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[post_content] => James Buckley MPS, fitness fanatic and partner at LiveLife Pharmacy Port Douglas, is full speed into the expanded Queensland prescribing pilot.
My high school chemistry teacher told me, ‘James, choose something you like, and something you’re good at’. I was good at chemistry at school and loved helping people, so why not do both? Pharmacy to me is about helping people understand their health through teaching them about their medicines. It’s rewarding to now formally prescribe S4 medicines, alongside existing scope of Schedule 2 and 3 medicines and lifestyle advice that will improve their health.
Tell us about prescribing under the Queensland Community Pharmacy Scope of Practice Pilot?
The pilot program gives pharmacists the ability to prescribe appropriate medicines for the patient’s condition as per the therapeutic guidelines, in many cases to suit the individual.
The structured protocols allow pharmacists to identify red flag and referral triggers for the patient and for us to practice safely and effectively.
Consult times allow for discussions between patient and pharmacist with the opportunity for all stages of the prescribing cycle. This includes information gathering, examination, therapeutic discussions, management and patient communication.
How does the service work?
When a patient presents to the pharmacy with symptoms, I take a brief history and offer a consultation.
During the consult, I take a detailed history including back-ground information, medical conditions, medicines and social history. Red flags for the patient’s condition are ruled out as part of the diagnostic framework, and appropriate physical examinations are conducted.
This can include taking vitals such as blood pressure, temperature and blood glucose levels and conducting an ear, nose, throat examination.
All the information is assessed and an appropriate treatment plan is agreed upon by both parties. This can include pharmacological or non-pharmacological treatment, lifestyle advice and preventative treatment, or a referral if warranted.
The patient is then reviewed for an appropriate follow-up date. After seeing patients for holistic care consults, there has been no apprehension to pay for the services.
For patients who are ineligible to participate or are price conscious, this feedback is also transmitted through the software as missed opportunities to provide health care to patients in need.
Introducing patients to the service?
Our pharmacists and staff are on the frontline explaining our services to patients at every opportunity. Our assistants are trained to refer any patient who presents with ear pain (among other conditions) to the pharmacist, resulting in an instant consultation. We also have a great relationship with the local GP clinic and hospital, so they refer patients to our trained pharmacists. Patients are often ecstatic, thrilled and relieved that we offer the service. They trust our knowledge and medicine expertise, and have no problems discussing their health with the prescribing pharmacist. We see people every day who are unable to see the doctor for weeks, and are desperate for our assistance.
What have you prescribed so far?
Within the first week I successfully reviewed patients and prescribed a course of antibiotic ear drops for an international patient who came to Australia to see the Great Barrier Reef and subsequently contracted an outer ear infection while diving. I also saw a concerned mother who presented with her child who had contracted a case of impetigo on the knee from school and could not see a doctor for 3 weeks. I was able to prescribe antibiotic ointment and oral antibiotics to treat the infection.
Advice for other ECPs?
Pharmacy is a constantly expanding and rewarding career. Find what you enjoy most and work hard to make your mark on the profession. I’ve always wanted to be a pharmacy owner, be the cornerstone of a community and provide exceptional services to people in need.
Find like-minded people and mentors who believe in you. I want to thank my mentors from LiveLife Pharmacy and PSA. I would not be here without them.
A day in the life of James Buckley MPS, Pharmacy Partner, LiveLife Pharmacy, Port Douglas, QLD
| 5.00 am |
Get up and moving Start the day with a HIIT class. Let’s do this! |
| 8.00 am |
First things first Open the pharmacy, review bookings – online orders, pharmacist consult bookings for COVID-19 and other vaccines. Our ear clinic for diving, flying and swimming infections from reef-based activities is constantly busy. All staff are trained to triage. We conduct multiple ear checks a day (10 is my daily record), especially on weekends when doctors are closed. |
| 9.00 am |
Vaccination clinic starts Administer shingles vaccine to a local couple. Other vaccines are booked online. All flu shots are free for Queensland residents and anyone aged 65+ is NIP-funded. |
| 11.00 am |
Oral contraceptive pill Miss Y needs to renew her contraceptive pill repeats that were misplaced. She was assessed and I was able to prescribe her regular medication. |
| 2.00 pm |
Prescribing time Miss P, aged 6, presents to the pharmacy with ear pain. She has been swimming a lot on her holiday and an examination is required. No red flags are present and she can safely be prescribed antibiotic ear drops. |
| 3.00 pm |
Touch base with staff Catch up with the team, which can be anything from helping with orders, professional development, staff training and upskilling on pharmacist consults or inducting new staff. On-the-floor quiz and teaching sessions with interns can include reviews of work in non-prescription areas, which for us is commonly bites and stings from mozzies and jellyfish and sunscreen uses for sunburn and (constant) heat rash. |
| 5.00 pm |
Winding down Instruct staff to finish, tidy dispensary, scan scripts, and get ready for the next day. |
| 6.00-9.00 pm | Home time Catch up with the ECP Community of Specialty Interest (CSI). Watch Netflix. Bed. |
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[post_content] => Mid-winter will be a busy time of year for pharmacists, with a range of practice, fee and career pathway updates kicking off on 1 July 2024.
Australian Pharmacist takes a look at the changes pharmacists will experience from next week.
1. Vaping ban comes into effect
The third tranche of vaping reform included in the Therapeutic Goods and other Legislation (Vaping Reforms) Bill 2024 will see all vape sales banned from general retailers from 1 July. Passing through the Senate this morning, the Bill limits the supply of all vapes strictly to community pharmacies from Monday.
These vaping products must adhere to quality and product standards including:
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[post_content] => Rabies causes an estimated 59,000 deaths annually, with almost half (40%) deaths occurring in children under 15. But underreporting could mean this death rate is much higher.
Post COVID-19, there has been an increase in rabies cases – with the abandonment of pets and a reduction in human-dog interaction leading to heightened aggression in dogs – who are responsible for most human rabies cases. Rabies hotspots include Asia, Africa and India, but 150 countries are considered high-risk rabies territories.
As we approach the winter school holidays and Australians escape the cold by heading overseas, pharmacists in New South Wales can now protect patients against the disease.
PSA advocacy was the key driver for the change to the NSW Pharmacist Vaccination Standards to allow pharmacists to administer the rabies vaccine, with the NSW Branch Committee working closely with the Ministry of Health to drive the change, said PSA NSW State Manager Amanda Fairjones MPS.
[caption id="attachment_25121" align="alignright" width="298"]
PSA NSW branch State Manager Amanda Fairjones MPS[/caption]
‘When undertaking travel health consultations, our members told us that it was the most common travel vaccine they were referring people back to their GP for,’ she said. ‘People were asking for it but we were unable to provide it.’
Having the vaccine available provides a great opportunity for pharmacists to sit down and have a chat to people about their travel vaccination needs, said Karen Carter FPS, Partner of Carter's Pharmacy Gunnedah and Owner Narrabri Pharmacy Narrabri in north-west NSW.
‘Because of the regime with some vaccines, we need to have them all done on one day or a week apart,’ she said. ‘ Now we can organise a vaccine regime to be completed at the pharmacy, rather than having to send patients back to their GP for part of it.’
Who is the vaccine indicated for?
Under the NSW Pharmacist Vaccination Standards, pharmacists can administer the rabies vaccine for pre-exposure prophylaxis treatment via intramuscular injection to people 5 years and over who are not immunocompromised.
‘When undertaking travel health consultations, our members told us that it was the most common travel vaccine they were referring people back to their GP for. People were asking for it but we were unable to provide it.'
amanda fairjones MPS
The Australian Immunisation Handbook (AIH), recommends pre-exposure rabies vaccine for:
Karen Carter FPS[/caption]
Post-exposure prophylaxis includes wound management, administration of rabies vaccine doses and human rabies immunoglobulin, taking into account:
If a prescriber writes a prescription for a vaccine – including the rabies vaccine – pharmacists are able to administer it in all states and territories other than Tasmania and South Australia.
However, in the case of the rabies vaccine, in Tasmania, authorised pharmacist immunisers can administer the rabies vaccine when prescribed by a medical or nurse practitioner.
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As winter kicked off, Australia was hit by a massive COVID-19 wave – fuelled by the new Omicron FLiRT subvariant.
There have been 93,049 cases of COVID-19 reported since April 2024. Case numbers are highest among those most at risk, with notifications peaking in the 75–79 (6,655), 80–84 (6,524) and 85+ (12,607) age brackets.
However, with limited testing and reporting COVID-19 cases, this figure does not tell the full story.
‘We’re looking at six to 10 times as many people actually infected as the case numbers are showing,’ said Professor Adrian Esterman, chair of biostatistics and epidemiology at the University of South Australia.
At the same time, reported influenza cases are also increasing. During the first week of June, influenza notifications to the Department of Health increased by 22% to 251 cases. This rise pushed the influenza case numbers above the seasonal threshold for the first time in 2024.
While these respiratory diseases circulate among the community – vaccination rates are waning.
While 2024 influenza vaccination in pharmacies has slightly increased compared to this time last year (87,232 versus 83,326 for the week 9–16 June) – there has been a significant decrease since 2022, when vaccination rates reached a high of 181,202 in the same period.
To boost vaccination rates among older Australians – whether in the community or in residential aged care facilities (RACFs) – three community pharmacists shared their top tips with Australian Pharmacist.
How to overcome vaccination fatigue
According to community pharmacist Yves Cruz, based in the New South Wales South Coast town of Nowra, 2024 has been particularly challenging for COVID-19 vaccine uptake.
‘What I have experienced is that people think 3, 4 or 5 doses is enough for them,’ he said.
However, Mr Cruz thinks leveraging trusting relationships with patients can help to overcome hesitancy.
‘If the people trust their pharmacist, I find they are willing to get the vaccine – even if they have reservations,’ he said.
‘Through communication and providing [evidence-based] information, this can help to remove their doubts.’
Queensland-based pharmacist Alicia Slight has similarly encountered some resistance to COVID-19 boosters, which she promptly addresses with factual information.
‘I use the Australian Technical Advisory Group on Immunisation (ATAGI) table to help navigate the conversation, and also describe [COVID-19 booster doses] as akin to having a yearly flu vaccine,’ she said. ‘I win over [around] three quarters of the fence sitters with a straightforward explanation and by not being too pushy on the matter.’
How to Get involved in outreach programs
As of 13 June 2024, there were 4,147 active COVID-19 cases reported in 487 active outbreaks in RACFs across Australia.
But only 40.3% of those in RACFs had received a COVID-19 booster dose in the last 6 months.
National Immunisation Program vaccines can now be administered off-site in RACFs under NIPVIP. Mark Butler, federal Minister for Health and Aged Care, has strongly advised pharmacists to get involved in these programs.
Since 29 April 2024, pharmacists have also been able to receive funding to deliver National Immunisation Program vaccines to patients in RACFs. From next month (1 July) NIPVIP payments will also be indexed in line with Medicare Benefits Schedule indexation.
‘Community pharmacists play a vital role in our healthcare system – and they will play an even bigger role by administering free, lifesaving vaccines to eligible patients living in aged care homes and disability homes,’ he said.
Pharmacists should also be actively engaged with community outreach as this enhances the uptake of vaccinations, said Dr Brian Chia MPS, community pharmacist, lecturer in Pharmacy and Pharmacology at the University of South Australia and member of the South Australian PSA Early Career working group.
‘This is not limited to COVID-19 or influenza vaccinations, but the scope for many other vaccinations pharmacists can provide,’ he said.
How to promote co-administration
For Mr Chia, promoting co-administration is key to ensuring vulnerable older patients are protected against both influenza and COVID-19 this season.
[caption id="attachment_26579" align="alignright" width="318"]
Dr Brian Chia MPS[/caption]
‘Whenever they come in for a COVID-19 vaccine, I usually ask them, “have you had your flu shot?”,’ he said.
‘A lot of patients are not aware that you can actually get the vaccines at the same time, and many of them say “if I can get them together, it will make my life so much more convenient”.’
Mr Cruz takes the opportunity to discuss influenza and COVID-19 vaccines when patients come in for a Shingrix vaccine – which is highly sought after by older Australians in his community.
‘Once we talk about shingles vaccine, we open up about the importance of flu and COVID-19 vaccines,’ he said. ‘Most of the time, this is successful. The majority of our loyal customers aged 65 years and over have received the COVID-19, influenza and shingles vaccines, and now we're starting to give the pneumococcal vaccine.’
How to leverage pharmacy’s accessibility
Community pharmacies are one of the most accessible vaccine providers around. But not all patients are aware of what vaccinations pharmacists can provide, and how simple the process is.
‘I had a patient who came in with a prescription for Boostrix and Vaxigrip Tetra,’ said Mr Chia.
‘I told a patient, “do you know you can actually walk in, we can provide you with these vaccinations? And it doesn't take more than 15 minutes.’
For Ms Slight, offering both appointments and walk-in vaccinations is a key driver for increasing uptake of influenza vaccines.
‘We also offer vaccination to patients when they hand in and pick up prescriptions – providing a constant reminder of our service [leads to] so many happy to get vaccinated then and there,’ she said.
During any vaccination, Ms Slight also shows patients their Australian Immunisation Register to highlight any upcoming or outstanding vaccinations, such as COVID-19, pneumococcal, DTPa or shingles.
‘I then arrange for those vaccinations to be administered – either on the same day or with an appropriate interval – depending on what needs to be done,’ she said. ‘Very rarely do I get resistance to this process.’
[post_title] => Vaccination rates wane as COVID-19 and influenza cases ramp up
[post_excerpt] => Vaccination rates are rapidly slipping in vulnerable older Australians. Three pharmacists share their advice for turning this around.
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[post_content] => NSW Health has issued an alert following a stream of newborn and infant presentations with symptoms of anticholinergic syndrome.
Colic preparations containing the toxic belladonna plant are the suspected culprit.
Other jurisdictions have reported similar incidents, with Queensland Health also issuing an alert after two infants presented to a Brisbane metropolitan hospital with suspected belladonna toxicity.
So what do pharmacists need to look out for? Australian Pharmacist delves into the signs and symptoms of colic, the recommended treatment options, how anticholinergic syndrome manifests and advice for struggling parents.
How, and when, does colic present?
Colic is defined as repeated, unexplained, inconsolable episodes of crying that persist for more than 3 hours per day, with parents unable to comfort their children.
The crying typically onsets suddenly at a similar time each day – more frequently occurring in the afternoons or evenings.
Other symptoms can include:
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[post_content] => James Buckley MPS, fitness fanatic and partner at LiveLife Pharmacy Port Douglas, is full speed into the expanded Queensland prescribing pilot.
My high school chemistry teacher told me, ‘James, choose something you like, and something you’re good at’. I was good at chemistry at school and loved helping people, so why not do both? Pharmacy to me is about helping people understand their health through teaching them about their medicines. It’s rewarding to now formally prescribe S4 medicines, alongside existing scope of Schedule 2 and 3 medicines and lifestyle advice that will improve their health.
Tell us about prescribing under the Queensland Community Pharmacy Scope of Practice Pilot?
The pilot program gives pharmacists the ability to prescribe appropriate medicines for the patient’s condition as per the therapeutic guidelines, in many cases to suit the individual.
The structured protocols allow pharmacists to identify red flag and referral triggers for the patient and for us to practice safely and effectively.
Consult times allow for discussions between patient and pharmacist with the opportunity for all stages of the prescribing cycle. This includes information gathering, examination, therapeutic discussions, management and patient communication.
How does the service work?
When a patient presents to the pharmacy with symptoms, I take a brief history and offer a consultation.
During the consult, I take a detailed history including back-ground information, medical conditions, medicines and social history. Red flags for the patient’s condition are ruled out as part of the diagnostic framework, and appropriate physical examinations are conducted.
This can include taking vitals such as blood pressure, temperature and blood glucose levels and conducting an ear, nose, throat examination.
All the information is assessed and an appropriate treatment plan is agreed upon by both parties. This can include pharmacological or non-pharmacological treatment, lifestyle advice and preventative treatment, or a referral if warranted.
The patient is then reviewed for an appropriate follow-up date. After seeing patients for holistic care consults, there has been no apprehension to pay for the services.
For patients who are ineligible to participate or are price conscious, this feedback is also transmitted through the software as missed opportunities to provide health care to patients in need.
Introducing patients to the service?
Our pharmacists and staff are on the frontline explaining our services to patients at every opportunity. Our assistants are trained to refer any patient who presents with ear pain (among other conditions) to the pharmacist, resulting in an instant consultation. We also have a great relationship with the local GP clinic and hospital, so they refer patients to our trained pharmacists. Patients are often ecstatic, thrilled and relieved that we offer the service. They trust our knowledge and medicine expertise, and have no problems discussing their health with the prescribing pharmacist. We see people every day who are unable to see the doctor for weeks, and are desperate for our assistance.
What have you prescribed so far?
Within the first week I successfully reviewed patients and prescribed a course of antibiotic ear drops for an international patient who came to Australia to see the Great Barrier Reef and subsequently contracted an outer ear infection while diving. I also saw a concerned mother who presented with her child who had contracted a case of impetigo on the knee from school and could not see a doctor for 3 weeks. I was able to prescribe antibiotic ointment and oral antibiotics to treat the infection.
Advice for other ECPs?
Pharmacy is a constantly expanding and rewarding career. Find what you enjoy most and work hard to make your mark on the profession. I’ve always wanted to be a pharmacy owner, be the cornerstone of a community and provide exceptional services to people in need.
Find like-minded people and mentors who believe in you. I want to thank my mentors from LiveLife Pharmacy and PSA. I would not be here without them.
A day in the life of James Buckley MPS, Pharmacy Partner, LiveLife Pharmacy, Port Douglas, QLD
| 5.00 am |
Get up and moving Start the day with a HIIT class. Let’s do this! |
| 8.00 am |
First things first Open the pharmacy, review bookings – online orders, pharmacist consult bookings for COVID-19 and other vaccines. Our ear clinic for diving, flying and swimming infections from reef-based activities is constantly busy. All staff are trained to triage. We conduct multiple ear checks a day (10 is my daily record), especially on weekends when doctors are closed. |
| 9.00 am |
Vaccination clinic starts Administer shingles vaccine to a local couple. Other vaccines are booked online. All flu shots are free for Queensland residents and anyone aged 65+ is NIP-funded. |
| 11.00 am |
Oral contraceptive pill Miss Y needs to renew her contraceptive pill repeats that were misplaced. She was assessed and I was able to prescribe her regular medication. |
| 2.00 pm |
Prescribing time Miss P, aged 6, presents to the pharmacy with ear pain. She has been swimming a lot on her holiday and an examination is required. No red flags are present and she can safely be prescribed antibiotic ear drops. |
| 3.00 pm |
Touch base with staff Catch up with the team, which can be anything from helping with orders, professional development, staff training and upskilling on pharmacist consults or inducting new staff. On-the-floor quiz and teaching sessions with interns can include reviews of work in non-prescription areas, which for us is commonly bites and stings from mozzies and jellyfish and sunscreen uses for sunburn and (constant) heat rash. |
| 5.00 pm |
Winding down Instruct staff to finish, tidy dispensary, scan scripts, and get ready for the next day. |
| 6.00-9.00 pm | Home time Catch up with the ECP Community of Specialty Interest (CSI). Watch Netflix. Bed. |
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[post_content] => Mid-winter will be a busy time of year for pharmacists, with a range of practice, fee and career pathway updates kicking off on 1 July 2024.
Australian Pharmacist takes a look at the changes pharmacists will experience from next week.
1. Vaping ban comes into effect
The third tranche of vaping reform included in the Therapeutic Goods and other Legislation (Vaping Reforms) Bill 2024 will see all vape sales banned from general retailers from 1 July. Passing through the Senate this morning, the Bill limits the supply of all vapes strictly to community pharmacies from Monday.
These vaping products must adhere to quality and product standards including:
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[post_content] => Rabies causes an estimated 59,000 deaths annually, with almost half (40%) deaths occurring in children under 15. But underreporting could mean this death rate is much higher.
Post COVID-19, there has been an increase in rabies cases – with the abandonment of pets and a reduction in human-dog interaction leading to heightened aggression in dogs – who are responsible for most human rabies cases. Rabies hotspots include Asia, Africa and India, but 150 countries are considered high-risk rabies territories.
As we approach the winter school holidays and Australians escape the cold by heading overseas, pharmacists in New South Wales can now protect patients against the disease.
PSA advocacy was the key driver for the change to the NSW Pharmacist Vaccination Standards to allow pharmacists to administer the rabies vaccine, with the NSW Branch Committee working closely with the Ministry of Health to drive the change, said PSA NSW State Manager Amanda Fairjones MPS.
[caption id="attachment_25121" align="alignright" width="298"] PSA NSW branch State Manager Amanda Fairjones MPS[/caption]
‘When undertaking travel health consultations, our members told us that it was the most common travel vaccine they were referring people back to their GP for,’ she said. ‘People were asking for it but we were unable to provide it.’
Having the vaccine available provides a great opportunity for pharmacists to sit down and have a chat to people about their travel vaccination needs, said Karen Carter FPS, Partner of Carter's Pharmacy Gunnedah and Owner Narrabri Pharmacy Narrabri in north-west NSW.
‘Because of the regime with some vaccines, we need to have them all done on one day or a week apart,’ she said. ‘ Now we can organise a vaccine regime to be completed at the pharmacy, rather than having to send patients back to their GP for part of it.’
Who is the vaccine indicated for?
Under the NSW Pharmacist Vaccination Standards, pharmacists can administer the rabies vaccine for pre-exposure prophylaxis treatment via intramuscular injection to people 5 years and over who are not immunocompromised.
‘When undertaking travel health consultations, our members told us that it was the most common travel vaccine they were referring people back to their GP for. People were asking for it but we were unable to provide it.'
amanda fairjones MPS
The Australian Immunisation Handbook (AIH), recommends pre-exposure rabies vaccine for:
Karen Carter FPS[/caption]
Post-exposure prophylaxis includes wound management, administration of rabies vaccine doses and human rabies immunoglobulin, taking into account:
If a prescriber writes a prescription for a vaccine – including the rabies vaccine – pharmacists are able to administer it in all states and territories other than Tasmania and South Australia.
However, in the case of the rabies vaccine, in Tasmania, authorised pharmacist immunisers can administer the rabies vaccine when prescribed by a medical or nurse practitioner.
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As winter kicked off, Australia was hit by a massive COVID-19 wave – fuelled by the new Omicron FLiRT subvariant.
There have been 93,049 cases of COVID-19 reported since April 2024. Case numbers are highest among those most at risk, with notifications peaking in the 75–79 (6,655), 80–84 (6,524) and 85+ (12,607) age brackets.
However, with limited testing and reporting COVID-19 cases, this figure does not tell the full story.
‘We’re looking at six to 10 times as many people actually infected as the case numbers are showing,’ said Professor Adrian Esterman, chair of biostatistics and epidemiology at the University of South Australia.
At the same time, reported influenza cases are also increasing. During the first week of June, influenza notifications to the Department of Health increased by 22% to 251 cases. This rise pushed the influenza case numbers above the seasonal threshold for the first time in 2024.
While these respiratory diseases circulate among the community – vaccination rates are waning.
While 2024 influenza vaccination in pharmacies has slightly increased compared to this time last year (87,232 versus 83,326 for the week 9–16 June) – there has been a significant decrease since 2022, when vaccination rates reached a high of 181,202 in the same period.
To boost vaccination rates among older Australians – whether in the community or in residential aged care facilities (RACFs) – three community pharmacists shared their top tips with Australian Pharmacist.
How to overcome vaccination fatigue
According to community pharmacist Yves Cruz, based in the New South Wales South Coast town of Nowra, 2024 has been particularly challenging for COVID-19 vaccine uptake.
‘What I have experienced is that people think 3, 4 or 5 doses is enough for them,’ he said.
However, Mr Cruz thinks leveraging trusting relationships with patients can help to overcome hesitancy.
‘If the people trust their pharmacist, I find they are willing to get the vaccine – even if they have reservations,’ he said.
‘Through communication and providing [evidence-based] information, this can help to remove their doubts.’
Queensland-based pharmacist Alicia Slight has similarly encountered some resistance to COVID-19 boosters, which she promptly addresses with factual information.
‘I use the Australian Technical Advisory Group on Immunisation (ATAGI) table to help navigate the conversation, and also describe [COVID-19 booster doses] as akin to having a yearly flu vaccine,’ she said. ‘I win over [around] three quarters of the fence sitters with a straightforward explanation and by not being too pushy on the matter.’
How to Get involved in outreach programs
As of 13 June 2024, there were 4,147 active COVID-19 cases reported in 487 active outbreaks in RACFs across Australia.
But only 40.3% of those in RACFs had received a COVID-19 booster dose in the last 6 months.
National Immunisation Program vaccines can now be administered off-site in RACFs under NIPVIP. Mark Butler, federal Minister for Health and Aged Care, has strongly advised pharmacists to get involved in these programs.
Since 29 April 2024, pharmacists have also been able to receive funding to deliver National Immunisation Program vaccines to patients in RACFs. From next month (1 July) NIPVIP payments will also be indexed in line with Medicare Benefits Schedule indexation.
‘Community pharmacists play a vital role in our healthcare system – and they will play an even bigger role by administering free, lifesaving vaccines to eligible patients living in aged care homes and disability homes,’ he said.
Pharmacists should also be actively engaged with community outreach as this enhances the uptake of vaccinations, said Dr Brian Chia MPS, community pharmacist, lecturer in Pharmacy and Pharmacology at the University of South Australia and member of the South Australian PSA Early Career working group.
‘This is not limited to COVID-19 or influenza vaccinations, but the scope for many other vaccinations pharmacists can provide,’ he said.
How to promote co-administration
For Mr Chia, promoting co-administration is key to ensuring vulnerable older patients are protected against both influenza and COVID-19 this season.
[caption id="attachment_26579" align="alignright" width="318"] Dr Brian Chia MPS[/caption]
‘Whenever they come in for a COVID-19 vaccine, I usually ask them, “have you had your flu shot?”,’ he said.
‘A lot of patients are not aware that you can actually get the vaccines at the same time, and many of them say “if I can get them together, it will make my life so much more convenient”.’
Mr Cruz takes the opportunity to discuss influenza and COVID-19 vaccines when patients come in for a Shingrix vaccine – which is highly sought after by older Australians in his community.
‘Once we talk about shingles vaccine, we open up about the importance of flu and COVID-19 vaccines,’ he said. ‘Most of the time, this is successful. The majority of our loyal customers aged 65 years and over have received the COVID-19, influenza and shingles vaccines, and now we're starting to give the pneumococcal vaccine.’
How to leverage pharmacy’s accessibility
Community pharmacies are one of the most accessible vaccine providers around. But not all patients are aware of what vaccinations pharmacists can provide, and how simple the process is.
‘I had a patient who came in with a prescription for Boostrix and Vaxigrip Tetra,’ said Mr Chia.
‘I told a patient, “do you know you can actually walk in, we can provide you with these vaccinations? And it doesn't take more than 15 minutes.’
For Ms Slight, offering both appointments and walk-in vaccinations is a key driver for increasing uptake of influenza vaccines.
‘We also offer vaccination to patients when they hand in and pick up prescriptions – providing a constant reminder of our service [leads to] so many happy to get vaccinated then and there,’ she said.
During any vaccination, Ms Slight also shows patients their Australian Immunisation Register to highlight any upcoming or outstanding vaccinations, such as COVID-19, pneumococcal, DTPa or shingles.
‘I then arrange for those vaccinations to be administered – either on the same day or with an appropriate interval – depending on what needs to be done,’ she said. ‘Very rarely do I get resistance to this process.’
[post_title] => Vaccination rates wane as COVID-19 and influenza cases ramp up
[post_excerpt] => Vaccination rates are rapidly slipping in vulnerable older Australians. Three pharmacists share their advice for turning this around.
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[post_content] => NSW Health has issued an alert following a stream of newborn and infant presentations with symptoms of anticholinergic syndrome.
Colic preparations containing the toxic belladonna plant are the suspected culprit.
Other jurisdictions have reported similar incidents, with Queensland Health also issuing an alert after two infants presented to a Brisbane metropolitan hospital with suspected belladonna toxicity.
So what do pharmacists need to look out for? Australian Pharmacist delves into the signs and symptoms of colic, the recommended treatment options, how anticholinergic syndrome manifests and advice for struggling parents.
How, and when, does colic present?
Colic is defined as repeated, unexplained, inconsolable episodes of crying that persist for more than 3 hours per day, with parents unable to comfort their children.
The crying typically onsets suddenly at a similar time each day – more frequently occurring in the afternoons or evenings.
Other symptoms can include:
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[post_content] => James Buckley MPS, fitness fanatic and partner at LiveLife Pharmacy Port Douglas, is full speed into the expanded Queensland prescribing pilot.
My high school chemistry teacher told me, ‘James, choose something you like, and something you’re good at’. I was good at chemistry at school and loved helping people, so why not do both? Pharmacy to me is about helping people understand their health through teaching them about their medicines. It’s rewarding to now formally prescribe S4 medicines, alongside existing scope of Schedule 2 and 3 medicines and lifestyle advice that will improve their health.
Tell us about prescribing under the Queensland Community Pharmacy Scope of Practice Pilot?
The pilot program gives pharmacists the ability to prescribe appropriate medicines for the patient’s condition as per the therapeutic guidelines, in many cases to suit the individual.
The structured protocols allow pharmacists to identify red flag and referral triggers for the patient and for us to practice safely and effectively.
Consult times allow for discussions between patient and pharmacist with the opportunity for all stages of the prescribing cycle. This includes information gathering, examination, therapeutic discussions, management and patient communication.
How does the service work?
When a patient presents to the pharmacy with symptoms, I take a brief history and offer a consultation.
During the consult, I take a detailed history including back-ground information, medical conditions, medicines and social history. Red flags for the patient’s condition are ruled out as part of the diagnostic framework, and appropriate physical examinations are conducted.
This can include taking vitals such as blood pressure, temperature and blood glucose levels and conducting an ear, nose, throat examination.
All the information is assessed and an appropriate treatment plan is agreed upon by both parties. This can include pharmacological or non-pharmacological treatment, lifestyle advice and preventative treatment, or a referral if warranted.
The patient is then reviewed for an appropriate follow-up date. After seeing patients for holistic care consults, there has been no apprehension to pay for the services.
For patients who are ineligible to participate or are price conscious, this feedback is also transmitted through the software as missed opportunities to provide health care to patients in need.
Introducing patients to the service?
Our pharmacists and staff are on the frontline explaining our services to patients at every opportunity. Our assistants are trained to refer any patient who presents with ear pain (among other conditions) to the pharmacist, resulting in an instant consultation. We also have a great relationship with the local GP clinic and hospital, so they refer patients to our trained pharmacists. Patients are often ecstatic, thrilled and relieved that we offer the service. They trust our knowledge and medicine expertise, and have no problems discussing their health with the prescribing pharmacist. We see people every day who are unable to see the doctor for weeks, and are desperate for our assistance.
What have you prescribed so far?
Within the first week I successfully reviewed patients and prescribed a course of antibiotic ear drops for an international patient who came to Australia to see the Great Barrier Reef and subsequently contracted an outer ear infection while diving. I also saw a concerned mother who presented with her child who had contracted a case of impetigo on the knee from school and could not see a doctor for 3 weeks. I was able to prescribe antibiotic ointment and oral antibiotics to treat the infection.
Advice for other ECPs?
Pharmacy is a constantly expanding and rewarding career. Find what you enjoy most and work hard to make your mark on the profession. I’ve always wanted to be a pharmacy owner, be the cornerstone of a community and provide exceptional services to people in need.
Find like-minded people and mentors who believe in you. I want to thank my mentors from LiveLife Pharmacy and PSA. I would not be here without them.
A day in the life of James Buckley MPS, Pharmacy Partner, LiveLife Pharmacy, Port Douglas, QLD
| 5.00 am |
Get up and moving Start the day with a HIIT class. Let’s do this! |
| 8.00 am |
First things first Open the pharmacy, review bookings – online orders, pharmacist consult bookings for COVID-19 and other vaccines. Our ear clinic for diving, flying and swimming infections from reef-based activities is constantly busy. All staff are trained to triage. We conduct multiple ear checks a day (10 is my daily record), especially on weekends when doctors are closed. |
| 9.00 am |
Vaccination clinic starts Administer shingles vaccine to a local couple. Other vaccines are booked online. All flu shots are free for Queensland residents and anyone aged 65+ is NIP-funded. |
| 11.00 am |
Oral contraceptive pill Miss Y needs to renew her contraceptive pill repeats that were misplaced. She was assessed and I was able to prescribe her regular medication. |
| 2.00 pm |
Prescribing time Miss P, aged 6, presents to the pharmacy with ear pain. She has been swimming a lot on her holiday and an examination is required. No red flags are present and she can safely be prescribed antibiotic ear drops. |
| 3.00 pm |
Touch base with staff Catch up with the team, which can be anything from helping with orders, professional development, staff training and upskilling on pharmacist consults or inducting new staff. On-the-floor quiz and teaching sessions with interns can include reviews of work in non-prescription areas, which for us is commonly bites and stings from mozzies and jellyfish and sunscreen uses for sunburn and (constant) heat rash. |
| 5.00 pm |
Winding down Instruct staff to finish, tidy dispensary, scan scripts, and get ready for the next day. |
| 6.00-9.00 pm | Home time Catch up with the ECP Community of Specialty Interest (CSI). Watch Netflix. Bed. |
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[post_content] => Mid-winter will be a busy time of year for pharmacists, with a range of practice, fee and career pathway updates kicking off on 1 July 2024.
Australian Pharmacist takes a look at the changes pharmacists will experience from next week.
1. Vaping ban comes into effect
The third tranche of vaping reform included in the Therapeutic Goods and other Legislation (Vaping Reforms) Bill 2024 will see all vape sales banned from general retailers from 1 July. Passing through the Senate this morning, the Bill limits the supply of all vapes strictly to community pharmacies from Monday.
These vaping products must adhere to quality and product standards including:
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[post_content] => Rabies causes an estimated 59,000 deaths annually, with almost half (40%) deaths occurring in children under 15. But underreporting could mean this death rate is much higher.
Post COVID-19, there has been an increase in rabies cases – with the abandonment of pets and a reduction in human-dog interaction leading to heightened aggression in dogs – who are responsible for most human rabies cases. Rabies hotspots include Asia, Africa and India, but 150 countries are considered high-risk rabies territories.
As we approach the winter school holidays and Australians escape the cold by heading overseas, pharmacists in New South Wales can now protect patients against the disease.
PSA advocacy was the key driver for the change to the NSW Pharmacist Vaccination Standards to allow pharmacists to administer the rabies vaccine, with the NSW Branch Committee working closely with the Ministry of Health to drive the change, said PSA NSW State Manager Amanda Fairjones MPS.
[caption id="attachment_25121" align="alignright" width="298"] PSA NSW branch State Manager Amanda Fairjones MPS[/caption]
‘When undertaking travel health consultations, our members told us that it was the most common travel vaccine they were referring people back to their GP for,’ she said. ‘People were asking for it but we were unable to provide it.’
Having the vaccine available provides a great opportunity for pharmacists to sit down and have a chat to people about their travel vaccination needs, said Karen Carter FPS, Partner of Carter's Pharmacy Gunnedah and Owner Narrabri Pharmacy Narrabri in north-west NSW.
‘Because of the regime with some vaccines, we need to have them all done on one day or a week apart,’ she said. ‘ Now we can organise a vaccine regime to be completed at the pharmacy, rather than having to send patients back to their GP for part of it.’
Who is the vaccine indicated for?
Under the NSW Pharmacist Vaccination Standards, pharmacists can administer the rabies vaccine for pre-exposure prophylaxis treatment via intramuscular injection to people 5 years and over who are not immunocompromised.
‘When undertaking travel health consultations, our members told us that it was the most common travel vaccine they were referring people back to their GP for. People were asking for it but we were unable to provide it.'
amanda fairjones MPS
The Australian Immunisation Handbook (AIH), recommends pre-exposure rabies vaccine for:
Karen Carter FPS[/caption]
Post-exposure prophylaxis includes wound management, administration of rabies vaccine doses and human rabies immunoglobulin, taking into account:
If a prescriber writes a prescription for a vaccine – including the rabies vaccine – pharmacists are able to administer it in all states and territories other than Tasmania and South Australia.
However, in the case of the rabies vaccine, in Tasmania, authorised pharmacist immunisers can administer the rabies vaccine when prescribed by a medical or nurse practitioner.
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As winter kicked off, Australia was hit by a massive COVID-19 wave – fuelled by the new Omicron FLiRT subvariant.
There have been 93,049 cases of COVID-19 reported since April 2024. Case numbers are highest among those most at risk, with notifications peaking in the 75–79 (6,655), 80–84 (6,524) and 85+ (12,607) age brackets.
However, with limited testing and reporting COVID-19 cases, this figure does not tell the full story.
‘We’re looking at six to 10 times as many people actually infected as the case numbers are showing,’ said Professor Adrian Esterman, chair of biostatistics and epidemiology at the University of South Australia.
At the same time, reported influenza cases are also increasing. During the first week of June, influenza notifications to the Department of Health increased by 22% to 251 cases. This rise pushed the influenza case numbers above the seasonal threshold for the first time in 2024.
While these respiratory diseases circulate among the community – vaccination rates are waning.
While 2024 influenza vaccination in pharmacies has slightly increased compared to this time last year (87,232 versus 83,326 for the week 9–16 June) – there has been a significant decrease since 2022, when vaccination rates reached a high of 181,202 in the same period.
To boost vaccination rates among older Australians – whether in the community or in residential aged care facilities (RACFs) – three community pharmacists shared their top tips with Australian Pharmacist.
How to overcome vaccination fatigue
According to community pharmacist Yves Cruz, based in the New South Wales South Coast town of Nowra, 2024 has been particularly challenging for COVID-19 vaccine uptake.
‘What I have experienced is that people think 3, 4 or 5 doses is enough for them,’ he said.
However, Mr Cruz thinks leveraging trusting relationships with patients can help to overcome hesitancy.
‘If the people trust their pharmacist, I find they are willing to get the vaccine – even if they have reservations,’ he said.
‘Through communication and providing [evidence-based] information, this can help to remove their doubts.’
Queensland-based pharmacist Alicia Slight has similarly encountered some resistance to COVID-19 boosters, which she promptly addresses with factual information.
‘I use the Australian Technical Advisory Group on Immunisation (ATAGI) table to help navigate the conversation, and also describe [COVID-19 booster doses] as akin to having a yearly flu vaccine,’ she said. ‘I win over [around] three quarters of the fence sitters with a straightforward explanation and by not being too pushy on the matter.’
How to Get involved in outreach programs
As of 13 June 2024, there were 4,147 active COVID-19 cases reported in 487 active outbreaks in RACFs across Australia.
But only 40.3% of those in RACFs had received a COVID-19 booster dose in the last 6 months.
National Immunisation Program vaccines can now be administered off-site in RACFs under NIPVIP. Mark Butler, federal Minister for Health and Aged Care, has strongly advised pharmacists to get involved in these programs.
Since 29 April 2024, pharmacists have also been able to receive funding to deliver National Immunisation Program vaccines to patients in RACFs. From next month (1 July) NIPVIP payments will also be indexed in line with Medicare Benefits Schedule indexation.
‘Community pharmacists play a vital role in our healthcare system – and they will play an even bigger role by administering free, lifesaving vaccines to eligible patients living in aged care homes and disability homes,’ he said.
Pharmacists should also be actively engaged with community outreach as this enhances the uptake of vaccinations, said Dr Brian Chia MPS, community pharmacist, lecturer in Pharmacy and Pharmacology at the University of South Australia and member of the South Australian PSA Early Career working group.
‘This is not limited to COVID-19 or influenza vaccinations, but the scope for many other vaccinations pharmacists can provide,’ he said.
How to promote co-administration
For Mr Chia, promoting co-administration is key to ensuring vulnerable older patients are protected against both influenza and COVID-19 this season.
[caption id="attachment_26579" align="alignright" width="318"] Dr Brian Chia MPS[/caption]
‘Whenever they come in for a COVID-19 vaccine, I usually ask them, “have you had your flu shot?”,’ he said.
‘A lot of patients are not aware that you can actually get the vaccines at the same time, and many of them say “if I can get them together, it will make my life so much more convenient”.’
Mr Cruz takes the opportunity to discuss influenza and COVID-19 vaccines when patients come in for a Shingrix vaccine – which is highly sought after by older Australians in his community.
‘Once we talk about shingles vaccine, we open up about the importance of flu and COVID-19 vaccines,’ he said. ‘Most of the time, this is successful. The majority of our loyal customers aged 65 years and over have received the COVID-19, influenza and shingles vaccines, and now we're starting to give the pneumococcal vaccine.’
How to leverage pharmacy’s accessibility
Community pharmacies are one of the most accessible vaccine providers around. But not all patients are aware of what vaccinations pharmacists can provide, and how simple the process is.
‘I had a patient who came in with a prescription for Boostrix and Vaxigrip Tetra,’ said Mr Chia.
‘I told a patient, “do you know you can actually walk in, we can provide you with these vaccinations? And it doesn't take more than 15 minutes.’
For Ms Slight, offering both appointments and walk-in vaccinations is a key driver for increasing uptake of influenza vaccines.
‘We also offer vaccination to patients when they hand in and pick up prescriptions – providing a constant reminder of our service [leads to] so many happy to get vaccinated then and there,’ she said.
During any vaccination, Ms Slight also shows patients their Australian Immunisation Register to highlight any upcoming or outstanding vaccinations, such as COVID-19, pneumococcal, DTPa or shingles.
‘I then arrange for those vaccinations to be administered – either on the same day or with an appropriate interval – depending on what needs to be done,’ she said. ‘Very rarely do I get resistance to this process.’
[post_title] => Vaccination rates wane as COVID-19 and influenza cases ramp up
[post_excerpt] => Vaccination rates are rapidly slipping in vulnerable older Australians. Three pharmacists share their advice for turning this around.
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[post_content] => NSW Health has issued an alert following a stream of newborn and infant presentations with symptoms of anticholinergic syndrome.
Colic preparations containing the toxic belladonna plant are the suspected culprit.
Other jurisdictions have reported similar incidents, with Queensland Health also issuing an alert after two infants presented to a Brisbane metropolitan hospital with suspected belladonna toxicity.
So what do pharmacists need to look out for? Australian Pharmacist delves into the signs and symptoms of colic, the recommended treatment options, how anticholinergic syndrome manifests and advice for struggling parents.
How, and when, does colic present?
Colic is defined as repeated, unexplained, inconsolable episodes of crying that persist for more than 3 hours per day, with parents unable to comfort their children.
The crying typically onsets suddenly at a similar time each day – more frequently occurring in the afternoons or evenings.
Other symptoms can include:
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[post_content] => James Buckley MPS, fitness fanatic and partner at LiveLife Pharmacy Port Douglas, is full speed into the expanded Queensland prescribing pilot.
My high school chemistry teacher told me, ‘James, choose something you like, and something you’re good at’. I was good at chemistry at school and loved helping people, so why not do both? Pharmacy to me is about helping people understand their health through teaching them about their medicines. It’s rewarding to now formally prescribe S4 medicines, alongside existing scope of Schedule 2 and 3 medicines and lifestyle advice that will improve their health.
Tell us about prescribing under the Queensland Community Pharmacy Scope of Practice Pilot?
The pilot program gives pharmacists the ability to prescribe appropriate medicines for the patient’s condition as per the therapeutic guidelines, in many cases to suit the individual.
The structured protocols allow pharmacists to identify red flag and referral triggers for the patient and for us to practice safely and effectively.
Consult times allow for discussions between patient and pharmacist with the opportunity for all stages of the prescribing cycle. This includes information gathering, examination, therapeutic discussions, management and patient communication.
How does the service work?
When a patient presents to the pharmacy with symptoms, I take a brief history and offer a consultation.
During the consult, I take a detailed history including back-ground information, medical conditions, medicines and social history. Red flags for the patient’s condition are ruled out as part of the diagnostic framework, and appropriate physical examinations are conducted.
This can include taking vitals such as blood pressure, temperature and blood glucose levels and conducting an ear, nose, throat examination.
All the information is assessed and an appropriate treatment plan is agreed upon by both parties. This can include pharmacological or non-pharmacological treatment, lifestyle advice and preventative treatment, or a referral if warranted.
The patient is then reviewed for an appropriate follow-up date. After seeing patients for holistic care consults, there has been no apprehension to pay for the services.
For patients who are ineligible to participate or are price conscious, this feedback is also transmitted through the software as missed opportunities to provide health care to patients in need.
Introducing patients to the service?
Our pharmacists and staff are on the frontline explaining our services to patients at every opportunity. Our assistants are trained to refer any patient who presents with ear pain (among other conditions) to the pharmacist, resulting in an instant consultation. We also have a great relationship with the local GP clinic and hospital, so they refer patients to our trained pharmacists. Patients are often ecstatic, thrilled and relieved that we offer the service. They trust our knowledge and medicine expertise, and have no problems discussing their health with the prescribing pharmacist. We see people every day who are unable to see the doctor for weeks, and are desperate for our assistance.
What have you prescribed so far?
Within the first week I successfully reviewed patients and prescribed a course of antibiotic ear drops for an international patient who came to Australia to see the Great Barrier Reef and subsequently contracted an outer ear infection while diving. I also saw a concerned mother who presented with her child who had contracted a case of impetigo on the knee from school and could not see a doctor for 3 weeks. I was able to prescribe antibiotic ointment and oral antibiotics to treat the infection.
Advice for other ECPs?
Pharmacy is a constantly expanding and rewarding career. Find what you enjoy most and work hard to make your mark on the profession. I’ve always wanted to be a pharmacy owner, be the cornerstone of a community and provide exceptional services to people in need.
Find like-minded people and mentors who believe in you. I want to thank my mentors from LiveLife Pharmacy and PSA. I would not be here without them.
A day in the life of James Buckley MPS, Pharmacy Partner, LiveLife Pharmacy, Port Douglas, QLD
| 5.00 am |
Get up and moving Start the day with a HIIT class. Let’s do this! |
| 8.00 am |
First things first Open the pharmacy, review bookings – online orders, pharmacist consult bookings for COVID-19 and other vaccines. Our ear clinic for diving, flying and swimming infections from reef-based activities is constantly busy. All staff are trained to triage. We conduct multiple ear checks a day (10 is my daily record), especially on weekends when doctors are closed. |
| 9.00 am |
Vaccination clinic starts Administer shingles vaccine to a local couple. Other vaccines are booked online. All flu shots are free for Queensland residents and anyone aged 65+ is NIP-funded. |
| 11.00 am |
Oral contraceptive pill Miss Y needs to renew her contraceptive pill repeats that were misplaced. She was assessed and I was able to prescribe her regular medication. |
| 2.00 pm |
Prescribing time Miss P, aged 6, presents to the pharmacy with ear pain. She has been swimming a lot on her holiday and an examination is required. No red flags are present and she can safely be prescribed antibiotic ear drops. |
| 3.00 pm |
Touch base with staff Catch up with the team, which can be anything from helping with orders, professional development, staff training and upskilling on pharmacist consults or inducting new staff. On-the-floor quiz and teaching sessions with interns can include reviews of work in non-prescription areas, which for us is commonly bites and stings from mozzies and jellyfish and sunscreen uses for sunburn and (constant) heat rash. |
| 5.00 pm |
Winding down Instruct staff to finish, tidy dispensary, scan scripts, and get ready for the next day. |
| 6.00-9.00 pm | Home time Catch up with the ECP Community of Specialty Interest (CSI). Watch Netflix. Bed. |
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[post_content] => Mid-winter will be a busy time of year for pharmacists, with a range of practice, fee and career pathway updates kicking off on 1 July 2024.
Australian Pharmacist takes a look at the changes pharmacists will experience from next week.
1. Vaping ban comes into effect
The third tranche of vaping reform included in the Therapeutic Goods and other Legislation (Vaping Reforms) Bill 2024 will see all vape sales banned from general retailers from 1 July. Passing through the Senate this morning, the Bill limits the supply of all vapes strictly to community pharmacies from Monday.
These vaping products must adhere to quality and product standards including:
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[post_content] => Rabies causes an estimated 59,000 deaths annually, with almost half (40%) deaths occurring in children under 15. But underreporting could mean this death rate is much higher.
Post COVID-19, there has been an increase in rabies cases – with the abandonment of pets and a reduction in human-dog interaction leading to heightened aggression in dogs – who are responsible for most human rabies cases. Rabies hotspots include Asia, Africa and India, but 150 countries are considered high-risk rabies territories.
As we approach the winter school holidays and Australians escape the cold by heading overseas, pharmacists in New South Wales can now protect patients against the disease.
PSA advocacy was the key driver for the change to the NSW Pharmacist Vaccination Standards to allow pharmacists to administer the rabies vaccine, with the NSW Branch Committee working closely with the Ministry of Health to drive the change, said PSA NSW State Manager Amanda Fairjones MPS.
[caption id="attachment_25121" align="alignright" width="298"] PSA NSW branch State Manager Amanda Fairjones MPS[/caption]
‘When undertaking travel health consultations, our members told us that it was the most common travel vaccine they were referring people back to their GP for,’ she said. ‘People were asking for it but we were unable to provide it.’
Having the vaccine available provides a great opportunity for pharmacists to sit down and have a chat to people about their travel vaccination needs, said Karen Carter FPS, Partner of Carter's Pharmacy Gunnedah and Owner Narrabri Pharmacy Narrabri in north-west NSW.
‘Because of the regime with some vaccines, we need to have them all done on one day or a week apart,’ she said. ‘ Now we can organise a vaccine regime to be completed at the pharmacy, rather than having to send patients back to their GP for part of it.’
Who is the vaccine indicated for?
Under the NSW Pharmacist Vaccination Standards, pharmacists can administer the rabies vaccine for pre-exposure prophylaxis treatment via intramuscular injection to people 5 years and over who are not immunocompromised.
‘When undertaking travel health consultations, our members told us that it was the most common travel vaccine they were referring people back to their GP for. People were asking for it but we were unable to provide it.'
amanda fairjones MPS
The Australian Immunisation Handbook (AIH), recommends pre-exposure rabies vaccine for:
Karen Carter FPS[/caption]
Post-exposure prophylaxis includes wound management, administration of rabies vaccine doses and human rabies immunoglobulin, taking into account:
If a prescriber writes a prescription for a vaccine – including the rabies vaccine – pharmacists are able to administer it in all states and territories other than Tasmania and South Australia.
However, in the case of the rabies vaccine, in Tasmania, authorised pharmacist immunisers can administer the rabies vaccine when prescribed by a medical or nurse practitioner.
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As winter kicked off, Australia was hit by a massive COVID-19 wave – fuelled by the new Omicron FLiRT subvariant.
There have been 93,049 cases of COVID-19 reported since April 2024. Case numbers are highest among those most at risk, with notifications peaking in the 75–79 (6,655), 80–84 (6,524) and 85+ (12,607) age brackets.
However, with limited testing and reporting COVID-19 cases, this figure does not tell the full story.
‘We’re looking at six to 10 times as many people actually infected as the case numbers are showing,’ said Professor Adrian Esterman, chair of biostatistics and epidemiology at the University of South Australia.
At the same time, reported influenza cases are also increasing. During the first week of June, influenza notifications to the Department of Health increased by 22% to 251 cases. This rise pushed the influenza case numbers above the seasonal threshold for the first time in 2024.
While these respiratory diseases circulate among the community – vaccination rates are waning.
While 2024 influenza vaccination in pharmacies has slightly increased compared to this time last year (87,232 versus 83,326 for the week 9–16 June) – there has been a significant decrease since 2022, when vaccination rates reached a high of 181,202 in the same period.
To boost vaccination rates among older Australians – whether in the community or in residential aged care facilities (RACFs) – three community pharmacists shared their top tips with Australian Pharmacist.
How to overcome vaccination fatigue
According to community pharmacist Yves Cruz, based in the New South Wales South Coast town of Nowra, 2024 has been particularly challenging for COVID-19 vaccine uptake.
‘What I have experienced is that people think 3, 4 or 5 doses is enough for them,’ he said.
However, Mr Cruz thinks leveraging trusting relationships with patients can help to overcome hesitancy.
‘If the people trust their pharmacist, I find they are willing to get the vaccine – even if they have reservations,’ he said.
‘Through communication and providing [evidence-based] information, this can help to remove their doubts.’
Queensland-based pharmacist Alicia Slight has similarly encountered some resistance to COVID-19 boosters, which she promptly addresses with factual information.
‘I use the Australian Technical Advisory Group on Immunisation (ATAGI) table to help navigate the conversation, and also describe [COVID-19 booster doses] as akin to having a yearly flu vaccine,’ she said. ‘I win over [around] three quarters of the fence sitters with a straightforward explanation and by not being too pushy on the matter.’
How to Get involved in outreach programs
As of 13 June 2024, there were 4,147 active COVID-19 cases reported in 487 active outbreaks in RACFs across Australia.
But only 40.3% of those in RACFs had received a COVID-19 booster dose in the last 6 months.
National Immunisation Program vaccines can now be administered off-site in RACFs under NIPVIP. Mark Butler, federal Minister for Health and Aged Care, has strongly advised pharmacists to get involved in these programs.
Since 29 April 2024, pharmacists have also been able to receive funding to deliver National Immunisation Program vaccines to patients in RACFs. From next month (1 July) NIPVIP payments will also be indexed in line with Medicare Benefits Schedule indexation.
‘Community pharmacists play a vital role in our healthcare system – and they will play an even bigger role by administering free, lifesaving vaccines to eligible patients living in aged care homes and disability homes,’ he said.
Pharmacists should also be actively engaged with community outreach as this enhances the uptake of vaccinations, said Dr Brian Chia MPS, community pharmacist, lecturer in Pharmacy and Pharmacology at the University of South Australia and member of the South Australian PSA Early Career working group.
‘This is not limited to COVID-19 or influenza vaccinations, but the scope for many other vaccinations pharmacists can provide,’ he said.
How to promote co-administration
For Mr Chia, promoting co-administration is key to ensuring vulnerable older patients are protected against both influenza and COVID-19 this season.
[caption id="attachment_26579" align="alignright" width="318"] Dr Brian Chia MPS[/caption]
‘Whenever they come in for a COVID-19 vaccine, I usually ask them, “have you had your flu shot?”,’ he said.
‘A lot of patients are not aware that you can actually get the vaccines at the same time, and many of them say “if I can get them together, it will make my life so much more convenient”.’
Mr Cruz takes the opportunity to discuss influenza and COVID-19 vaccines when patients come in for a Shingrix vaccine – which is highly sought after by older Australians in his community.
‘Once we talk about shingles vaccine, we open up about the importance of flu and COVID-19 vaccines,’ he said. ‘Most of the time, this is successful. The majority of our loyal customers aged 65 years and over have received the COVID-19, influenza and shingles vaccines, and now we're starting to give the pneumococcal vaccine.’
How to leverage pharmacy’s accessibility
Community pharmacies are one of the most accessible vaccine providers around. But not all patients are aware of what vaccinations pharmacists can provide, and how simple the process is.
‘I had a patient who came in with a prescription for Boostrix and Vaxigrip Tetra,’ said Mr Chia.
‘I told a patient, “do you know you can actually walk in, we can provide you with these vaccinations? And it doesn't take more than 15 minutes.’
For Ms Slight, offering both appointments and walk-in vaccinations is a key driver for increasing uptake of influenza vaccines.
‘We also offer vaccination to patients when they hand in and pick up prescriptions – providing a constant reminder of our service [leads to] so many happy to get vaccinated then and there,’ she said.
During any vaccination, Ms Slight also shows patients their Australian Immunisation Register to highlight any upcoming or outstanding vaccinations, such as COVID-19, pneumococcal, DTPa or shingles.
‘I then arrange for those vaccinations to be administered – either on the same day or with an appropriate interval – depending on what needs to be done,’ she said. ‘Very rarely do I get resistance to this process.’
[post_title] => Vaccination rates wane as COVID-19 and influenza cases ramp up
[post_excerpt] => Vaccination rates are rapidly slipping in vulnerable older Australians. Three pharmacists share their advice for turning this around.
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[title_attribute] => Vaccination rates wane as COVID-19 and influenza cases ramp up
[title] => Vaccination rates wane as COVID-19 and influenza cases ramp up
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[post_content] => NSW Health has issued an alert following a stream of newborn and infant presentations with symptoms of anticholinergic syndrome.
Colic preparations containing the toxic belladonna plant are the suspected culprit.
Other jurisdictions have reported similar incidents, with Queensland Health also issuing an alert after two infants presented to a Brisbane metropolitan hospital with suspected belladonna toxicity.
So what do pharmacists need to look out for? Australian Pharmacist delves into the signs and symptoms of colic, the recommended treatment options, how anticholinergic syndrome manifests and advice for struggling parents.
How, and when, does colic present?
Colic is defined as repeated, unexplained, inconsolable episodes of crying that persist for more than 3 hours per day, with parents unable to comfort their children.
The crying typically onsets suddenly at a similar time each day – more frequently occurring in the afternoons or evenings.
Other symptoms can include:
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Australian Pharmacist is the official journal for Pharmaceutical Society of Australia Ltd.
