this year, and that's across all provider types.’
Australian Immunisation Register data revealed uptake of the meningococcal B vaccine reduces with age, with the rates in various age cohorts including:
‘They are more than likely not going to die from shingles, but they could die from flu, COVID-19 or RSV [Respiratory syncytial virus].' Sarah risdale MPS‘With National Immunisation Program Vaccinations in Pharmacy (NIPVIP) funding, it's a big opportunity for pharmacists to start engaging more with the older community. ‘But [it’s important] to balance that relationship with the pharmacist and the GP and make sure people are getting what they need from the right provider.’ But while older Australians are at risk of serious and life-threatening complications from influenza, Ms Risdale said they are far more likely to actively seek out shingles vaccines than influenza and COVID-19 immunisation. There was a 2.6% reduction in the influenza vaccination rate in Australians aged 65 and over this year, dropping from 64.1% to 61.5% coverage. ‘They are more than likely not going to die from shingles, but they could die from flu, COVID-19 or RSV [Respiratory syncytial virus],’ she said. Despite numerous government and health body messages about the importance of vaccination against these potentially deadly diseases, it’s challenging to change perceptions. ‘That did help for a time, then people started to say, 'I'm getting COVID-19 and [influenza] anyway, so why would I go get that [vaccine]?’ While having conversations with people about their questions, concerns and fears about vaccines takes time, it adds long-term value, said Ms Risdale. ‘People come back to you as a trusted professional who spent half an hour talking to them about how important getting the MMR [measles, mumps, and rubella] vaccine was for their child, or how important having the pneumococcal vaccine was for their husband,’ she said. ‘They start to understand that you have time for them, you really value them as a person, and can give them reliable and helpful information, and they will come back to you again.’
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[post_content] => At the 2024 Queensland Excellence Awards in Brisbane on Saturday night, these five pharmacists were honoured for their commitment to excellence in pharmacy practice.
PSA Queensland President Shane MacDonald MPS acknowledged the achievements of the award winners as well as the continued dedication of pharmacists practising throughout the state.
‘It’s an inspiration to see the amazing work pharmacists are doing in communities across Queensland, and a great privilege to recognise them for their dedication in advancing the profession,’ he said.
‘On behalf of the PSA I congratulate the outstanding pharmacists presented with awards and thank them for their commitment to bettering the health of Queenslanders.’
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PSA Queensland Pharmacist of the Year Associate Professor Esther Lau MPS, University of Queensland
One of the first trained pharmacy vaccinators in Australia, A/Prof Lau was the cornerstone for the development of Australia’s first non-medical prescribing course at Queensland Institute of Technology, a foundation for the expansion of the current North Queensland practice prescribing pilots. For the past decade she has written AP’s Old Drug New Indication column, mentored many students and reviewed the APF and PSA’s 2023 Professional Practice Standards.
PSA Queensland Early Career Pharmacist of the Year James Buckley MPS, LiveLife Pharmacy Port Douglas
Filling a critical gap in his Far North Queensland community, Mr Buckley upskilled in otoscopy to accurately identify conditions like otitis media and otitis externa, as well as collaborative pathways to ensure patients were referred seamlessly for timely treatment. One of the first pharmacists to pass the North Queensland Pharmacist Full Scope of Practice Pilot, he sits on the ECP Community of Specialty Interest (CSI) leadership group and promotes pharmacy practice to students and interns.
PSA Queensland Intern Pharmacist of the Year Antonia Hurd, Kepnock Pharmacy Bundaberg
Interning at four separate pharmacies in Bundaberg, Peregian Springs, remote Agnes Water and regional town Cooroy, Ms Hurd has demonstrated exceptional leadership and initiative across pharmacy services including managing a dose administration aid service, an R U OK Day presentation, training in compounding and providing vaccination and first aid advice. Her research on managing the quality of life for people living with severe and persistent mental illness has been published as part of the PhaMIbridge trial.
Lifetime Achievement Award Beverley Glass FPS, James Cook University
After a lifetime of service and devotion to the pharmacy profession as a clinician, teacher, researcher, academic and advocate, South African-born Professor Glass has made an outstanding contribution to the development of pharmacy education, practice and research, specifically within rural and remote Queensland and Australia. She has invested immense amounts of time into the future academic workforce, some of whom are among her 50 honours and 33 PhD and Masters students.
Professor James Dare Graduate of the Year Shylee-Jade Hadar-Pagliari, James Cook University
As a final year pharmacy student, Ms Hadar-Pagliari has packed in many experiences since starting as a pharmacy assistant in 2020. Not only does she represent NAPSA students at pharmacy conferences, she has learned under supervision at the Alive Pharmacy Warehouse in Cairns how to dispense medicines, assist patients with non-prescription requests and run the complex compounding laboratory. She is known for her caring nature with patients.
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[post_excerpt] => At the 2024 Queensland Excellence Awards, these five pharmacists were honoured for their commitment to excellence in pharmacy practice.
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[post_content] => At one point in time, Menopausal hormone therapy (MHT) was used fairly extensively.
But this has changed since 2002, when the Women's Health Initiative (WHI) published a study linking combined MHT (oestrogen and progestin) with an increased risk of blood clots, stroke, breast cancer and heart attacks.
Almost overnight, women stopped using hormone therapy, said CEO of Jean Hailes for Women's Health, Dr Sarah White.
[caption id="attachment_27901" align="alignright" width="300"]
Dr Sarah White[/caption]
But there are several factors that led to the study results being skewed.
‘It was [based on] an older group of women who started taking hormone therapy late, and it was a different form of hormone therapy, so those results did not stand up and the increased risk in breast cancer was terribly small,’ she said.
The sensationalist reporting did a huge amount of damage, Dr White said.
‘We still have women today who believe that MHT causes breast cancer, and GPs who are nervous about prescribing it.’
While around one in four women who go through menopause will be asymptomatic or have mild symptoms, a quarter will be at the opposite end of the spectrum and experience severe symptoms, said Dr White.
‘We're talking about an inability to sleep, terrible brain fog, anxiety, a loss of confidence, and hot flushes that can be catastrophic,’ she said.
The remaining half of women are on a spectrum of experiencing mildly annoying to must-be-managed symptoms.
‘We have women who are trying to soldier on through some really unpleasant physical and mental effects,’ she said. ‘And it's a bit heartbreaking to think that there's a medication that can help manage a lot of the symptoms and women are worried about taking it when they have no need to be.’
Is MHT underprescribed?
There's ‘no doubt’ that MHT is underused in Australia, said Dr White – with barriers to access a compounding factor.
‘It's not just going to get that doctor's appointment, it's the cost of the MHT,’ she said.
Some forms of MHT are subsidised under the Pharmaceutical Benefits Scheme (PBS), such as estradiol patches, but there has been a global shortage of this therapy in 2024.
But newer medicines such as Prometrium – a progesterone-based treatment matching the hormone the body makes when ovulating – are not, setting women back around $60 per month.
Are all women suitable candidates for MHT?
No, cautioned Dr White.
For example, a person who has had a hormone responsive cancer should have a careful discussion with their GP about whether the risks of MHT outweigh the benefits.
‘If you've had a hormone responsive cancer, then taking a hormone increases the risk of recurrence,’ she said.
Oral combined MHT will increase the ‘baseline’ risk of thrombosis around two-fold – however the baseline risk remains low in most women. Thrombosis risk increases with increasing age, smoking, increased body weight, in those with genetic predisposition to clotting and in certain illnesses. Risk factors should be considered prior to commencing MHT.
MHT treatment should be individualised based on the patient’s needs, clinical features and risk assessment, and reviewed regularly. Women with a personal or family history of venous thrombosis should undergo screening for risk factors to guide the choice of MHT delivery method. In cases where a woman is deemed to be at high risk for developing deep vein thrombosis (DVT), transdermal MHT should be used.
‘That’s why the message is very clear to speak about your individual circumstances with your doctor,’ added Dr White, who said a consultation to discuss the appropriateness of therapy could include:
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[post_content] => The Unleashing the Potential of our Health Workforce – Scope of Practice Review final report and implementation plan is slated for delivery by October 2024.
But many states and territories are forging ahead with expanding pharmacist scope of practice in the interim.
Australian Pharmacist has rounded up some of the most recent updates.
Queensland pharmacy prescribing pilot could go permanent
Ahead of the Queensland state election next week (26 October), incumbent Premier Steven Miles and Health Minister Shannon Fentiman have vowed to make both the Community Pharmacy Scope of Practice Pilot and the Community Pharmacy Hormonal Contraception Pilot permanent if reelected.
Opposition Leader David Crisafulli has since announced intentions to expand both pilots.
Since the scope of practice pilot rolled out in April, trained pharmacists have been able to provide medication management services, autonomous prescribing for specified acute common conditions, and structured prescribing as part of a chronic disease management program.
With Queensland introducing the Community Pharmacy Hormonal Contraception Pilot, making this service permanent would bring Queensland in line with some other states and territories.
Since both pilots kicked off, hundreds of Queenslanders have benefitted from accessing care from their local pharmacy.
Queensland is a largely decentralised state, with more than half (50.7%) of Queensland’s population residing outside of Greater Brisbane.
PSA welcomes the commitment to expanding the scope of practice for pharmacists, said PSA Queensland State Manager Karen Castle MPS.
‘If the scope of practice pilots become permanent, it would have a significant positive impact on the health of Queenslanders and improve access to healthcare, particularly for rural and regional communities where accessing a GP can be challenging,’ she said.
‘Patients already see their pharmacist as a trusted healthcare professional, and this expanded scope will further enhance their role in delivering healthcare, reduce waiting times and improve patient outcomes.
‘As pharmacists expand their practice and the public becomes more aware of the broader services available, we anticipate significant growth in the uptake of services provided by pharmacists.’
Canberrans could soon access more pharmacy services
With the ACT election only days away (19 October), both ACT Labor and the Canberra Liberals have committed to expanding pharmacists' scope of practice.
Pharmacists in the ACT have already been providing consultations for uncomplicated urinary tract infections (UTI) and resupplying OCP under the NSW pilot.
In alignment with NSW, the expanded scope will cover a broader range of common and mild conditions, including ear infections, nausea and vomiting, reflux, acne, muscle pain and wound management.
Certain chronic conditions will also be included.
While PSA ACT Branch President Olivia Collenette MPS said the services will be introduced as a trial, PSA has been advised that there’s no intention to roll back service once it has started.
‘This will be great for Canberrans, where it is the most expensive city in Australia to see a GP,’ Ms Collenette told AP.
‘We have the lowest bulk billing rates in the country and wait times [to see a doctor] are in the weeks. This is all about patient access, ensuring appropriate care is there at the time it's needed.’
Both parties will work to ensure pharmacists can administer vaccines to patients of all ages.
PSA has been advocating for pharmacists to be able to administer all vaccines to all ages in all locations, she said.
‘Pharmacists are trusted healthcare professionals, helping the ACT maintain its above average for Australia vaccination rates,’ Ms Collenette said. ‘Patients have spoken with their feet that they like that pharmacists are providing these services, so we want to ensure they can continue to do so regardless of which vaccine/s they are after.’
Victoria’s scope of practice pilot extended
The Secretary Approval for 12-month Victorian Community Pharmacist Statewide Pilot, due to wrap up this month, was recently extended until June 2025 – ensuring all pharmacists who are already enrolled in the program continue be able to provide services during the evaluation period.
The pilot allows appropriately trained pharmacists to provide certain Schedule 4 medicines for:
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[post_content] => The landscape for glucagon-like peptide-1 receptor agonists (GLP-1RAs) used for weight loss is changing in Australia as demand continues to grow.
Australian Pharmacist explains what options are available, and restricted, for weight loss patients.
Ozempic is out of stock … again
There is no end in sight to the Ozempic shortage, with Novo Nordisk recently informing the Therapeutic Goods Administration (TGA) that supply of the medicine will remain limited for the rest of 2024.
The TGA has continued to ask prescribers not to initiate new patients on Ozempic unless there are no suitable alternatives, with supplies prioritised for patients with type 2 diabetes who are stabilised on the medicine.
Patients who have been using the medicine for weight loss should potentially be switched to an alternative, such as Wegovy which is approved for this indication.
In the experience of Brisbane-based community pharmacist and diabetes educator Rory Johnston MPS, the persistent Ozempic shortages have led to patients seeking the medicine for weight loss being treated with ‘great contempt’ by some healthcare professionals.
[caption id="attachment_27827" align="alignright" width="300"]
Rory Johnston MPS[/caption]
There is often a perception that people are simply overweight due to overeating, said Mr Johnston, but there are myriad conditions and medicine classes that can cause patients to gain weight, including:
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[post_content] => Despite vaccination rates dropping, pharmacists continue to be vaccinators of choice for COVID-19 and influenza vaccinations. But more needs to be done to reach vulnerable groups.
These key insights, and more, were revealed at the 2024 Queensland Immunisation Symposium, held on Friday (18 October).
Pharmacists continue to lead COVID-19 and influenza vaccination
The COVID-19 vaccine rollout was the largest immunisation program Australia has seen as a country, with pharmacists delivering over 12.5 million COVID-19 vaccines alone in a 3-year period, said Genevieve Donnelly Assistant Secretary, Access, Engagement and Compliance Branch at the Department of Health and Aged Care.
‘Pharmacists have consistently delivered close to 50% of the COVID-19 vaccinations in primary care,’ she said.
‘It speaks quite considerably to the trust that people have in you as a profession as to how to access care and where they see that they can easily access it’
Furthermore, while influenza vaccination rates are declining nationally, Ms Donnelly said pharmacists were the only channel that not only held the number of vaccines administered this year for influenza, but increased it.
‘In an environment where people aren't taking the opportunity to go elsewhere, they will come to the pharmacy,’ she said. ‘That's where the trust is, and that's where the access is.’
Childhood vaccination continues to drop below the critical 95% mark
The fluctuating community sentiment about healthcare, spurred on by COVID-19, is driving vaccination rates down, said Ms Donnelly.
‘I don't think I've ever seen anyone so engaged in a medicine as what we saw during COVID-19 … on such a scale,’ she said. ‘[But] unfortunately, we’ve seen a sustained decline in childhood immunisations in this country.’
[caption id="attachment_27970" align="alignnone" width="2096"] Source: Queensland Health Immunisation Program[/caption]
The decline in childhood vaccination for children under 5 continued in 2024, moving Australia further from the 95% coverage target it held prior to the pandemic.
The vaccination rate of First Nations people is below the national average – particularly in the 1–2 years age cohort, said Sarah Risdale from the Queensland Health Immunisation Program.
‘The biggest risk for us is that some of these diseases rely on herd immunity, so the more we drop off, the more risk that previously eradicated diseases will return,’ warned Ms Risdale.
Because many vaccine-preventable diseases, such as polio and measles, were under control for many years – a key challenge is that many people don’t know the health impacts they can wreak.
‘It's really hard to sell something to someone when they don't really understand or have never seen what the impact could be,’ she said. ‘Particularly off the back of COVID-19, everyone is hesitant to believe what the government is telling them, and they seek their own healthcare advice and information.’
But because pharmacists have always been trusted healthcare professionals who the community comes to for advice, patients will be willing to trust that advice on vaccination, Ms Risdale advised.
‘It's a big responsibility for pharmacists when they're engaging with people [about] healthcare,’ she said.
Long way to go on meningococcal B protection
Pharmacists should also prioritise meningococcal B vaccination – with outbreaks of the deadly disease occurring in far North Queensland among other regions recently, said Ms Risdale.
‘This year in Queensland, we have a state-funded meningococcal B program for infants under 2 and adolescents 15–19,’ she said. ‘Unfortunately, we haven't seen the uptake we thought we would see this year, and that's across all provider types.’
Australian Immunisation Register data revealed uptake of the meningococcal B vaccine reduces with age, with the rates in various age cohorts including:
‘They are more than likely not going to die from shingles, but they could die from flu, COVID-19 or RSV [Respiratory syncytial virus].' Sarah risdale MPS‘With National Immunisation Program Vaccinations in Pharmacy (NIPVIP) funding, it's a big opportunity for pharmacists to start engaging more with the older community. ‘But [it’s important] to balance that relationship with the pharmacist and the GP and make sure people are getting what they need from the right provider.’ But while older Australians are at risk of serious and life-threatening complications from influenza, Ms Risdale said they are far more likely to actively seek out shingles vaccines than influenza and COVID-19 immunisation. There was a 2.6% reduction in the influenza vaccination rate in Australians aged 65 and over this year, dropping from 64.1% to 61.5% coverage. ‘They are more than likely not going to die from shingles, but they could die from flu, COVID-19 or RSV [Respiratory syncytial virus],’ she said. Despite numerous government and health body messages about the importance of vaccination against these potentially deadly diseases, it’s challenging to change perceptions. ‘That did help for a time, then people started to say, 'I'm getting COVID-19 and [influenza] anyway, so why would I go get that [vaccine]?’ While having conversations with people about their questions, concerns and fears about vaccines takes time, it adds long-term value, said Ms Risdale. ‘People come back to you as a trusted professional who spent half an hour talking to them about how important getting the MMR [measles, mumps, and rubella] vaccine was for their child, or how important having the pneumococcal vaccine was for their husband,’ she said. ‘They start to understand that you have time for them, you really value them as a person, and can give them reliable and helpful information, and they will come back to you again.’
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[post_content] => At the 2024 Queensland Excellence Awards in Brisbane on Saturday night, these five pharmacists were honoured for their commitment to excellence in pharmacy practice.
PSA Queensland President Shane MacDonald MPS acknowledged the achievements of the award winners as well as the continued dedication of pharmacists practising throughout the state.
‘It’s an inspiration to see the amazing work pharmacists are doing in communities across Queensland, and a great privilege to recognise them for their dedication in advancing the profession,’ he said.
‘On behalf of the PSA I congratulate the outstanding pharmacists presented with awards and thank them for their commitment to bettering the health of Queenslanders.’
[gallery type="flexslider" size="full" ids="27956,27957,27955,27958,27959"]
PSA Queensland Pharmacist of the Year Associate Professor Esther Lau MPS, University of Queensland
One of the first trained pharmacy vaccinators in Australia, A/Prof Lau was the cornerstone for the development of Australia’s first non-medical prescribing course at Queensland Institute of Technology, a foundation for the expansion of the current North Queensland practice prescribing pilots. For the past decade she has written AP’s Old Drug New Indication column, mentored many students and reviewed the APF and PSA’s 2023 Professional Practice Standards.
PSA Queensland Early Career Pharmacist of the Year James Buckley MPS, LiveLife Pharmacy Port Douglas
Filling a critical gap in his Far North Queensland community, Mr Buckley upskilled in otoscopy to accurately identify conditions like otitis media and otitis externa, as well as collaborative pathways to ensure patients were referred seamlessly for timely treatment. One of the first pharmacists to pass the North Queensland Pharmacist Full Scope of Practice Pilot, he sits on the ECP Community of Specialty Interest (CSI) leadership group and promotes pharmacy practice to students and interns.
PSA Queensland Intern Pharmacist of the Year Antonia Hurd, Kepnock Pharmacy Bundaberg
Interning at four separate pharmacies in Bundaberg, Peregian Springs, remote Agnes Water and regional town Cooroy, Ms Hurd has demonstrated exceptional leadership and initiative across pharmacy services including managing a dose administration aid service, an R U OK Day presentation, training in compounding and providing vaccination and first aid advice. Her research on managing the quality of life for people living with severe and persistent mental illness has been published as part of the PhaMIbridge trial.
Lifetime Achievement Award Beverley Glass FPS, James Cook University
After a lifetime of service and devotion to the pharmacy profession as a clinician, teacher, researcher, academic and advocate, South African-born Professor Glass has made an outstanding contribution to the development of pharmacy education, practice and research, specifically within rural and remote Queensland and Australia. She has invested immense amounts of time into the future academic workforce, some of whom are among her 50 honours and 33 PhD and Masters students.
Professor James Dare Graduate of the Year Shylee-Jade Hadar-Pagliari, James Cook University
As a final year pharmacy student, Ms Hadar-Pagliari has packed in many experiences since starting as a pharmacy assistant in 2020. Not only does she represent NAPSA students at pharmacy conferences, she has learned under supervision at the Alive Pharmacy Warehouse in Cairns how to dispense medicines, assist patients with non-prescription requests and run the complex compounding laboratory. She is known for her caring nature with patients.
[post_title] => PSA awards leading Queensland pharmacists
[post_excerpt] => At the 2024 Queensland Excellence Awards, these five pharmacists were honoured for their commitment to excellence in pharmacy practice.
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[post_content] => At one point in time, Menopausal hormone therapy (MHT) was used fairly extensively.
But this has changed since 2002, when the Women's Health Initiative (WHI) published a study linking combined MHT (oestrogen and progestin) with an increased risk of blood clots, stroke, breast cancer and heart attacks.
Almost overnight, women stopped using hormone therapy, said CEO of Jean Hailes for Women's Health, Dr Sarah White.
[caption id="attachment_27901" align="alignright" width="300"] Dr Sarah White[/caption]
But there are several factors that led to the study results being skewed.
‘It was [based on] an older group of women who started taking hormone therapy late, and it was a different form of hormone therapy, so those results did not stand up and the increased risk in breast cancer was terribly small,’ she said.
The sensationalist reporting did a huge amount of damage, Dr White said.
‘We still have women today who believe that MHT causes breast cancer, and GPs who are nervous about prescribing it.’
While around one in four women who go through menopause will be asymptomatic or have mild symptoms, a quarter will be at the opposite end of the spectrum and experience severe symptoms, said Dr White.
‘We're talking about an inability to sleep, terrible brain fog, anxiety, a loss of confidence, and hot flushes that can be catastrophic,’ she said.
The remaining half of women are on a spectrum of experiencing mildly annoying to must-be-managed symptoms.
‘We have women who are trying to soldier on through some really unpleasant physical and mental effects,’ she said. ‘And it's a bit heartbreaking to think that there's a medication that can help manage a lot of the symptoms and women are worried about taking it when they have no need to be.’
Is MHT underprescribed?
There's ‘no doubt’ that MHT is underused in Australia, said Dr White – with barriers to access a compounding factor.
‘It's not just going to get that doctor's appointment, it's the cost of the MHT,’ she said.
Some forms of MHT are subsidised under the Pharmaceutical Benefits Scheme (PBS), such as estradiol patches, but there has been a global shortage of this therapy in 2024.
But newer medicines such as Prometrium – a progesterone-based treatment matching the hormone the body makes when ovulating – are not, setting women back around $60 per month.
Are all women suitable candidates for MHT?
No, cautioned Dr White.
For example, a person who has had a hormone responsive cancer should have a careful discussion with their GP about whether the risks of MHT outweigh the benefits.
‘If you've had a hormone responsive cancer, then taking a hormone increases the risk of recurrence,’ she said.
Oral combined MHT will increase the ‘baseline’ risk of thrombosis around two-fold – however the baseline risk remains low in most women. Thrombosis risk increases with increasing age, smoking, increased body weight, in those with genetic predisposition to clotting and in certain illnesses. Risk factors should be considered prior to commencing MHT.
MHT treatment should be individualised based on the patient’s needs, clinical features and risk assessment, and reviewed regularly. Women with a personal or family history of venous thrombosis should undergo screening for risk factors to guide the choice of MHT delivery method. In cases where a woman is deemed to be at high risk for developing deep vein thrombosis (DVT), transdermal MHT should be used.
‘That’s why the message is very clear to speak about your individual circumstances with your doctor,’ added Dr White, who said a consultation to discuss the appropriateness of therapy could include:
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[post_content] => The Unleashing the Potential of our Health Workforce – Scope of Practice Review final report and implementation plan is slated for delivery by October 2024.
But many states and territories are forging ahead with expanding pharmacist scope of practice in the interim.
Australian Pharmacist has rounded up some of the most recent updates.
Queensland pharmacy prescribing pilot could go permanent
Ahead of the Queensland state election next week (26 October), incumbent Premier Steven Miles and Health Minister Shannon Fentiman have vowed to make both the Community Pharmacy Scope of Practice Pilot and the Community Pharmacy Hormonal Contraception Pilot permanent if reelected.
Opposition Leader David Crisafulli has since announced intentions to expand both pilots.
Since the scope of practice pilot rolled out in April, trained pharmacists have been able to provide medication management services, autonomous prescribing for specified acute common conditions, and structured prescribing as part of a chronic disease management program.
With Queensland introducing the Community Pharmacy Hormonal Contraception Pilot, making this service permanent would bring Queensland in line with some other states and territories.
Since both pilots kicked off, hundreds of Queenslanders have benefitted from accessing care from their local pharmacy.
Queensland is a largely decentralised state, with more than half (50.7%) of Queensland’s population residing outside of Greater Brisbane.
PSA welcomes the commitment to expanding the scope of practice for pharmacists, said PSA Queensland State Manager Karen Castle MPS.
‘If the scope of practice pilots become permanent, it would have a significant positive impact on the health of Queenslanders and improve access to healthcare, particularly for rural and regional communities where accessing a GP can be challenging,’ she said.
‘Patients already see their pharmacist as a trusted healthcare professional, and this expanded scope will further enhance their role in delivering healthcare, reduce waiting times and improve patient outcomes.
‘As pharmacists expand their practice and the public becomes more aware of the broader services available, we anticipate significant growth in the uptake of services provided by pharmacists.’
Canberrans could soon access more pharmacy services
With the ACT election only days away (19 October), both ACT Labor and the Canberra Liberals have committed to expanding pharmacists' scope of practice.
Pharmacists in the ACT have already been providing consultations for uncomplicated urinary tract infections (UTI) and resupplying OCP under the NSW pilot.
In alignment with NSW, the expanded scope will cover a broader range of common and mild conditions, including ear infections, nausea and vomiting, reflux, acne, muscle pain and wound management.
Certain chronic conditions will also be included.
While PSA ACT Branch President Olivia Collenette MPS said the services will be introduced as a trial, PSA has been advised that there’s no intention to roll back service once it has started.
‘This will be great for Canberrans, where it is the most expensive city in Australia to see a GP,’ Ms Collenette told AP.
‘We have the lowest bulk billing rates in the country and wait times [to see a doctor] are in the weeks. This is all about patient access, ensuring appropriate care is there at the time it's needed.’
Both parties will work to ensure pharmacists can administer vaccines to patients of all ages.
PSA has been advocating for pharmacists to be able to administer all vaccines to all ages in all locations, she said.
‘Pharmacists are trusted healthcare professionals, helping the ACT maintain its above average for Australia vaccination rates,’ Ms Collenette said. ‘Patients have spoken with their feet that they like that pharmacists are providing these services, so we want to ensure they can continue to do so regardless of which vaccine/s they are after.’
Victoria’s scope of practice pilot extended
The Secretary Approval for 12-month Victorian Community Pharmacist Statewide Pilot, due to wrap up this month, was recently extended until June 2025 – ensuring all pharmacists who are already enrolled in the program continue be able to provide services during the evaluation period.
The pilot allows appropriately trained pharmacists to provide certain Schedule 4 medicines for:
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[post_content] => The landscape for glucagon-like peptide-1 receptor agonists (GLP-1RAs) used for weight loss is changing in Australia as demand continues to grow.
Australian Pharmacist explains what options are available, and restricted, for weight loss patients.
Ozempic is out of stock … again
There is no end in sight to the Ozempic shortage, with Novo Nordisk recently informing the Therapeutic Goods Administration (TGA) that supply of the medicine will remain limited for the rest of 2024.
The TGA has continued to ask prescribers not to initiate new patients on Ozempic unless there are no suitable alternatives, with supplies prioritised for patients with type 2 diabetes who are stabilised on the medicine.
Patients who have been using the medicine for weight loss should potentially be switched to an alternative, such as Wegovy which is approved for this indication.
In the experience of Brisbane-based community pharmacist and diabetes educator Rory Johnston MPS, the persistent Ozempic shortages have led to patients seeking the medicine for weight loss being treated with ‘great contempt’ by some healthcare professionals.
[caption id="attachment_27827" align="alignright" width="300"] Rory Johnston MPS[/caption]
There is often a perception that people are simply overweight due to overeating, said Mr Johnston, but there are myriad conditions and medicine classes that can cause patients to gain weight, including:
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[post_content] => Despite vaccination rates dropping, pharmacists continue to be vaccinators of choice for COVID-19 and influenza vaccinations. But more needs to be done to reach vulnerable groups.
These key insights, and more, were revealed at the 2024 Queensland Immunisation Symposium, held on Friday (18 October).
Pharmacists continue to lead COVID-19 and influenza vaccination
The COVID-19 vaccine rollout was the largest immunisation program Australia has seen as a country, with pharmacists delivering over 12.5 million COVID-19 vaccines alone in a 3-year period, said Genevieve Donnelly Assistant Secretary, Access, Engagement and Compliance Branch at the Department of Health and Aged Care.
‘Pharmacists have consistently delivered close to 50% of the COVID-19 vaccinations in primary care,’ she said.
‘It speaks quite considerably to the trust that people have in you as a profession as to how to access care and where they see that they can easily access it’
Furthermore, while influenza vaccination rates are declining nationally, Ms Donnelly said pharmacists were the only channel that not only held the number of vaccines administered this year for influenza, but increased it.
‘In an environment where people aren't taking the opportunity to go elsewhere, they will come to the pharmacy,’ she said. ‘That's where the trust is, and that's where the access is.’
Childhood vaccination continues to drop below the critical 95% mark
The fluctuating community sentiment about healthcare, spurred on by COVID-19, is driving vaccination rates down, said Ms Donnelly.
‘I don't think I've ever seen anyone so engaged in a medicine as what we saw during COVID-19 … on such a scale,’ she said. ‘[But] unfortunately, we’ve seen a sustained decline in childhood immunisations in this country.’
[caption id="attachment_27970" align="alignnone" width="2096"] Source: Queensland Health Immunisation Program[/caption]
The decline in childhood vaccination for children under 5 continued in 2024, moving Australia further from the 95% coverage target it held prior to the pandemic.
The vaccination rate of First Nations people is below the national average – particularly in the 1–2 years age cohort, said Sarah Risdale from the Queensland Health Immunisation Program.
‘The biggest risk for us is that some of these diseases rely on herd immunity, so the more we drop off, the more risk that previously eradicated diseases will return,’ warned Ms Risdale.
Because many vaccine-preventable diseases, such as polio and measles, were under control for many years – a key challenge is that many people don’t know the health impacts they can wreak.
‘It's really hard to sell something to someone when they don't really understand or have never seen what the impact could be,’ she said. ‘Particularly off the back of COVID-19, everyone is hesitant to believe what the government is telling them, and they seek their own healthcare advice and information.’
But because pharmacists have always been trusted healthcare professionals who the community comes to for advice, patients will be willing to trust that advice on vaccination, Ms Risdale advised.
‘It's a big responsibility for pharmacists when they're engaging with people [about] healthcare,’ she said.
Long way to go on meningococcal B protection
Pharmacists should also prioritise meningococcal B vaccination – with outbreaks of the deadly disease occurring in far North Queensland among other regions recently, said Ms Risdale.
‘This year in Queensland, we have a state-funded meningococcal B program for infants under 2 and adolescents 15–19,’ she said. ‘Unfortunately, we haven't seen the uptake we thought we would see this year, and that's across all provider types.’
Australian Immunisation Register data revealed uptake of the meningococcal B vaccine reduces with age, with the rates in various age cohorts including:
‘They are more than likely not going to die from shingles, but they could die from flu, COVID-19 or RSV [Respiratory syncytial virus].' Sarah risdale MPS‘With National Immunisation Program Vaccinations in Pharmacy (NIPVIP) funding, it's a big opportunity for pharmacists to start engaging more with the older community. ‘But [it’s important] to balance that relationship with the pharmacist and the GP and make sure people are getting what they need from the right provider.’ But while older Australians are at risk of serious and life-threatening complications from influenza, Ms Risdale said they are far more likely to actively seek out shingles vaccines than influenza and COVID-19 immunisation. There was a 2.6% reduction in the influenza vaccination rate in Australians aged 65 and over this year, dropping from 64.1% to 61.5% coverage. ‘They are more than likely not going to die from shingles, but they could die from flu, COVID-19 or RSV [Respiratory syncytial virus],’ she said. Despite numerous government and health body messages about the importance of vaccination against these potentially deadly diseases, it’s challenging to change perceptions. ‘That did help for a time, then people started to say, 'I'm getting COVID-19 and [influenza] anyway, so why would I go get that [vaccine]?’ While having conversations with people about their questions, concerns and fears about vaccines takes time, it adds long-term value, said Ms Risdale. ‘People come back to you as a trusted professional who spent half an hour talking to them about how important getting the MMR [measles, mumps, and rubella] vaccine was for their child, or how important having the pneumococcal vaccine was for their husband,’ she said. ‘They start to understand that you have time for them, you really value them as a person, and can give them reliable and helpful information, and they will come back to you again.’
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[post_content] => At the 2024 Queensland Excellence Awards in Brisbane on Saturday night, these five pharmacists were honoured for their commitment to excellence in pharmacy practice.
PSA Queensland President Shane MacDonald MPS acknowledged the achievements of the award winners as well as the continued dedication of pharmacists practising throughout the state.
‘It’s an inspiration to see the amazing work pharmacists are doing in communities across Queensland, and a great privilege to recognise them for their dedication in advancing the profession,’ he said.
‘On behalf of the PSA I congratulate the outstanding pharmacists presented with awards and thank them for their commitment to bettering the health of Queenslanders.’
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PSA Queensland Pharmacist of the Year Associate Professor Esther Lau MPS, University of Queensland
One of the first trained pharmacy vaccinators in Australia, A/Prof Lau was the cornerstone for the development of Australia’s first non-medical prescribing course at Queensland Institute of Technology, a foundation for the expansion of the current North Queensland practice prescribing pilots. For the past decade she has written AP’s Old Drug New Indication column, mentored many students and reviewed the APF and PSA’s 2023 Professional Practice Standards.
PSA Queensland Early Career Pharmacist of the Year James Buckley MPS, LiveLife Pharmacy Port Douglas
Filling a critical gap in his Far North Queensland community, Mr Buckley upskilled in otoscopy to accurately identify conditions like otitis media and otitis externa, as well as collaborative pathways to ensure patients were referred seamlessly for timely treatment. One of the first pharmacists to pass the North Queensland Pharmacist Full Scope of Practice Pilot, he sits on the ECP Community of Specialty Interest (CSI) leadership group and promotes pharmacy practice to students and interns.
PSA Queensland Intern Pharmacist of the Year Antonia Hurd, Kepnock Pharmacy Bundaberg
Interning at four separate pharmacies in Bundaberg, Peregian Springs, remote Agnes Water and regional town Cooroy, Ms Hurd has demonstrated exceptional leadership and initiative across pharmacy services including managing a dose administration aid service, an R U OK Day presentation, training in compounding and providing vaccination and first aid advice. Her research on managing the quality of life for people living with severe and persistent mental illness has been published as part of the PhaMIbridge trial.
Lifetime Achievement Award Beverley Glass FPS, James Cook University
After a lifetime of service and devotion to the pharmacy profession as a clinician, teacher, researcher, academic and advocate, South African-born Professor Glass has made an outstanding contribution to the development of pharmacy education, practice and research, specifically within rural and remote Queensland and Australia. She has invested immense amounts of time into the future academic workforce, some of whom are among her 50 honours and 33 PhD and Masters students.
Professor James Dare Graduate of the Year Shylee-Jade Hadar-Pagliari, James Cook University
As a final year pharmacy student, Ms Hadar-Pagliari has packed in many experiences since starting as a pharmacy assistant in 2020. Not only does she represent NAPSA students at pharmacy conferences, she has learned under supervision at the Alive Pharmacy Warehouse in Cairns how to dispense medicines, assist patients with non-prescription requests and run the complex compounding laboratory. She is known for her caring nature with patients.
[post_title] => PSA awards leading Queensland pharmacists
[post_excerpt] => At the 2024 Queensland Excellence Awards, these five pharmacists were honoured for their commitment to excellence in pharmacy practice.
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[post_content] => At one point in time, Menopausal hormone therapy (MHT) was used fairly extensively.
But this has changed since 2002, when the Women's Health Initiative (WHI) published a study linking combined MHT (oestrogen and progestin) with an increased risk of blood clots, stroke, breast cancer and heart attacks.
Almost overnight, women stopped using hormone therapy, said CEO of Jean Hailes for Women's Health, Dr Sarah White.
[caption id="attachment_27901" align="alignright" width="300"] Dr Sarah White[/caption]
But there are several factors that led to the study results being skewed.
‘It was [based on] an older group of women who started taking hormone therapy late, and it was a different form of hormone therapy, so those results did not stand up and the increased risk in breast cancer was terribly small,’ she said.
The sensationalist reporting did a huge amount of damage, Dr White said.
‘We still have women today who believe that MHT causes breast cancer, and GPs who are nervous about prescribing it.’
While around one in four women who go through menopause will be asymptomatic or have mild symptoms, a quarter will be at the opposite end of the spectrum and experience severe symptoms, said Dr White.
‘We're talking about an inability to sleep, terrible brain fog, anxiety, a loss of confidence, and hot flushes that can be catastrophic,’ she said.
The remaining half of women are on a spectrum of experiencing mildly annoying to must-be-managed symptoms.
‘We have women who are trying to soldier on through some really unpleasant physical and mental effects,’ she said. ‘And it's a bit heartbreaking to think that there's a medication that can help manage a lot of the symptoms and women are worried about taking it when they have no need to be.’
Is MHT underprescribed?
There's ‘no doubt’ that MHT is underused in Australia, said Dr White – with barriers to access a compounding factor.
‘It's not just going to get that doctor's appointment, it's the cost of the MHT,’ she said.
Some forms of MHT are subsidised under the Pharmaceutical Benefits Scheme (PBS), such as estradiol patches, but there has been a global shortage of this therapy in 2024.
But newer medicines such as Prometrium – a progesterone-based treatment matching the hormone the body makes when ovulating – are not, setting women back around $60 per month.
Are all women suitable candidates for MHT?
No, cautioned Dr White.
For example, a person who has had a hormone responsive cancer should have a careful discussion with their GP about whether the risks of MHT outweigh the benefits.
‘If you've had a hormone responsive cancer, then taking a hormone increases the risk of recurrence,’ she said.
Oral combined MHT will increase the ‘baseline’ risk of thrombosis around two-fold – however the baseline risk remains low in most women. Thrombosis risk increases with increasing age, smoking, increased body weight, in those with genetic predisposition to clotting and in certain illnesses. Risk factors should be considered prior to commencing MHT.
MHT treatment should be individualised based on the patient’s needs, clinical features and risk assessment, and reviewed regularly. Women with a personal or family history of venous thrombosis should undergo screening for risk factors to guide the choice of MHT delivery method. In cases where a woman is deemed to be at high risk for developing deep vein thrombosis (DVT), transdermal MHT should be used.
‘That’s why the message is very clear to speak about your individual circumstances with your doctor,’ added Dr White, who said a consultation to discuss the appropriateness of therapy could include:
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[post_content] => The Unleashing the Potential of our Health Workforce – Scope of Practice Review final report and implementation plan is slated for delivery by October 2024.
But many states and territories are forging ahead with expanding pharmacist scope of practice in the interim.
Australian Pharmacist has rounded up some of the most recent updates.
Queensland pharmacy prescribing pilot could go permanent
Ahead of the Queensland state election next week (26 October), incumbent Premier Steven Miles and Health Minister Shannon Fentiman have vowed to make both the Community Pharmacy Scope of Practice Pilot and the Community Pharmacy Hormonal Contraception Pilot permanent if reelected.
Opposition Leader David Crisafulli has since announced intentions to expand both pilots.
Since the scope of practice pilot rolled out in April, trained pharmacists have been able to provide medication management services, autonomous prescribing for specified acute common conditions, and structured prescribing as part of a chronic disease management program.
With Queensland introducing the Community Pharmacy Hormonal Contraception Pilot, making this service permanent would bring Queensland in line with some other states and territories.
Since both pilots kicked off, hundreds of Queenslanders have benefitted from accessing care from their local pharmacy.
Queensland is a largely decentralised state, with more than half (50.7%) of Queensland’s population residing outside of Greater Brisbane.
PSA welcomes the commitment to expanding the scope of practice for pharmacists, said PSA Queensland State Manager Karen Castle MPS.
‘If the scope of practice pilots become permanent, it would have a significant positive impact on the health of Queenslanders and improve access to healthcare, particularly for rural and regional communities where accessing a GP can be challenging,’ she said.
‘Patients already see their pharmacist as a trusted healthcare professional, and this expanded scope will further enhance their role in delivering healthcare, reduce waiting times and improve patient outcomes.
‘As pharmacists expand their practice and the public becomes more aware of the broader services available, we anticipate significant growth in the uptake of services provided by pharmacists.’
Canberrans could soon access more pharmacy services
With the ACT election only days away (19 October), both ACT Labor and the Canberra Liberals have committed to expanding pharmacists' scope of practice.
Pharmacists in the ACT have already been providing consultations for uncomplicated urinary tract infections (UTI) and resupplying OCP under the NSW pilot.
In alignment with NSW, the expanded scope will cover a broader range of common and mild conditions, including ear infections, nausea and vomiting, reflux, acne, muscle pain and wound management.
Certain chronic conditions will also be included.
While PSA ACT Branch President Olivia Collenette MPS said the services will be introduced as a trial, PSA has been advised that there’s no intention to roll back service once it has started.
‘This will be great for Canberrans, where it is the most expensive city in Australia to see a GP,’ Ms Collenette told AP.
‘We have the lowest bulk billing rates in the country and wait times [to see a doctor] are in the weeks. This is all about patient access, ensuring appropriate care is there at the time it's needed.’
Both parties will work to ensure pharmacists can administer vaccines to patients of all ages.
PSA has been advocating for pharmacists to be able to administer all vaccines to all ages in all locations, she said.
‘Pharmacists are trusted healthcare professionals, helping the ACT maintain its above average for Australia vaccination rates,’ Ms Collenette said. ‘Patients have spoken with their feet that they like that pharmacists are providing these services, so we want to ensure they can continue to do so regardless of which vaccine/s they are after.’
Victoria’s scope of practice pilot extended
The Secretary Approval for 12-month Victorian Community Pharmacist Statewide Pilot, due to wrap up this month, was recently extended until June 2025 – ensuring all pharmacists who are already enrolled in the program continue be able to provide services during the evaluation period.
The pilot allows appropriately trained pharmacists to provide certain Schedule 4 medicines for:
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[post_content] => The landscape for glucagon-like peptide-1 receptor agonists (GLP-1RAs) used for weight loss is changing in Australia as demand continues to grow.
Australian Pharmacist explains what options are available, and restricted, for weight loss patients.
Ozempic is out of stock … again
There is no end in sight to the Ozempic shortage, with Novo Nordisk recently informing the Therapeutic Goods Administration (TGA) that supply of the medicine will remain limited for the rest of 2024.
The TGA has continued to ask prescribers not to initiate new patients on Ozempic unless there are no suitable alternatives, with supplies prioritised for patients with type 2 diabetes who are stabilised on the medicine.
Patients who have been using the medicine for weight loss should potentially be switched to an alternative, such as Wegovy which is approved for this indication.
In the experience of Brisbane-based community pharmacist and diabetes educator Rory Johnston MPS, the persistent Ozempic shortages have led to patients seeking the medicine for weight loss being treated with ‘great contempt’ by some healthcare professionals.
[caption id="attachment_27827" align="alignright" width="300"] Rory Johnston MPS[/caption]
There is often a perception that people are simply overweight due to overeating, said Mr Johnston, but there are myriad conditions and medicine classes that can cause patients to gain weight, including:
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[post_content] => Despite vaccination rates dropping, pharmacists continue to be vaccinators of choice for COVID-19 and influenza vaccinations. But more needs to be done to reach vulnerable groups.
These key insights, and more, were revealed at the 2024 Queensland Immunisation Symposium, held on Friday (18 October).
Pharmacists continue to lead COVID-19 and influenza vaccination
The COVID-19 vaccine rollout was the largest immunisation program Australia has seen as a country, with pharmacists delivering over 12.5 million COVID-19 vaccines alone in a 3-year period, said Genevieve Donnelly Assistant Secretary, Access, Engagement and Compliance Branch at the Department of Health and Aged Care.
‘Pharmacists have consistently delivered close to 50% of the COVID-19 vaccinations in primary care,’ she said.
‘It speaks quite considerably to the trust that people have in you as a profession as to how to access care and where they see that they can easily access it’
Furthermore, while influenza vaccination rates are declining nationally, Ms Donnelly said pharmacists were the only channel that not only held the number of vaccines administered this year for influenza, but increased it.
‘In an environment where people aren't taking the opportunity to go elsewhere, they will come to the pharmacy,’ she said. ‘That's where the trust is, and that's where the access is.’
Childhood vaccination continues to drop below the critical 95% mark
The fluctuating community sentiment about healthcare, spurred on by COVID-19, is driving vaccination rates down, said Ms Donnelly.
‘I don't think I've ever seen anyone so engaged in a medicine as what we saw during COVID-19 … on such a scale,’ she said. ‘[But] unfortunately, we’ve seen a sustained decline in childhood immunisations in this country.’
[caption id="attachment_27970" align="alignnone" width="2096"] Source: Queensland Health Immunisation Program[/caption]
The decline in childhood vaccination for children under 5 continued in 2024, moving Australia further from the 95% coverage target it held prior to the pandemic.
The vaccination rate of First Nations people is below the national average – particularly in the 1–2 years age cohort, said Sarah Risdale from the Queensland Health Immunisation Program.
‘The biggest risk for us is that some of these diseases rely on herd immunity, so the more we drop off, the more risk that previously eradicated diseases will return,’ warned Ms Risdale.
Because many vaccine-preventable diseases, such as polio and measles, were under control for many years – a key challenge is that many people don’t know the health impacts they can wreak.
‘It's really hard to sell something to someone when they don't really understand or have never seen what the impact could be,’ she said. ‘Particularly off the back of COVID-19, everyone is hesitant to believe what the government is telling them, and they seek their own healthcare advice and information.’
But because pharmacists have always been trusted healthcare professionals who the community comes to for advice, patients will be willing to trust that advice on vaccination, Ms Risdale advised.
‘It's a big responsibility for pharmacists when they're engaging with people [about] healthcare,’ she said.
Long way to go on meningococcal B protection
Pharmacists should also prioritise meningococcal B vaccination – with outbreaks of the deadly disease occurring in far North Queensland among other regions recently, said Ms Risdale.
‘This year in Queensland, we have a state-funded meningococcal B program for infants under 2 and adolescents 15–19,’ she said. ‘Unfortunately, we haven't seen the uptake we thought we would see this year, and that's across all provider types.’
Australian Immunisation Register data revealed uptake of the meningococcal B vaccine reduces with age, with the rates in various age cohorts including:
‘They are more than likely not going to die from shingles, but they could die from flu, COVID-19 or RSV [Respiratory syncytial virus].' Sarah risdale MPS‘With National Immunisation Program Vaccinations in Pharmacy (NIPVIP) funding, it's a big opportunity for pharmacists to start engaging more with the older community. ‘But [it’s important] to balance that relationship with the pharmacist and the GP and make sure people are getting what they need from the right provider.’ But while older Australians are at risk of serious and life-threatening complications from influenza, Ms Risdale said they are far more likely to actively seek out shingles vaccines than influenza and COVID-19 immunisation. There was a 2.6% reduction in the influenza vaccination rate in Australians aged 65 and over this year, dropping from 64.1% to 61.5% coverage. ‘They are more than likely not going to die from shingles, but they could die from flu, COVID-19 or RSV [Respiratory syncytial virus],’ she said. Despite numerous government and health body messages about the importance of vaccination against these potentially deadly diseases, it’s challenging to change perceptions. ‘That did help for a time, then people started to say, 'I'm getting COVID-19 and [influenza] anyway, so why would I go get that [vaccine]?’ While having conversations with people about their questions, concerns and fears about vaccines takes time, it adds long-term value, said Ms Risdale. ‘People come back to you as a trusted professional who spent half an hour talking to them about how important getting the MMR [measles, mumps, and rubella] vaccine was for their child, or how important having the pneumococcal vaccine was for their husband,’ she said. ‘They start to understand that you have time for them, you really value them as a person, and can give them reliable and helpful information, and they will come back to you again.’
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[post_content] => At the 2024 Queensland Excellence Awards in Brisbane on Saturday night, these five pharmacists were honoured for their commitment to excellence in pharmacy practice.
PSA Queensland President Shane MacDonald MPS acknowledged the achievements of the award winners as well as the continued dedication of pharmacists practising throughout the state.
‘It’s an inspiration to see the amazing work pharmacists are doing in communities across Queensland, and a great privilege to recognise them for their dedication in advancing the profession,’ he said.
‘On behalf of the PSA I congratulate the outstanding pharmacists presented with awards and thank them for their commitment to bettering the health of Queenslanders.’
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PSA Queensland Pharmacist of the Year Associate Professor Esther Lau MPS, University of Queensland
One of the first trained pharmacy vaccinators in Australia, A/Prof Lau was the cornerstone for the development of Australia’s first non-medical prescribing course at Queensland Institute of Technology, a foundation for the expansion of the current North Queensland practice prescribing pilots. For the past decade she has written AP’s Old Drug New Indication column, mentored many students and reviewed the APF and PSA’s 2023 Professional Practice Standards.
PSA Queensland Early Career Pharmacist of the Year James Buckley MPS, LiveLife Pharmacy Port Douglas
Filling a critical gap in his Far North Queensland community, Mr Buckley upskilled in otoscopy to accurately identify conditions like otitis media and otitis externa, as well as collaborative pathways to ensure patients were referred seamlessly for timely treatment. One of the first pharmacists to pass the North Queensland Pharmacist Full Scope of Practice Pilot, he sits on the ECP Community of Specialty Interest (CSI) leadership group and promotes pharmacy practice to students and interns.
PSA Queensland Intern Pharmacist of the Year Antonia Hurd, Kepnock Pharmacy Bundaberg
Interning at four separate pharmacies in Bundaberg, Peregian Springs, remote Agnes Water and regional town Cooroy, Ms Hurd has demonstrated exceptional leadership and initiative across pharmacy services including managing a dose administration aid service, an R U OK Day presentation, training in compounding and providing vaccination and first aid advice. Her research on managing the quality of life for people living with severe and persistent mental illness has been published as part of the PhaMIbridge trial.
Lifetime Achievement Award Beverley Glass FPS, James Cook University
After a lifetime of service and devotion to the pharmacy profession as a clinician, teacher, researcher, academic and advocate, South African-born Professor Glass has made an outstanding contribution to the development of pharmacy education, practice and research, specifically within rural and remote Queensland and Australia. She has invested immense amounts of time into the future academic workforce, some of whom are among her 50 honours and 33 PhD and Masters students.
Professor James Dare Graduate of the Year Shylee-Jade Hadar-Pagliari, James Cook University
As a final year pharmacy student, Ms Hadar-Pagliari has packed in many experiences since starting as a pharmacy assistant in 2020. Not only does she represent NAPSA students at pharmacy conferences, she has learned under supervision at the Alive Pharmacy Warehouse in Cairns how to dispense medicines, assist patients with non-prescription requests and run the complex compounding laboratory. She is known for her caring nature with patients.
[post_title] => PSA awards leading Queensland pharmacists
[post_excerpt] => At the 2024 Queensland Excellence Awards, these five pharmacists were honoured for their commitment to excellence in pharmacy practice.
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[post_content] => At one point in time, Menopausal hormone therapy (MHT) was used fairly extensively.
But this has changed since 2002, when the Women's Health Initiative (WHI) published a study linking combined MHT (oestrogen and progestin) with an increased risk of blood clots, stroke, breast cancer and heart attacks.
Almost overnight, women stopped using hormone therapy, said CEO of Jean Hailes for Women's Health, Dr Sarah White.
[caption id="attachment_27901" align="alignright" width="300"] Dr Sarah White[/caption]
But there are several factors that led to the study results being skewed.
‘It was [based on] an older group of women who started taking hormone therapy late, and it was a different form of hormone therapy, so those results did not stand up and the increased risk in breast cancer was terribly small,’ she said.
The sensationalist reporting did a huge amount of damage, Dr White said.
‘We still have women today who believe that MHT causes breast cancer, and GPs who are nervous about prescribing it.’
While around one in four women who go through menopause will be asymptomatic or have mild symptoms, a quarter will be at the opposite end of the spectrum and experience severe symptoms, said Dr White.
‘We're talking about an inability to sleep, terrible brain fog, anxiety, a loss of confidence, and hot flushes that can be catastrophic,’ she said.
The remaining half of women are on a spectrum of experiencing mildly annoying to must-be-managed symptoms.
‘We have women who are trying to soldier on through some really unpleasant physical and mental effects,’ she said. ‘And it's a bit heartbreaking to think that there's a medication that can help manage a lot of the symptoms and women are worried about taking it when they have no need to be.’
Is MHT underprescribed?
There's ‘no doubt’ that MHT is underused in Australia, said Dr White – with barriers to access a compounding factor.
‘It's not just going to get that doctor's appointment, it's the cost of the MHT,’ she said.
Some forms of MHT are subsidised under the Pharmaceutical Benefits Scheme (PBS), such as estradiol patches, but there has been a global shortage of this therapy in 2024.
But newer medicines such as Prometrium – a progesterone-based treatment matching the hormone the body makes when ovulating – are not, setting women back around $60 per month.
Are all women suitable candidates for MHT?
No, cautioned Dr White.
For example, a person who has had a hormone responsive cancer should have a careful discussion with their GP about whether the risks of MHT outweigh the benefits.
‘If you've had a hormone responsive cancer, then taking a hormone increases the risk of recurrence,’ she said.
Oral combined MHT will increase the ‘baseline’ risk of thrombosis around two-fold – however the baseline risk remains low in most women. Thrombosis risk increases with increasing age, smoking, increased body weight, in those with genetic predisposition to clotting and in certain illnesses. Risk factors should be considered prior to commencing MHT.
MHT treatment should be individualised based on the patient’s needs, clinical features and risk assessment, and reviewed regularly. Women with a personal or family history of venous thrombosis should undergo screening for risk factors to guide the choice of MHT delivery method. In cases where a woman is deemed to be at high risk for developing deep vein thrombosis (DVT), transdermal MHT should be used.
‘That’s why the message is very clear to speak about your individual circumstances with your doctor,’ added Dr White, who said a consultation to discuss the appropriateness of therapy could include:
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[post_date] => 2024-10-14 12:24:46
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[post_content] => The Unleashing the Potential of our Health Workforce – Scope of Practice Review final report and implementation plan is slated for delivery by October 2024.
But many states and territories are forging ahead with expanding pharmacist scope of practice in the interim.
Australian Pharmacist has rounded up some of the most recent updates.
Queensland pharmacy prescribing pilot could go permanent
Ahead of the Queensland state election next week (26 October), incumbent Premier Steven Miles and Health Minister Shannon Fentiman have vowed to make both the Community Pharmacy Scope of Practice Pilot and the Community Pharmacy Hormonal Contraception Pilot permanent if reelected.
Opposition Leader David Crisafulli has since announced intentions to expand both pilots.
Since the scope of practice pilot rolled out in April, trained pharmacists have been able to provide medication management services, autonomous prescribing for specified acute common conditions, and structured prescribing as part of a chronic disease management program.
With Queensland introducing the Community Pharmacy Hormonal Contraception Pilot, making this service permanent would bring Queensland in line with some other states and territories.
Since both pilots kicked off, hundreds of Queenslanders have benefitted from accessing care from their local pharmacy.
Queensland is a largely decentralised state, with more than half (50.7%) of Queensland’s population residing outside of Greater Brisbane.
PSA welcomes the commitment to expanding the scope of practice for pharmacists, said PSA Queensland State Manager Karen Castle MPS.
‘If the scope of practice pilots become permanent, it would have a significant positive impact on the health of Queenslanders and improve access to healthcare, particularly for rural and regional communities where accessing a GP can be challenging,’ she said.
‘Patients already see their pharmacist as a trusted healthcare professional, and this expanded scope will further enhance their role in delivering healthcare, reduce waiting times and improve patient outcomes.
‘As pharmacists expand their practice and the public becomes more aware of the broader services available, we anticipate significant growth in the uptake of services provided by pharmacists.’
Canberrans could soon access more pharmacy services
With the ACT election only days away (19 October), both ACT Labor and the Canberra Liberals have committed to expanding pharmacists' scope of practice.
Pharmacists in the ACT have already been providing consultations for uncomplicated urinary tract infections (UTI) and resupplying OCP under the NSW pilot.
In alignment with NSW, the expanded scope will cover a broader range of common and mild conditions, including ear infections, nausea and vomiting, reflux, acne, muscle pain and wound management.
Certain chronic conditions will also be included.
While PSA ACT Branch President Olivia Collenette MPS said the services will be introduced as a trial, PSA has been advised that there’s no intention to roll back service once it has started.
‘This will be great for Canberrans, where it is the most expensive city in Australia to see a GP,’ Ms Collenette told AP.
‘We have the lowest bulk billing rates in the country and wait times [to see a doctor] are in the weeks. This is all about patient access, ensuring appropriate care is there at the time it's needed.’
Both parties will work to ensure pharmacists can administer vaccines to patients of all ages.
PSA has been advocating for pharmacists to be able to administer all vaccines to all ages in all locations, she said.
‘Pharmacists are trusted healthcare professionals, helping the ACT maintain its above average for Australia vaccination rates,’ Ms Collenette said. ‘Patients have spoken with their feet that they like that pharmacists are providing these services, so we want to ensure they can continue to do so regardless of which vaccine/s they are after.’
Victoria’s scope of practice pilot extended
The Secretary Approval for 12-month Victorian Community Pharmacist Statewide Pilot, due to wrap up this month, was recently extended until June 2025 – ensuring all pharmacists who are already enrolled in the program continue be able to provide services during the evaluation period.
The pilot allows appropriately trained pharmacists to provide certain Schedule 4 medicines for:
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[post_content] => The landscape for glucagon-like peptide-1 receptor agonists (GLP-1RAs) used for weight loss is changing in Australia as demand continues to grow.
Australian Pharmacist explains what options are available, and restricted, for weight loss patients.
Ozempic is out of stock … again
There is no end in sight to the Ozempic shortage, with Novo Nordisk recently informing the Therapeutic Goods Administration (TGA) that supply of the medicine will remain limited for the rest of 2024.
The TGA has continued to ask prescribers not to initiate new patients on Ozempic unless there are no suitable alternatives, with supplies prioritised for patients with type 2 diabetes who are stabilised on the medicine.
Patients who have been using the medicine for weight loss should potentially be switched to an alternative, such as Wegovy which is approved for this indication.
In the experience of Brisbane-based community pharmacist and diabetes educator Rory Johnston MPS, the persistent Ozempic shortages have led to patients seeking the medicine for weight loss being treated with ‘great contempt’ by some healthcare professionals.
[caption id="attachment_27827" align="alignright" width="300"] Rory Johnston MPS[/caption]
There is often a perception that people are simply overweight due to overeating, said Mr Johnston, but there are myriad conditions and medicine classes that can cause patients to gain weight, including:
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Australian Pharmacist is the official journal for Pharmaceutical Society of Australia Ltd.
