7 March 2022

UTI pilot needs proper evaluation: petition

Pharmacy

Queensland’s existing pharmacist-prescribing pilot program is under new scrutiny since the ‘Scope of Practice’ proposal became public.


Opponents of a pilot in which pharmacists can diagnose and prescribe for urinary tract infections are calling on the state government to provide a publicly available, “full and transparent evaluation” of the program.

The Urinary Tract Infection Pharmacy Pilot – Queensland (UTIPP-Q) – which commenced in June 2020 and has been extended to 30 June 2022 – allows trained community pharmacists to provide “appropriate treatment for uncomplicated urinary tract infections”, according to the Pharmacy Guild’s Queensland branch.

While convenient access to a healthcare professional for women experiencing the symptoms of a UTI is widely acknowledged as a benefit, petitioners have grave concerns about how patient outcomes are being evaluated.

The petition from James Lake of Kuranda, Queensland, which had over 1100 signatures at the time of writing, calls for a thorough evaluation of the UTI program to be conducted and made public. This should include at minimum:

  • the number and percentage of GP presentations that occurred following a consultation with a pharmacist but where symptoms remained unresolved
  • the number and percentage of emergency department presentations that occurred following a consultation with a pharmacist but where symptoms remained unresolved
  • the number and percentage of patients for whom the pharmacist declined to make a formal diagnosis and referred the patient to a GP, ED or other health care facility
  • the number of patients provided treatment for a UTI that were subsequently discovered to have been misdiagnosed
  • the average cost to the patient of the consultation and treatment provided by the pharmacists and a comparative analysis of the costs associated with a GP presentation
  • the average income generated by the pharmacists in relation to each patient presentation
  • the number of patients who presented on more than one occasion to a pharmacist for the same episode.

The extension of the UTI program to the end of June is “a definitive commitment to the advancement of women’s healthcare in the state”, according to the Pharmacy Guild.

“The extension of the pilot gives women affected by an uncomplicated UTI access to early, convenient and effective treatment from their participating local community pharmacy,” Chris Owen, president of the guild’s Queensland branch, said in a statement.

“Access to timely and appropriate medical treatment can be difficult for many Queensland women. The quicker a UTI can be diagnosed and treated, or referred to another healthcare provider, if necessary, the less likely the patient is to experience further complications that may result in hospitalisation.”

However, the Guild’s view is not shared by Queensland GP, Dr Stephanie Dawson-Smith, who raised similar concerns last month in a separate petition opposing the controversial North Queensland Pharmacy Scope of Practice Trial.

“Unfortunately, the success of [the UTI] pilot has been based on how much patients liked being able to access antibiotics for a possible UTI without seeing a doctor,” she wrote on change.org, “rather than on appropriate clinical outcome measures like assessing whether any of the treated women actually had a UTI and how many in fact had non-UTI urogenital infections (e.g. genital chlamydia), interstitial cystitis or other serious pelvic pathology.”

The UTI petition, which can be viewed on the Queensland Parliament website, remains open until 30 April 2022.