Amitriptyline for Irritable Bowel Syndrome
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[post_content] => The gap between evidence and everyday practice is impacting patient access to emergency contraception.
Community pharmacies are often the first – and sometimes only – point of access for emergency contraception in Australia.
But a new qualitative study found there are still persistent gaps between what the guidelines say and what happens in practice.
Ruth Nona, pharmacist and researcher at James Cook University, who interviewed community pharmacists about providing emergency contraception services, describes a workforce that is broadly willing to help, but not always set up to deliver consistently equitable care.
1. Not recommending ulipristal as first-line
One of the most significant gaps identified in the study was the tendency for pharmacists to default to levonorgestrel, despite guidance in the Australian Pharmaceutical Formulary and Handbook (APF) that ulipristal acetate is generally considered more effective than levonorgestrel and can be used up to 120 hours after unprotected intercourse.
‘Habit definitely plays a role,’ Ms Nona said. ‘Some pharmacists felt more comfortable and confident supplying levonorgestrel. For example, if someone requested emergency contraception within 24 hours, pharmacists felt levonorgestrel was acceptable within that timeframe, without fully considering efficacy.’
[caption id="attachment_31329" align="alignright" width="250"]
Ruth Nona[/caption]
In some pharmacies, price differences influenced whether ulipristal acetate was presented as an option.
‘In certain socio-economic areas, cost was a driver,’ Ms Nona said. ‘Cost considerations were also sometimes linked to younger people coming in and asking whether there was a cheaper option.’
Sometimes, levonorgestrel was the only medicine on hand.
‘There was research that came out showing that some pharmacies still did not stock ulipristal acetate,’ she said. ‘It’s been an ongoing issue, and something that really needs to be addressed.’
However, patients need to be able to make an informed decision about which medicine to take.
‘As stated in the guidelines, it’s about making sure all patients are given the information they need to make an informed and equitable choice. If the patient wants a particular option, that’s fine, but they need to be able to make that decision with the full information,’ Ms Nona said.
‘When pharmacists did give the full picture and explained the differences, more often than not the patient chose ulipristal acetate, even though it cost more.’
‘If the patient wants a particular option, that’s fine, but they need to be able to make that decision with the full information.'
Ruth nona
2. Uncertainty when responding to third-party requests
Pharmacists reported particular uncertainty when providing emergency contraception to third parties, with many wary about consent and unsure whether they could provide it to someone who wasn’t the patient.
‘In most cases, they would follow up and ask to contact the patient directly,’ Ms Nona said. ‘It wasn’t that they didn’t want to provide it – they just felt unsure and they wanted to make sure that the patient had consented.’
While in many cases, speaking to the intended person directly can help provide key information and counselling, in circumstances where this is not possible, it is usually possible to determine the medicine is safe and therapeutically appropriate, and supply in a manner consistent with APF guidance and legal obligations.
3. Uncertainty providing emergency contraception to adolescents
Similarly, pharmacists were ‘uncomfortable’ providing the service to adolescents.
This uncertainty often centred on fear of making the wrong decision or facing professional consequences.
‘They still wanted to provide the service, but it was more that internal question of, “Should I do this? Am I going to get in trouble?”’
There are no jurisdictions where there’s a legal restriction from supplying emergency contraception to minors. The APF guidance helps pharmacists navigate Gillick competency and consent in adolescents, ensuring they demonstrate sufficient maturity and understanding to provide informed consent.
Ms Nona emphasised that the issue was confidence, not capability.
‘It’s about being familiar with the guidelines, making sure we’re as up to date as possible and realising that it’s okay for us to provide these services, provided the adolescent is [assessed as Gillick competent] mentally mature and safe,’ she said.
The APF references Gillick competency provided the adolescent is [assessed as Gillick competent (demonstrating sufficient maturity and understanding to provide informed consent)]
4. Uncertainty for transgender people on gender affirming hormone therapy
While pharmacists were generally supportive towards transgender and gender-diverse patients, lack of familiarity with hormone therapy raised hesitation.
‘There are absolutely no interactions between emergency contraception and gender-affirming hormones’ Ms Nona said. ‘It really comes down to knowledge, which builds confidence, and being up to date to make sure the service we provide is timely and equitable.’
In some areas, pharmacists may frequently encounter transgender and gender- diverse patients requesting emergency contraception, while pharmacists in other areas do not.
‘That’s why it’s also about being prepared. You never know when that situation might arise,’ she added.
Should pharmacists feel unsure during these consultations, pharmacists can and should engage with the APF.
‘Pharmacists did say that if that situation did occur with a transgender or gender- diverse person that they would be honest and say to them, “Do you mind if I consult my resources?”’
Another reason the APF is a mandatory text for all community pharmacists
Despite lack of guideline use, pharmacists acknowledged how essential guidelines
such as the APF are, Ms Nona said.
‘And when pharmacists did use them, they found the information provided was invaluable.’
‘[But] a lot of the challenges stemmed from lack of time and, in some cases, a lack of up-to-date knowledge. We have so many things to do, and we need more time to do everything and to keep ourselves up to date.’
For Ms Nona, the solution lies in supporting pharmacists to use guidelines confidently and consistently in real-world conditions.
Some pharmacists report to PSA that they will often bring up the APF digital on the screen in the consultation room in emergency contraception discussions, particularly in situations which are new or unfamiliar.
Delivering a critical intervention
The key to emergency contraception provision is recognising the stakes.
‘The whole picture of providing emergency contraception is to make sure we are preventing pregnancies when people don't want to get pregnant – whatever the reason may be,’ Ms Nona said. ‘That’s why they come to see a pharmacist – to ensure the person has the best possible chance of preventing an unintended pregnancy.’
When pharmacists are supported to provide full information and informed choice, patients respond accordingly.
The Australian Pharmaceutical Formulary and Handbook (APF) chapter on ‘Emergency Contraception’, provides essential guidance on:
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[post_content] => Rapidly evolving scope of practice means that traditional community pharmacy workflows need review. What works (and what doesn’t)?
The range of professional services delivered by community pharmacists has expanded rapidly in recent years, from vaccination to UTI prescribing and beyond. As
these services increase in popularity, they are shifting from ancillary service to core business.
This widening scope is forcing community pharmacies to review how they conduct their business and the way front-of-house staff interact with patients.
No longer is dispensing prescriptions on a first come, first served basis sustainable. With adjustments to workflow, vaccinations and other booked services have been prioritised and run simultaneously, says Queensland-based prescribing pharmacist Kate Gunthorpe MPS.
‘We are moving away from the mindset that dispensing always comes first. We need to triage effectively and manage expectations, so every patient feels seen and cared for,’ she says.
And it isn’t just about sequential processes. Workflow changes also require a shift of communication approaches and pre-existing mindsets around professional service provision.
‘The biggest pitfall I’ve discovered is apologising for charging or determining that the consultation wasn’t worth charging for,’ Ms Gunthorpe says. ‘That instantly undermines the service’s value. Every consultation, whether the outcome is a prescription, advice or reassurance, involves clinical reasoning, professional judgement and patient care.’
So, how should the profession move forward? The PSA’s foundation documents are clear that all services must remain patient-centric.
That means redesigning workflows on the floor, developing new communication strategies for staff and providing additional training for pharmacy assistants to ensure a consistent, professional patient experience.
AP spoke with Ms Gunthorpe and pharmacy assistant Madison Low about adapting workflow to integrate services without disrupting dispensing. product or medicines transaction. I now explain that I will assess their presentation, then create a unique shared management plan for them – which may or may not involve a prescription. Setting that expectation upfront helps enormously.
Case 1 Kate Gunthorpe MPS
Pharmacist prescriber, Implementation and Change Specialist, TerryWhite Chemmart, Samford, Queensland
[caption id="attachment_31312" align="alignright" width="185"]
Kate Gunthorpe MPS[/caption]
Our team started by mapping our busiest times to understand where bottlenecks occurred. We then built clear workflows – for example, using a booking system for consultations where possible, and ensuring at least one pharmacist remained consult-focused during every day.
We trained our assistants to triage appropriately and use consistent language, such as ‘the pharmacist will see you shortly for your consultation’, which helped the process feel deliberate rather than disruptive. Once the team understood that consultations were core services, not interruptions, the process flowed more smoothly.
Patients often expect a prescription outcome from a consultation, so I changed the framework, ensuring the consultation became a clinical one, not a product or medicines transaction. I now explain that I will assess their presentation, then create a unique shared management plan for them – which may or may not involve a prescription. Setting that expectation upfront helps enormously.
When we changed our front-of-shop language, patients stopped viewing consultations as waiting in a queue. That one shift in language lifted the professionalism of the whole process; patients were more patient, staff felt more confident explaining the service, and we saw an improvement in how people valued the pharmacist’s time.
One thing I would advise other pharmacists about charging appropriately for their time, even when the consultation doesn’t end with a script, is to start valuing their expertise. The consultation is the service, not the outcome. We’re expertly trained to assess, diagnose and provide evidence-based care. That deserves to be remunerated. Once pharmacists stop apologising and start consistently charging for their time and expertise, patients begin to respect that boundary too.
I find it is better to be transparent and consistent with pricing. I explain what’s included in the consultation, so patients understand what they’re paying for. Most importantly, I believe in it myself. If you hesitate to charge, your team and patients will pick up on that.
The work floor also needs redesigning to normalise consulting services as part of everyday care. It starts with the physical layout and staffing models. Pharmacies should expect consultations to happen and allocate dedicated private spaces, clear booking systems and enough pharmacist coverage, so that one can focus on clinical care, while others oversee dispensing and other services. Culturally, it’s all been about mindset: we stopped treating services as extra and started treating them as central to what we do.
That meant redistributing roles, upskilling support staff with more autonomy to triage and manage appointments, and introducing appointment blocks.
The effect of all these new processes has resulted in major change. Our pharmacy assistants are our front line, and their language is setting the tone for the entire patient experience. We have invested time in scripting and role-playing, so that the assistants feel comfortable discussing new services. The staff have learned to understand what each service involves, how long it typically takes, and when to book or triage patients.
Scripts no longer automatically take priority over walk-up service requests. They are both core services. Pharmacies are healthcare hubs where patients can expect to have a prescription filled but also be able to discuss their health concerns.
Patients also value honesty and clarity. If a medication is not appropriate, explaining why builds understanding and trust – especially when you provide alternative options or safety net advice.
Because pharmacy staff use consistent, confident language and understand the workflow, everything runs much more smoothly. It has also empowered the staff to take pride in being responsible for a part of the patient care process, not just the retail side.
When staff describe services as core health care, not as ‘extras’ or ‘add-ons’, patients have started to see the pharmacist as a clinician involved in their primary care.
It’s a subtle but powerful mindset shift that’s transforming how the pharmacy is perceived.
Case 2 Madison Low
Retail manager, TerryWhite Chemmart, Arana Hills, Queensland
[caption id="attachment_31313" align="alignright" width="277"]
Madison Low[/caption]
Since we started offering services like UTI consultations and vaccinations, my role has expanded significantly. We no longer just provide products; we’re delivering a more complete healthcare solution.
A person recently came to the counter, visibly frustrated because they had symptoms of a urinary tract infection but couldn’t get in to see their doctor. They were holding a box of Ural.
Rather than just selling them the product, I suggested they talk to the pharmacist, assuring them that in many cases the pharmacist can provide a full treatment without needing a doctor’s visit.
I asked a few questions about their symptoms, then checked with the pharmacist to confirm a consultation was possible immediately. It was, and not long afterwards the patient went away happy.
Asthma management is one of the most common chronic conditions we see. Many patients believe they understand how to manage the condition, especially because they can access inhalers over the counter. But often that’s not the case. One of my roles is to let patients know there may be better solutions. Our pharmacists can review their current treatment and provide an improved management plan.
Since becoming more mindful of the language I use with patients, I’ve noticed a positive change in how they respond to me.
By communicating in a more empathetic and approachable way, I’ve found patients are more comfortable asking questions and discussing their concerns. This has made it easier to identify when a patient might benefit from a review with one of our pharmacists.
This change in language has also strengthened trust between patients and the pharmacy team. Patients seem more engaged and confident in the care they receive, and I feel more confident in my role as a link between them and our pharmacists.
The biggest challenge has been balancing our time – especially during busy periods like the flu season, when there are lots of vaccines to administer, prescriptions to dispense and consultations to organise. I’m proud of how our team works together to ensure our patients are looked after promptly and get the attention they need.
[post_title] => How expanded scope is redefining pharmacy practice
[post_excerpt] => Rapidly evolving scope of practice means that traditional community pharmacy workflows need review. What works (and what doesn’t)?
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[title] => How expanded scope is redefining pharmacy practice
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[post_content] => Case scenario
Alicia, 27, visits your pharmacy regularly for naproxen and heat patches to manage period pain. She confides that her pain has worsened over the past 2 years, radiates down her legs, interferes with work and affects intimacy.
Her periods are heavy, lasting around 9 days, and leave her feeling exhausted and sometimes even bedridden. Alicia has seen several GPs, who told her it was ‘normal for your age’. She says, ‘It feels like someone’s wringing out my insides – nothing helps much. Is this really normal?’
Learning objectivesAfter reading this article, pharmacists should be able to:
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References: Therapeutic Guidelines1, Buggio et al12, Rossi13 Hornstein26, Vercellini27
Note: Bone mineral density typically recovers within two years of cessation of GnRH therapies.27
Drospirenone currently off-label for endometriosis in Australia.1
The addition of Ryeqo (relugolix, estradiol, norethisterone) (July 2022) and Visanne (dienogest) (December 2024) to the PBS expands accessible hormonal therapy options for endometriosis.29
Case scenario continuedYou reassure Alicia that severe period pain is not something she has to accept and suggest tracking her symptoms with a menstrual diary and consulting a women’s health GP. You also provide advice on safe NSAID use and non-pharmacological strategies. Alicia returns 2 months later, now diagnosed with endometriosis and receiving hormonal therapy and pelvic physiotherapy. She continues to experience chronic pelvic pain and questions her medicines, so you organise a Home Medicines Review, identifying potential naproxen overuse and interactions with her sertraline, prompting treatment adjustments. You also recommend a local endometriosis support group, which Alicia joins, and she has since referred two friends with similar symptoms. Through ongoing support, she feels more empowered to manage her condition. |
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[post_content] => New Pharmaceutical Benefits Advisory Committee (PBAC) recommendations could significantly change who can access funded COVID-19 and RSV vaccines.
At its December 2025 meeting, PBAC considered applications for funding COVID-19 vaccines and RSV vaccines on the National Immunisation Program (NIP). While both recommendations were positive, how would they apply in practice?
Smaller cohort recommended for COVID-19 vaccine eligibility
PBAC recommended significantly tighter eligibility criteria for COVID-19 vaccines going forward.
The National COVID-19 Vaccination Program – including the community pharmacy program is scheduled to end on 30 June 2026. While no announcements have yet been made, the PBAC outcomes signal COVID-19 vaccination will be incorporated into the NIP. PBAC recommendation is an important step to enable this NIP listing.
PBAC considered a proposal to fund Pfizer’s Comirnaty COVID-19 vaccines in a smaller population cohort. The proposal has been supported by PBAC, recommending NIP funding for four cohorts of adults as requested by Pfizer, the product sponsor.
Who would be eligible for funded COVID-19 vaccination?
For current and future Comirnaty COVID-19 vaccines, PBAC’s recommendation supports NIP funding in specific age and risk groups only.
Under this framework, NIP-funded doses would only be available for patients who are:
There’s no clear timeframe. PBAC recommendations for vaccines require price negotiation, government approval, procurement and regulatory listing to become funded on the NIP.
Given the expiry of COVID-19 immunisation program funding, 1 July 2026 could be a potential implementation date for the COVID-19 NIP funding. Current COVID-19 vaccine program eligibility is based on ATAGI advice, so changes could happen at any time ATAGI chooses to provide updated advice.
And as for patients asking when the RSV vaccine may be funded on the NIP? They probably could be encouraged to keep their eye on the TV news for any future announcements!
Upskill in vaccination administration and legislation by visiting the PSA Vaccination (immunisation) Education Hub. [post_title] => PBAC recommends new NIP adult vaccine listings [post_excerpt] => [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => pbac-recommends-new-nip-adult-vaccine-listings [to_ping] => [pinged] => [post_modified] => 2026-02-04 15:42:54 [post_modified_gmt] => 2026-02-04 04:42:54 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=31280 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => PBAC recommends new NIP adult vaccine listings [title] => PBAC recommends new NIP adult vaccine listings [href] => https://www.australianpharmacist.com.au/pbac-recommends-new-nip-adult-vaccine-listings/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 31282 [authorType] => )
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[post_content] => Genevieve Adamo MPS did not set out to work in poisons information. After beginning her career in community pharmacy as an assistant pharmacist and progressing into management, Ms Adamo joined the New South Wales Poisons Information Centre in 2004.
‘I sort of fell into poisons,’ she said. ‘After having a few children, I had some time off and wanted to do something where I was learning again.’
Each call is different, providing a continuous learning opportunity, said Ms Adamo, who took on a role with the National Poisons Register in 2023.
‘You don’t know what you’re going to get at the end of the phone when you pick it up,’ she added.
Because so many of the calls to the poisons centre related to medicines poisoning, whether overdoses or errors, being a pharmacist is a distinct advantage.
‘We have really extensive knowledge of the drugs, as well as a really good base in physiology and pharmacology,’ Ms Adamo said.
[caption id="attachment_18818" align="aligncenter" width="600"]
Genevieve Adamo MPS (Image: Steve Christo Photography)[/caption]
Here, she outlines what’s needed to enter and flourish in the space, as told to delegates at PSA’s Voices of Pharmacy – Passion, Purpose and Possibility webinar, held on 26 November 2025.
Core skills for poisons information practice
Poisons information demands a distinct skill set, combining deep scientific knowledge with the ability to work confidently under pressure. Calls are often urgent, information may be incomplete and decisions must be made quickly.
‘Every call provides a clinical problem that you’ve got to solve. Many of which there’s no clear answer,’ Ms Adamo said. ‘And we can't always look something up in a reference [because] not everything is listed there.’
Because it’s neither ethical nor feasible to conduct controlled trials in poisoning, evidence gaps are common.
‘We can’t go and poison a whole lot of people to create clinical trials to find the answers for poisoning questions. We have to wait until these situations happen and then turn those into research themselves,’ she said. ‘So because of that, we often have to go back to basics, and use those pharmacology principles we learned way back in uni.’
This includes:
‘You’ve got to get all the history, work out what you know, look things up and provide advice all within about 5 minutes.' Genevieve Adamo MPS‘We all have the ability to be involved in research, because we're recruiting patients through our calls,’ Ms Adamo said. ‘Our staff also create new guidelines for education and training, supporting both external poisoning prevention initiatives and the ongoing training of new and existing staff.’ Another major function is toxicovigilance – the systematic monitoring of poisoning trends with a focus on prevention and risk reduction. ‘That can involve all sorts of things [including] media and education,’ she said. ‘There’s often a lot of number crunching as well, and then working with regulators to change the laws to restrict access, because we know that one of the best ways to minimise harm and exposures is to restrict access.’ A key scheduling change Ms Adamo and her team were involved in was the changes to paracetamol regulations that were ushered in early last year. ‘We were contracted by the TGA to collect extra information about all the paracetamol calls we got,’ Ms Adamo said. ‘Paracetamol calls are the most common call to the poison centre every year, and all of that information was collated by our Head of Research and our consultant toxicologists – with the report used as the basis for the proposed scheduling changes that occurred.’ Sometimes individual cases can lead to broader system change. ‘I was involved in a case with a mum whose little one got really sick, and it was eventually worked out that it was a chronic choline salicylate toxicity,’ she said. ‘She couldn’t believe she’d been giving this poison to her kid and didn’t realise it was poisonous, because she bought it from [a supermarket] and thought it must be safe.’ In response, Adamo submitted an application to reschedule choline salicylate to Schedule 2. ‘Now it has to have more labelling, and it can only be available in a pharmacy,’ she said. ‘Those are the really interesting and rewarding aspects of poisoning work.’ For pharmacists considering the field, Ms Adamo believes the appeal lies in its tangible public health impact – shaping national safety standards and preventing future harm, particularly among children. ‘You know the work you’re doing actually changes outcomes.’ Read PSA’s Medicine Safety: Child and adolescent care report to understand the key poisoning risks and how pharmacists can help mitigate them. [post_title] => How pharmacists can prepare for poisons information roles [post_excerpt] => Poisons information pharmacists turn individual calls into population-level insights that inform regulatory and scheduling decisions. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => how-pharmacists-can-prepare-for-poisons-information-roles [to_ping] => [pinged] => [post_modified] => 2026-02-02 18:25:34 [post_modified_gmt] => 2026-02-02 07:25:34 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=31254 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => How pharmacists can prepare for poisons information roles [title] => How pharmacists can prepare for poisons information roles [href] => https://www.australianpharmacist.com.au/how-pharmacists-can-prepare-for-poisons-information-roles/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 31258 [authorType] => )
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[post_content] => The gap between evidence and everyday practice is impacting patient access to emergency contraception.
Community pharmacies are often the first – and sometimes only – point of access for emergency contraception in Australia.
But a new qualitative study found there are still persistent gaps between what the guidelines say and what happens in practice.
Ruth Nona, pharmacist and researcher at James Cook University, who interviewed community pharmacists about providing emergency contraception services, describes a workforce that is broadly willing to help, but not always set up to deliver consistently equitable care.
1. Not recommending ulipristal as first-line
One of the most significant gaps identified in the study was the tendency for pharmacists to default to levonorgestrel, despite guidance in the Australian Pharmaceutical Formulary and Handbook (APF) that ulipristal acetate is generally considered more effective than levonorgestrel and can be used up to 120 hours after unprotected intercourse.
‘Habit definitely plays a role,’ Ms Nona said. ‘Some pharmacists felt more comfortable and confident supplying levonorgestrel. For example, if someone requested emergency contraception within 24 hours, pharmacists felt levonorgestrel was acceptable within that timeframe, without fully considering efficacy.’
[caption id="attachment_31329" align="alignright" width="250"] Ruth Nona[/caption]
In some pharmacies, price differences influenced whether ulipristal acetate was presented as an option.
‘In certain socio-economic areas, cost was a driver,’ Ms Nona said. ‘Cost considerations were also sometimes linked to younger people coming in and asking whether there was a cheaper option.’
Sometimes, levonorgestrel was the only medicine on hand.
‘There was research that came out showing that some pharmacies still did not stock ulipristal acetate,’ she said. ‘It’s been an ongoing issue, and something that really needs to be addressed.’
However, patients need to be able to make an informed decision about which medicine to take.
‘As stated in the guidelines, it’s about making sure all patients are given the information they need to make an informed and equitable choice. If the patient wants a particular option, that’s fine, but they need to be able to make that decision with the full information,’ Ms Nona said.
‘When pharmacists did give the full picture and explained the differences, more often than not the patient chose ulipristal acetate, even though it cost more.’
‘If the patient wants a particular option, that’s fine, but they need to be able to make that decision with the full information.'
Ruth nona
2. Uncertainty when responding to third-party requests
Pharmacists reported particular uncertainty when providing emergency contraception to third parties, with many wary about consent and unsure whether they could provide it to someone who wasn’t the patient.
‘In most cases, they would follow up and ask to contact the patient directly,’ Ms Nona said. ‘It wasn’t that they didn’t want to provide it – they just felt unsure and they wanted to make sure that the patient had consented.’
While in many cases, speaking to the intended person directly can help provide key information and counselling, in circumstances where this is not possible, it is usually possible to determine the medicine is safe and therapeutically appropriate, and supply in a manner consistent with APF guidance and legal obligations.
3. Uncertainty providing emergency contraception to adolescents
Similarly, pharmacists were ‘uncomfortable’ providing the service to adolescents.
This uncertainty often centred on fear of making the wrong decision or facing professional consequences.
‘They still wanted to provide the service, but it was more that internal question of, “Should I do this? Am I going to get in trouble?”’
There are no jurisdictions where there’s a legal restriction from supplying emergency contraception to minors. The APF guidance helps pharmacists navigate Gillick competency and consent in adolescents, ensuring they demonstrate sufficient maturity and understanding to provide informed consent.
Ms Nona emphasised that the issue was confidence, not capability.
‘It’s about being familiar with the guidelines, making sure we’re as up to date as possible and realising that it’s okay for us to provide these services, provided the adolescent is [assessed as Gillick competent] mentally mature and safe,’ she said.
The APF references Gillick competency provided the adolescent is [assessed as Gillick competent (demonstrating sufficient maturity and understanding to provide informed consent)]
4. Uncertainty for transgender people on gender affirming hormone therapy
While pharmacists were generally supportive towards transgender and gender-diverse patients, lack of familiarity with hormone therapy raised hesitation.
‘There are absolutely no interactions between emergency contraception and gender-affirming hormones’ Ms Nona said. ‘It really comes down to knowledge, which builds confidence, and being up to date to make sure the service we provide is timely and equitable.’
In some areas, pharmacists may frequently encounter transgender and gender- diverse patients requesting emergency contraception, while pharmacists in other areas do not.
‘That’s why it’s also about being prepared. You never know when that situation might arise,’ she added.
Should pharmacists feel unsure during these consultations, pharmacists can and should engage with the APF.
‘Pharmacists did say that if that situation did occur with a transgender or gender- diverse person that they would be honest and say to them, “Do you mind if I consult my resources?”’
Another reason the APF is a mandatory text for all community pharmacists
Despite lack of guideline use, pharmacists acknowledged how essential guidelines
such as the APF are, Ms Nona said.
‘And when pharmacists did use them, they found the information provided was invaluable.’
‘[But] a lot of the challenges stemmed from lack of time and, in some cases, a lack of up-to-date knowledge. We have so many things to do, and we need more time to do everything and to keep ourselves up to date.’
For Ms Nona, the solution lies in supporting pharmacists to use guidelines confidently and consistently in real-world conditions.
Some pharmacists report to PSA that they will often bring up the APF digital on the screen in the consultation room in emergency contraception discussions, particularly in situations which are new or unfamiliar.
Delivering a critical intervention
The key to emergency contraception provision is recognising the stakes.
‘The whole picture of providing emergency contraception is to make sure we are preventing pregnancies when people don't want to get pregnant – whatever the reason may be,’ Ms Nona said. ‘That’s why they come to see a pharmacist – to ensure the person has the best possible chance of preventing an unintended pregnancy.’
When pharmacists are supported to provide full information and informed choice, patients respond accordingly.
The Australian Pharmaceutical Formulary and Handbook (APF) chapter on ‘Emergency Contraception’, provides essential guidance on:
|
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[post_content] => Rapidly evolving scope of practice means that traditional community pharmacy workflows need review. What works (and what doesn’t)?
The range of professional services delivered by community pharmacists has expanded rapidly in recent years, from vaccination to UTI prescribing and beyond. As
these services increase in popularity, they are shifting from ancillary service to core business.
This widening scope is forcing community pharmacies to review how they conduct their business and the way front-of-house staff interact with patients.
No longer is dispensing prescriptions on a first come, first served basis sustainable. With adjustments to workflow, vaccinations and other booked services have been prioritised and run simultaneously, says Queensland-based prescribing pharmacist Kate Gunthorpe MPS.
‘We are moving away from the mindset that dispensing always comes first. We need to triage effectively and manage expectations, so every patient feels seen and cared for,’ she says.
And it isn’t just about sequential processes. Workflow changes also require a shift of communication approaches and pre-existing mindsets around professional service provision.
‘The biggest pitfall I’ve discovered is apologising for charging or determining that the consultation wasn’t worth charging for,’ Ms Gunthorpe says. ‘That instantly undermines the service’s value. Every consultation, whether the outcome is a prescription, advice or reassurance, involves clinical reasoning, professional judgement and patient care.’
So, how should the profession move forward? The PSA’s foundation documents are clear that all services must remain patient-centric.
That means redesigning workflows on the floor, developing new communication strategies for staff and providing additional training for pharmacy assistants to ensure a consistent, professional patient experience.
AP spoke with Ms Gunthorpe and pharmacy assistant Madison Low about adapting workflow to integrate services without disrupting dispensing. product or medicines transaction. I now explain that I will assess their presentation, then create a unique shared management plan for them – which may or may not involve a prescription. Setting that expectation upfront helps enormously.
Case 1 Kate Gunthorpe MPS
Pharmacist prescriber, Implementation and Change Specialist, TerryWhite Chemmart, Samford, Queensland
[caption id="attachment_31312" align="alignright" width="185"] Kate Gunthorpe MPS[/caption]
Our team started by mapping our busiest times to understand where bottlenecks occurred. We then built clear workflows – for example, using a booking system for consultations where possible, and ensuring at least one pharmacist remained consult-focused during every day.
We trained our assistants to triage appropriately and use consistent language, such as ‘the pharmacist will see you shortly for your consultation’, which helped the process feel deliberate rather than disruptive. Once the team understood that consultations were core services, not interruptions, the process flowed more smoothly.
Patients often expect a prescription outcome from a consultation, so I changed the framework, ensuring the consultation became a clinical one, not a product or medicines transaction. I now explain that I will assess their presentation, then create a unique shared management plan for them – which may or may not involve a prescription. Setting that expectation upfront helps enormously.
When we changed our front-of-shop language, patients stopped viewing consultations as waiting in a queue. That one shift in language lifted the professionalism of the whole process; patients were more patient, staff felt more confident explaining the service, and we saw an improvement in how people valued the pharmacist’s time.
One thing I would advise other pharmacists about charging appropriately for their time, even when the consultation doesn’t end with a script, is to start valuing their expertise. The consultation is the service, not the outcome. We’re expertly trained to assess, diagnose and provide evidence-based care. That deserves to be remunerated. Once pharmacists stop apologising and start consistently charging for their time and expertise, patients begin to respect that boundary too.
I find it is better to be transparent and consistent with pricing. I explain what’s included in the consultation, so patients understand what they’re paying for. Most importantly, I believe in it myself. If you hesitate to charge, your team and patients will pick up on that.
The work floor also needs redesigning to normalise consulting services as part of everyday care. It starts with the physical layout and staffing models. Pharmacies should expect consultations to happen and allocate dedicated private spaces, clear booking systems and enough pharmacist coverage, so that one can focus on clinical care, while others oversee dispensing and other services. Culturally, it’s all been about mindset: we stopped treating services as extra and started treating them as central to what we do.
That meant redistributing roles, upskilling support staff with more autonomy to triage and manage appointments, and introducing appointment blocks.
The effect of all these new processes has resulted in major change. Our pharmacy assistants are our front line, and their language is setting the tone for the entire patient experience. We have invested time in scripting and role-playing, so that the assistants feel comfortable discussing new services. The staff have learned to understand what each service involves, how long it typically takes, and when to book or triage patients.
Scripts no longer automatically take priority over walk-up service requests. They are both core services. Pharmacies are healthcare hubs where patients can expect to have a prescription filled but also be able to discuss their health concerns.
Patients also value honesty and clarity. If a medication is not appropriate, explaining why builds understanding and trust – especially when you provide alternative options or safety net advice.
Because pharmacy staff use consistent, confident language and understand the workflow, everything runs much more smoothly. It has also empowered the staff to take pride in being responsible for a part of the patient care process, not just the retail side.
When staff describe services as core health care, not as ‘extras’ or ‘add-ons’, patients have started to see the pharmacist as a clinician involved in their primary care.
It’s a subtle but powerful mindset shift that’s transforming how the pharmacy is perceived.
Case 2 Madison Low
Retail manager, TerryWhite Chemmart, Arana Hills, Queensland
[caption id="attachment_31313" align="alignright" width="277"] Madison Low[/caption]
Since we started offering services like UTI consultations and vaccinations, my role has expanded significantly. We no longer just provide products; we’re delivering a more complete healthcare solution.
A person recently came to the counter, visibly frustrated because they had symptoms of a urinary tract infection but couldn’t get in to see their doctor. They were holding a box of Ural.
Rather than just selling them the product, I suggested they talk to the pharmacist, assuring them that in many cases the pharmacist can provide a full treatment without needing a doctor’s visit.
I asked a few questions about their symptoms, then checked with the pharmacist to confirm a consultation was possible immediately. It was, and not long afterwards the patient went away happy.
Asthma management is one of the most common chronic conditions we see. Many patients believe they understand how to manage the condition, especially because they can access inhalers over the counter. But often that’s not the case. One of my roles is to let patients know there may be better solutions. Our pharmacists can review their current treatment and provide an improved management plan.
Since becoming more mindful of the language I use with patients, I’ve noticed a positive change in how they respond to me.
By communicating in a more empathetic and approachable way, I’ve found patients are more comfortable asking questions and discussing their concerns. This has made it easier to identify when a patient might benefit from a review with one of our pharmacists.
This change in language has also strengthened trust between patients and the pharmacy team. Patients seem more engaged and confident in the care they receive, and I feel more confident in my role as a link between them and our pharmacists.
The biggest challenge has been balancing our time – especially during busy periods like the flu season, when there are lots of vaccines to administer, prescriptions to dispense and consultations to organise. I’m proud of how our team works together to ensure our patients are looked after promptly and get the attention they need.
[post_title] => How expanded scope is redefining pharmacy practice
[post_excerpt] => Rapidly evolving scope of practice means that traditional community pharmacy workflows need review. What works (and what doesn’t)?
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[post_content] => Case scenario
Alicia, 27, visits your pharmacy regularly for naproxen and heat patches to manage period pain. She confides that her pain has worsened over the past 2 years, radiates down her legs, interferes with work and affects intimacy.
Her periods are heavy, lasting around 9 days, and leave her feeling exhausted and sometimes even bedridden. Alicia has seen several GPs, who told her it was ‘normal for your age’. She says, ‘It feels like someone’s wringing out my insides – nothing helps much. Is this really normal?’
Learning objectivesAfter reading this article, pharmacists should be able to:
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References: Therapeutic Guidelines1, Buggio et al12, Rossi13 Hornstein26, Vercellini27
Note: Bone mineral density typically recovers within two years of cessation of GnRH therapies.27
Drospirenone currently off-label for endometriosis in Australia.1
The addition of Ryeqo (relugolix, estradiol, norethisterone) (July 2022) and Visanne (dienogest) (December 2024) to the PBS expands accessible hormonal therapy options for endometriosis.29
Case scenario continuedYou reassure Alicia that severe period pain is not something she has to accept and suggest tracking her symptoms with a menstrual diary and consulting a women’s health GP. You also provide advice on safe NSAID use and non-pharmacological strategies. Alicia returns 2 months later, now diagnosed with endometriosis and receiving hormonal therapy and pelvic physiotherapy. She continues to experience chronic pelvic pain and questions her medicines, so you organise a Home Medicines Review, identifying potential naproxen overuse and interactions with her sertraline, prompting treatment adjustments. You also recommend a local endometriosis support group, which Alicia joins, and she has since referred two friends with similar symptoms. Through ongoing support, she feels more empowered to manage her condition. |
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[post_content] => New Pharmaceutical Benefits Advisory Committee (PBAC) recommendations could significantly change who can access funded COVID-19 and RSV vaccines.
At its December 2025 meeting, PBAC considered applications for funding COVID-19 vaccines and RSV vaccines on the National Immunisation Program (NIP). While both recommendations were positive, how would they apply in practice?
Smaller cohort recommended for COVID-19 vaccine eligibility
PBAC recommended significantly tighter eligibility criteria for COVID-19 vaccines going forward.
The National COVID-19 Vaccination Program – including the community pharmacy program is scheduled to end on 30 June 2026. While no announcements have yet been made, the PBAC outcomes signal COVID-19 vaccination will be incorporated into the NIP. PBAC recommendation is an important step to enable this NIP listing.
PBAC considered a proposal to fund Pfizer’s Comirnaty COVID-19 vaccines in a smaller population cohort. The proposal has been supported by PBAC, recommending NIP funding for four cohorts of adults as requested by Pfizer, the product sponsor.
Who would be eligible for funded COVID-19 vaccination?
For current and future Comirnaty COVID-19 vaccines, PBAC’s recommendation supports NIP funding in specific age and risk groups only.
Under this framework, NIP-funded doses would only be available for patients who are:
There’s no clear timeframe. PBAC recommendations for vaccines require price negotiation, government approval, procurement and regulatory listing to become funded on the NIP.
Given the expiry of COVID-19 immunisation program funding, 1 July 2026 could be a potential implementation date for the COVID-19 NIP funding. Current COVID-19 vaccine program eligibility is based on ATAGI advice, so changes could happen at any time ATAGI chooses to provide updated advice.
And as for patients asking when the RSV vaccine may be funded on the NIP? They probably could be encouraged to keep their eye on the TV news for any future announcements!
Upskill in vaccination administration and legislation by visiting the PSA Vaccination (immunisation) Education Hub. [post_title] => PBAC recommends new NIP adult vaccine listings [post_excerpt] => [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => pbac-recommends-new-nip-adult-vaccine-listings [to_ping] => [pinged] => [post_modified] => 2026-02-04 15:42:54 [post_modified_gmt] => 2026-02-04 04:42:54 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=31280 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => PBAC recommends new NIP adult vaccine listings [title] => PBAC recommends new NIP adult vaccine listings [href] => https://www.australianpharmacist.com.au/pbac-recommends-new-nip-adult-vaccine-listings/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 31282 [authorType] => )td_module_mega_menu Object
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[post_content] => Genevieve Adamo MPS did not set out to work in poisons information. After beginning her career in community pharmacy as an assistant pharmacist and progressing into management, Ms Adamo joined the New South Wales Poisons Information Centre in 2004.
‘I sort of fell into poisons,’ she said. ‘After having a few children, I had some time off and wanted to do something where I was learning again.’
Each call is different, providing a continuous learning opportunity, said Ms Adamo, who took on a role with the National Poisons Register in 2023.
‘You don’t know what you’re going to get at the end of the phone when you pick it up,’ she added.
Because so many of the calls to the poisons centre related to medicines poisoning, whether overdoses or errors, being a pharmacist is a distinct advantage.
‘We have really extensive knowledge of the drugs, as well as a really good base in physiology and pharmacology,’ Ms Adamo said.
[caption id="attachment_18818" align="aligncenter" width="600"] Genevieve Adamo MPS (Image: Steve Christo Photography)[/caption]
Here, she outlines what’s needed to enter and flourish in the space, as told to delegates at PSA’s Voices of Pharmacy – Passion, Purpose and Possibility webinar, held on 26 November 2025.
Core skills for poisons information practice
Poisons information demands a distinct skill set, combining deep scientific knowledge with the ability to work confidently under pressure. Calls are often urgent, information may be incomplete and decisions must be made quickly.
‘Every call provides a clinical problem that you’ve got to solve. Many of which there’s no clear answer,’ Ms Adamo said. ‘And we can't always look something up in a reference [because] not everything is listed there.’
Because it’s neither ethical nor feasible to conduct controlled trials in poisoning, evidence gaps are common.
‘We can’t go and poison a whole lot of people to create clinical trials to find the answers for poisoning questions. We have to wait until these situations happen and then turn those into research themselves,’ she said. ‘So because of that, we often have to go back to basics, and use those pharmacology principles we learned way back in uni.’
This includes:
‘You’ve got to get all the history, work out what you know, look things up and provide advice all within about 5 minutes.' Genevieve Adamo MPS‘We all have the ability to be involved in research, because we're recruiting patients through our calls,’ Ms Adamo said. ‘Our staff also create new guidelines for education and training, supporting both external poisoning prevention initiatives and the ongoing training of new and existing staff.’ Another major function is toxicovigilance – the systematic monitoring of poisoning trends with a focus on prevention and risk reduction. ‘That can involve all sorts of things [including] media and education,’ she said. ‘There’s often a lot of number crunching as well, and then working with regulators to change the laws to restrict access, because we know that one of the best ways to minimise harm and exposures is to restrict access.’ A key scheduling change Ms Adamo and her team were involved in was the changes to paracetamol regulations that were ushered in early last year. ‘We were contracted by the TGA to collect extra information about all the paracetamol calls we got,’ Ms Adamo said. ‘Paracetamol calls are the most common call to the poison centre every year, and all of that information was collated by our Head of Research and our consultant toxicologists – with the report used as the basis for the proposed scheduling changes that occurred.’ Sometimes individual cases can lead to broader system change. ‘I was involved in a case with a mum whose little one got really sick, and it was eventually worked out that it was a chronic choline salicylate toxicity,’ she said. ‘She couldn’t believe she’d been giving this poison to her kid and didn’t realise it was poisonous, because she bought it from [a supermarket] and thought it must be safe.’ In response, Adamo submitted an application to reschedule choline salicylate to Schedule 2. ‘Now it has to have more labelling, and it can only be available in a pharmacy,’ she said. ‘Those are the really interesting and rewarding aspects of poisoning work.’ For pharmacists considering the field, Ms Adamo believes the appeal lies in its tangible public health impact – shaping national safety standards and preventing future harm, particularly among children. ‘You know the work you’re doing actually changes outcomes.’ Read PSA’s Medicine Safety: Child and adolescent care report to understand the key poisoning risks and how pharmacists can help mitigate them. [post_title] => How pharmacists can prepare for poisons information roles [post_excerpt] => Poisons information pharmacists turn individual calls into population-level insights that inform regulatory and scheduling decisions. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => how-pharmacists-can-prepare-for-poisons-information-roles [to_ping] => [pinged] => [post_modified] => 2026-02-02 18:25:34 [post_modified_gmt] => 2026-02-02 07:25:34 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=31254 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => How pharmacists can prepare for poisons information roles [title] => How pharmacists can prepare for poisons information roles [href] => https://www.australianpharmacist.com.au/how-pharmacists-can-prepare-for-poisons-information-roles/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 31258 [authorType] => )
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[post_content] => The gap between evidence and everyday practice is impacting patient access to emergency contraception.
Community pharmacies are often the first – and sometimes only – point of access for emergency contraception in Australia.
But a new qualitative study found there are still persistent gaps between what the guidelines say and what happens in practice.
Ruth Nona, pharmacist and researcher at James Cook University, who interviewed community pharmacists about providing emergency contraception services, describes a workforce that is broadly willing to help, but not always set up to deliver consistently equitable care.
1. Not recommending ulipristal as first-line
One of the most significant gaps identified in the study was the tendency for pharmacists to default to levonorgestrel, despite guidance in the Australian Pharmaceutical Formulary and Handbook (APF) that ulipristal acetate is generally considered more effective than levonorgestrel and can be used up to 120 hours after unprotected intercourse.
‘Habit definitely plays a role,’ Ms Nona said. ‘Some pharmacists felt more comfortable and confident supplying levonorgestrel. For example, if someone requested emergency contraception within 24 hours, pharmacists felt levonorgestrel was acceptable within that timeframe, without fully considering efficacy.’
[caption id="attachment_31329" align="alignright" width="250"] Ruth Nona[/caption]
In some pharmacies, price differences influenced whether ulipristal acetate was presented as an option.
‘In certain socio-economic areas, cost was a driver,’ Ms Nona said. ‘Cost considerations were also sometimes linked to younger people coming in and asking whether there was a cheaper option.’
Sometimes, levonorgestrel was the only medicine on hand.
‘There was research that came out showing that some pharmacies still did not stock ulipristal acetate,’ she said. ‘It’s been an ongoing issue, and something that really needs to be addressed.’
However, patients need to be able to make an informed decision about which medicine to take.
‘As stated in the guidelines, it’s about making sure all patients are given the information they need to make an informed and equitable choice. If the patient wants a particular option, that’s fine, but they need to be able to make that decision with the full information,’ Ms Nona said.
‘When pharmacists did give the full picture and explained the differences, more often than not the patient chose ulipristal acetate, even though it cost more.’
‘If the patient wants a particular option, that’s fine, but they need to be able to make that decision with the full information.'
Ruth nona
2. Uncertainty when responding to third-party requests
Pharmacists reported particular uncertainty when providing emergency contraception to third parties, with many wary about consent and unsure whether they could provide it to someone who wasn’t the patient.
‘In most cases, they would follow up and ask to contact the patient directly,’ Ms Nona said. ‘It wasn’t that they didn’t want to provide it – they just felt unsure and they wanted to make sure that the patient had consented.’
While in many cases, speaking to the intended person directly can help provide key information and counselling, in circumstances where this is not possible, it is usually possible to determine the medicine is safe and therapeutically appropriate, and supply in a manner consistent with APF guidance and legal obligations.
3. Uncertainty providing emergency contraception to adolescents
Similarly, pharmacists were ‘uncomfortable’ providing the service to adolescents.
This uncertainty often centred on fear of making the wrong decision or facing professional consequences.
‘They still wanted to provide the service, but it was more that internal question of, “Should I do this? Am I going to get in trouble?”’
There are no jurisdictions where there’s a legal restriction from supplying emergency contraception to minors. The APF guidance helps pharmacists navigate Gillick competency and consent in adolescents, ensuring they demonstrate sufficient maturity and understanding to provide informed consent.
Ms Nona emphasised that the issue was confidence, not capability.
‘It’s about being familiar with the guidelines, making sure we’re as up to date as possible and realising that it’s okay for us to provide these services, provided the adolescent is [assessed as Gillick competent] mentally mature and safe,’ she said.
The APF references Gillick competency provided the adolescent is [assessed as Gillick competent (demonstrating sufficient maturity and understanding to provide informed consent)]
4. Uncertainty for transgender people on gender affirming hormone therapy
While pharmacists were generally supportive towards transgender and gender-diverse patients, lack of familiarity with hormone therapy raised hesitation.
‘There are absolutely no interactions between emergency contraception and gender-affirming hormones’ Ms Nona said. ‘It really comes down to knowledge, which builds confidence, and being up to date to make sure the service we provide is timely and equitable.’
In some areas, pharmacists may frequently encounter transgender and gender- diverse patients requesting emergency contraception, while pharmacists in other areas do not.
‘That’s why it’s also about being prepared. You never know when that situation might arise,’ she added.
Should pharmacists feel unsure during these consultations, pharmacists can and should engage with the APF.
‘Pharmacists did say that if that situation did occur with a transgender or gender- diverse person that they would be honest and say to them, “Do you mind if I consult my resources?”’
Another reason the APF is a mandatory text for all community pharmacists
Despite lack of guideline use, pharmacists acknowledged how essential guidelines
such as the APF are, Ms Nona said.
‘And when pharmacists did use them, they found the information provided was invaluable.’
‘[But] a lot of the challenges stemmed from lack of time and, in some cases, a lack of up-to-date knowledge. We have so many things to do, and we need more time to do everything and to keep ourselves up to date.’
For Ms Nona, the solution lies in supporting pharmacists to use guidelines confidently and consistently in real-world conditions.
Some pharmacists report to PSA that they will often bring up the APF digital on the screen in the consultation room in emergency contraception discussions, particularly in situations which are new or unfamiliar.
Delivering a critical intervention
The key to emergency contraception provision is recognising the stakes.
‘The whole picture of providing emergency contraception is to make sure we are preventing pregnancies when people don't want to get pregnant – whatever the reason may be,’ Ms Nona said. ‘That’s why they come to see a pharmacist – to ensure the person has the best possible chance of preventing an unintended pregnancy.’
When pharmacists are supported to provide full information and informed choice, patients respond accordingly.
The Australian Pharmaceutical Formulary and Handbook (APF) chapter on ‘Emergency Contraception’, provides essential guidance on:
|
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[post_content] => Rapidly evolving scope of practice means that traditional community pharmacy workflows need review. What works (and what doesn’t)?
The range of professional services delivered by community pharmacists has expanded rapidly in recent years, from vaccination to UTI prescribing and beyond. As
these services increase in popularity, they are shifting from ancillary service to core business.
This widening scope is forcing community pharmacies to review how they conduct their business and the way front-of-house staff interact with patients.
No longer is dispensing prescriptions on a first come, first served basis sustainable. With adjustments to workflow, vaccinations and other booked services have been prioritised and run simultaneously, says Queensland-based prescribing pharmacist Kate Gunthorpe MPS.
‘We are moving away from the mindset that dispensing always comes first. We need to triage effectively and manage expectations, so every patient feels seen and cared for,’ she says.
And it isn’t just about sequential processes. Workflow changes also require a shift of communication approaches and pre-existing mindsets around professional service provision.
‘The biggest pitfall I’ve discovered is apologising for charging or determining that the consultation wasn’t worth charging for,’ Ms Gunthorpe says. ‘That instantly undermines the service’s value. Every consultation, whether the outcome is a prescription, advice or reassurance, involves clinical reasoning, professional judgement and patient care.’
So, how should the profession move forward? The PSA’s foundation documents are clear that all services must remain patient-centric.
That means redesigning workflows on the floor, developing new communication strategies for staff and providing additional training for pharmacy assistants to ensure a consistent, professional patient experience.
AP spoke with Ms Gunthorpe and pharmacy assistant Madison Low about adapting workflow to integrate services without disrupting dispensing. product or medicines transaction. I now explain that I will assess their presentation, then create a unique shared management plan for them – which may or may not involve a prescription. Setting that expectation upfront helps enormously.
Case 1 Kate Gunthorpe MPS
Pharmacist prescriber, Implementation and Change Specialist, TerryWhite Chemmart, Samford, Queensland
[caption id="attachment_31312" align="alignright" width="185"] Kate Gunthorpe MPS[/caption]
Our team started by mapping our busiest times to understand where bottlenecks occurred. We then built clear workflows – for example, using a booking system for consultations where possible, and ensuring at least one pharmacist remained consult-focused during every day.
We trained our assistants to triage appropriately and use consistent language, such as ‘the pharmacist will see you shortly for your consultation’, which helped the process feel deliberate rather than disruptive. Once the team understood that consultations were core services, not interruptions, the process flowed more smoothly.
Patients often expect a prescription outcome from a consultation, so I changed the framework, ensuring the consultation became a clinical one, not a product or medicines transaction. I now explain that I will assess their presentation, then create a unique shared management plan for them – which may or may not involve a prescription. Setting that expectation upfront helps enormously.
When we changed our front-of-shop language, patients stopped viewing consultations as waiting in a queue. That one shift in language lifted the professionalism of the whole process; patients were more patient, staff felt more confident explaining the service, and we saw an improvement in how people valued the pharmacist’s time.
One thing I would advise other pharmacists about charging appropriately for their time, even when the consultation doesn’t end with a script, is to start valuing their expertise. The consultation is the service, not the outcome. We’re expertly trained to assess, diagnose and provide evidence-based care. That deserves to be remunerated. Once pharmacists stop apologising and start consistently charging for their time and expertise, patients begin to respect that boundary too.
I find it is better to be transparent and consistent with pricing. I explain what’s included in the consultation, so patients understand what they’re paying for. Most importantly, I believe in it myself. If you hesitate to charge, your team and patients will pick up on that.
The work floor also needs redesigning to normalise consulting services as part of everyday care. It starts with the physical layout and staffing models. Pharmacies should expect consultations to happen and allocate dedicated private spaces, clear booking systems and enough pharmacist coverage, so that one can focus on clinical care, while others oversee dispensing and other services. Culturally, it’s all been about mindset: we stopped treating services as extra and started treating them as central to what we do.
That meant redistributing roles, upskilling support staff with more autonomy to triage and manage appointments, and introducing appointment blocks.
The effect of all these new processes has resulted in major change. Our pharmacy assistants are our front line, and their language is setting the tone for the entire patient experience. We have invested time in scripting and role-playing, so that the assistants feel comfortable discussing new services. The staff have learned to understand what each service involves, how long it typically takes, and when to book or triage patients.
Scripts no longer automatically take priority over walk-up service requests. They are both core services. Pharmacies are healthcare hubs where patients can expect to have a prescription filled but also be able to discuss their health concerns.
Patients also value honesty and clarity. If a medication is not appropriate, explaining why builds understanding and trust – especially when you provide alternative options or safety net advice.
Because pharmacy staff use consistent, confident language and understand the workflow, everything runs much more smoothly. It has also empowered the staff to take pride in being responsible for a part of the patient care process, not just the retail side.
When staff describe services as core health care, not as ‘extras’ or ‘add-ons’, patients have started to see the pharmacist as a clinician involved in their primary care.
It’s a subtle but powerful mindset shift that’s transforming how the pharmacy is perceived.
Case 2 Madison Low
Retail manager, TerryWhite Chemmart, Arana Hills, Queensland
[caption id="attachment_31313" align="alignright" width="277"] Madison Low[/caption]
Since we started offering services like UTI consultations and vaccinations, my role has expanded significantly. We no longer just provide products; we’re delivering a more complete healthcare solution.
A person recently came to the counter, visibly frustrated because they had symptoms of a urinary tract infection but couldn’t get in to see their doctor. They were holding a box of Ural.
Rather than just selling them the product, I suggested they talk to the pharmacist, assuring them that in many cases the pharmacist can provide a full treatment without needing a doctor’s visit.
I asked a few questions about their symptoms, then checked with the pharmacist to confirm a consultation was possible immediately. It was, and not long afterwards the patient went away happy.
Asthma management is one of the most common chronic conditions we see. Many patients believe they understand how to manage the condition, especially because they can access inhalers over the counter. But often that’s not the case. One of my roles is to let patients know there may be better solutions. Our pharmacists can review their current treatment and provide an improved management plan.
Since becoming more mindful of the language I use with patients, I’ve noticed a positive change in how they respond to me.
By communicating in a more empathetic and approachable way, I’ve found patients are more comfortable asking questions and discussing their concerns. This has made it easier to identify when a patient might benefit from a review with one of our pharmacists.
This change in language has also strengthened trust between patients and the pharmacy team. Patients seem more engaged and confident in the care they receive, and I feel more confident in my role as a link between them and our pharmacists.
The biggest challenge has been balancing our time – especially during busy periods like the flu season, when there are lots of vaccines to administer, prescriptions to dispense and consultations to organise. I’m proud of how our team works together to ensure our patients are looked after promptly and get the attention they need.
[post_title] => How expanded scope is redefining pharmacy practice
[post_excerpt] => Rapidly evolving scope of practice means that traditional community pharmacy workflows need review. What works (and what doesn’t)?
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[post_content] => Case scenario
Alicia, 27, visits your pharmacy regularly for naproxen and heat patches to manage period pain. She confides that her pain has worsened over the past 2 years, radiates down her legs, interferes with work and affects intimacy.
Her periods are heavy, lasting around 9 days, and leave her feeling exhausted and sometimes even bedridden. Alicia has seen several GPs, who told her it was ‘normal for your age’. She says, ‘It feels like someone’s wringing out my insides – nothing helps much. Is this really normal?’
Learning objectivesAfter reading this article, pharmacists should be able to:
|
References: Therapeutic Guidelines1, Buggio et al12, Rossi13 Hornstein26, Vercellini27
Note: Bone mineral density typically recovers within two years of cessation of GnRH therapies.27
Drospirenone currently off-label for endometriosis in Australia.1
The addition of Ryeqo (relugolix, estradiol, norethisterone) (July 2022) and Visanne (dienogest) (December 2024) to the PBS expands accessible hormonal therapy options for endometriosis.29
Case scenario continuedYou reassure Alicia that severe period pain is not something she has to accept and suggest tracking her symptoms with a menstrual diary and consulting a women’s health GP. You also provide advice on safe NSAID use and non-pharmacological strategies. Alicia returns 2 months later, now diagnosed with endometriosis and receiving hormonal therapy and pelvic physiotherapy. She continues to experience chronic pelvic pain and questions her medicines, so you organise a Home Medicines Review, identifying potential naproxen overuse and interactions with her sertraline, prompting treatment adjustments. You also recommend a local endometriosis support group, which Alicia joins, and she has since referred two friends with similar symptoms. Through ongoing support, she feels more empowered to manage her condition. |
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[post_content] => New Pharmaceutical Benefits Advisory Committee (PBAC) recommendations could significantly change who can access funded COVID-19 and RSV vaccines.
At its December 2025 meeting, PBAC considered applications for funding COVID-19 vaccines and RSV vaccines on the National Immunisation Program (NIP). While both recommendations were positive, how would they apply in practice?
Smaller cohort recommended for COVID-19 vaccine eligibility
PBAC recommended significantly tighter eligibility criteria for COVID-19 vaccines going forward.
The National COVID-19 Vaccination Program – including the community pharmacy program is scheduled to end on 30 June 2026. While no announcements have yet been made, the PBAC outcomes signal COVID-19 vaccination will be incorporated into the NIP. PBAC recommendation is an important step to enable this NIP listing.
PBAC considered a proposal to fund Pfizer’s Comirnaty COVID-19 vaccines in a smaller population cohort. The proposal has been supported by PBAC, recommending NIP funding for four cohorts of adults as requested by Pfizer, the product sponsor.
Who would be eligible for funded COVID-19 vaccination?
For current and future Comirnaty COVID-19 vaccines, PBAC’s recommendation supports NIP funding in specific age and risk groups only.
Under this framework, NIP-funded doses would only be available for patients who are:
There’s no clear timeframe. PBAC recommendations for vaccines require price negotiation, government approval, procurement and regulatory listing to become funded on the NIP.
Given the expiry of COVID-19 immunisation program funding, 1 July 2026 could be a potential implementation date for the COVID-19 NIP funding. Current COVID-19 vaccine program eligibility is based on ATAGI advice, so changes could happen at any time ATAGI chooses to provide updated advice.
And as for patients asking when the RSV vaccine may be funded on the NIP? They probably could be encouraged to keep their eye on the TV news for any future announcements!
Upskill in vaccination administration and legislation by visiting the PSA Vaccination (immunisation) Education Hub. [post_title] => PBAC recommends new NIP adult vaccine listings [post_excerpt] => [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => pbac-recommends-new-nip-adult-vaccine-listings [to_ping] => [pinged] => [post_modified] => 2026-02-04 15:42:54 [post_modified_gmt] => 2026-02-04 04:42:54 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=31280 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => PBAC recommends new NIP adult vaccine listings [title] => PBAC recommends new NIP adult vaccine listings [href] => https://www.australianpharmacist.com.au/pbac-recommends-new-nip-adult-vaccine-listings/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 31282 [authorType] => )td_module_mega_menu Object
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[post_content] => Genevieve Adamo MPS did not set out to work in poisons information. After beginning her career in community pharmacy as an assistant pharmacist and progressing into management, Ms Adamo joined the New South Wales Poisons Information Centre in 2004.
‘I sort of fell into poisons,’ she said. ‘After having a few children, I had some time off and wanted to do something where I was learning again.’
Each call is different, providing a continuous learning opportunity, said Ms Adamo, who took on a role with the National Poisons Register in 2023.
‘You don’t know what you’re going to get at the end of the phone when you pick it up,’ she added.
Because so many of the calls to the poisons centre related to medicines poisoning, whether overdoses or errors, being a pharmacist is a distinct advantage.
‘We have really extensive knowledge of the drugs, as well as a really good base in physiology and pharmacology,’ Ms Adamo said.
[caption id="attachment_18818" align="aligncenter" width="600"] Genevieve Adamo MPS (Image: Steve Christo Photography)[/caption]
Here, she outlines what’s needed to enter and flourish in the space, as told to delegates at PSA’s Voices of Pharmacy – Passion, Purpose and Possibility webinar, held on 26 November 2025.
Core skills for poisons information practice
Poisons information demands a distinct skill set, combining deep scientific knowledge with the ability to work confidently under pressure. Calls are often urgent, information may be incomplete and decisions must be made quickly.
‘Every call provides a clinical problem that you’ve got to solve. Many of which there’s no clear answer,’ Ms Adamo said. ‘And we can't always look something up in a reference [because] not everything is listed there.’
Because it’s neither ethical nor feasible to conduct controlled trials in poisoning, evidence gaps are common.
‘We can’t go and poison a whole lot of people to create clinical trials to find the answers for poisoning questions. We have to wait until these situations happen and then turn those into research themselves,’ she said. ‘So because of that, we often have to go back to basics, and use those pharmacology principles we learned way back in uni.’
This includes:
‘You’ve got to get all the history, work out what you know, look things up and provide advice all within about 5 minutes.' Genevieve Adamo MPS‘We all have the ability to be involved in research, because we're recruiting patients through our calls,’ Ms Adamo said. ‘Our staff also create new guidelines for education and training, supporting both external poisoning prevention initiatives and the ongoing training of new and existing staff.’ Another major function is toxicovigilance – the systematic monitoring of poisoning trends with a focus on prevention and risk reduction. ‘That can involve all sorts of things [including] media and education,’ she said. ‘There’s often a lot of number crunching as well, and then working with regulators to change the laws to restrict access, because we know that one of the best ways to minimise harm and exposures is to restrict access.’ A key scheduling change Ms Adamo and her team were involved in was the changes to paracetamol regulations that were ushered in early last year. ‘We were contracted by the TGA to collect extra information about all the paracetamol calls we got,’ Ms Adamo said. ‘Paracetamol calls are the most common call to the poison centre every year, and all of that information was collated by our Head of Research and our consultant toxicologists – with the report used as the basis for the proposed scheduling changes that occurred.’ Sometimes individual cases can lead to broader system change. ‘I was involved in a case with a mum whose little one got really sick, and it was eventually worked out that it was a chronic choline salicylate toxicity,’ she said. ‘She couldn’t believe she’d been giving this poison to her kid and didn’t realise it was poisonous, because she bought it from [a supermarket] and thought it must be safe.’ In response, Adamo submitted an application to reschedule choline salicylate to Schedule 2. ‘Now it has to have more labelling, and it can only be available in a pharmacy,’ she said. ‘Those are the really interesting and rewarding aspects of poisoning work.’ For pharmacists considering the field, Ms Adamo believes the appeal lies in its tangible public health impact – shaping national safety standards and preventing future harm, particularly among children. ‘You know the work you’re doing actually changes outcomes.’ Read PSA’s Medicine Safety: Child and adolescent care report to understand the key poisoning risks and how pharmacists can help mitigate them. [post_title] => How pharmacists can prepare for poisons information roles [post_excerpt] => Poisons information pharmacists turn individual calls into population-level insights that inform regulatory and scheduling decisions. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => how-pharmacists-can-prepare-for-poisons-information-roles [to_ping] => [pinged] => [post_modified] => 2026-02-02 18:25:34 [post_modified_gmt] => 2026-02-02 07:25:34 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=31254 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => How pharmacists can prepare for poisons information roles [title] => How pharmacists can prepare for poisons information roles [href] => https://www.australianpharmacist.com.au/how-pharmacists-can-prepare-for-poisons-information-roles/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 31258 [authorType] => )
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[post_content] => The gap between evidence and everyday practice is impacting patient access to emergency contraception.
Community pharmacies are often the first – and sometimes only – point of access for emergency contraception in Australia.
But a new qualitative study found there are still persistent gaps between what the guidelines say and what happens in practice.
Ruth Nona, pharmacist and researcher at James Cook University, who interviewed community pharmacists about providing emergency contraception services, describes a workforce that is broadly willing to help, but not always set up to deliver consistently equitable care.
1. Not recommending ulipristal as first-line
One of the most significant gaps identified in the study was the tendency for pharmacists to default to levonorgestrel, despite guidance in the Australian Pharmaceutical Formulary and Handbook (APF) that ulipristal acetate is generally considered more effective than levonorgestrel and can be used up to 120 hours after unprotected intercourse.
‘Habit definitely plays a role,’ Ms Nona said. ‘Some pharmacists felt more comfortable and confident supplying levonorgestrel. For example, if someone requested emergency contraception within 24 hours, pharmacists felt levonorgestrel was acceptable within that timeframe, without fully considering efficacy.’
[caption id="attachment_31329" align="alignright" width="250"] Ruth Nona[/caption]
In some pharmacies, price differences influenced whether ulipristal acetate was presented as an option.
‘In certain socio-economic areas, cost was a driver,’ Ms Nona said. ‘Cost considerations were also sometimes linked to younger people coming in and asking whether there was a cheaper option.’
Sometimes, levonorgestrel was the only medicine on hand.
‘There was research that came out showing that some pharmacies still did not stock ulipristal acetate,’ she said. ‘It’s been an ongoing issue, and something that really needs to be addressed.’
However, patients need to be able to make an informed decision about which medicine to take.
‘As stated in the guidelines, it’s about making sure all patients are given the information they need to make an informed and equitable choice. If the patient wants a particular option, that’s fine, but they need to be able to make that decision with the full information,’ Ms Nona said.
‘When pharmacists did give the full picture and explained the differences, more often than not the patient chose ulipristal acetate, even though it cost more.’
‘If the patient wants a particular option, that’s fine, but they need to be able to make that decision with the full information.'
Ruth nona
2. Uncertainty when responding to third-party requests
Pharmacists reported particular uncertainty when providing emergency contraception to third parties, with many wary about consent and unsure whether they could provide it to someone who wasn’t the patient.
‘In most cases, they would follow up and ask to contact the patient directly,’ Ms Nona said. ‘It wasn’t that they didn’t want to provide it – they just felt unsure and they wanted to make sure that the patient had consented.’
While in many cases, speaking to the intended person directly can help provide key information and counselling, in circumstances where this is not possible, it is usually possible to determine the medicine is safe and therapeutically appropriate, and supply in a manner consistent with APF guidance and legal obligations.
3. Uncertainty providing emergency contraception to adolescents
Similarly, pharmacists were ‘uncomfortable’ providing the service to adolescents.
This uncertainty often centred on fear of making the wrong decision or facing professional consequences.
‘They still wanted to provide the service, but it was more that internal question of, “Should I do this? Am I going to get in trouble?”’
There are no jurisdictions where there’s a legal restriction from supplying emergency contraception to minors. The APF guidance helps pharmacists navigate Gillick competency and consent in adolescents, ensuring they demonstrate sufficient maturity and understanding to provide informed consent.
Ms Nona emphasised that the issue was confidence, not capability.
‘It’s about being familiar with the guidelines, making sure we’re as up to date as possible and realising that it’s okay for us to provide these services, provided the adolescent is [assessed as Gillick competent] mentally mature and safe,’ she said.
The APF references Gillick competency provided the adolescent is [assessed as Gillick competent (demonstrating sufficient maturity and understanding to provide informed consent)]
4. Uncertainty for transgender people on gender affirming hormone therapy
While pharmacists were generally supportive towards transgender and gender-diverse patients, lack of familiarity with hormone therapy raised hesitation.
‘There are absolutely no interactions between emergency contraception and gender-affirming hormones’ Ms Nona said. ‘It really comes down to knowledge, which builds confidence, and being up to date to make sure the service we provide is timely and equitable.’
In some areas, pharmacists may frequently encounter transgender and gender- diverse patients requesting emergency contraception, while pharmacists in other areas do not.
‘That’s why it’s also about being prepared. You never know when that situation might arise,’ she added.
Should pharmacists feel unsure during these consultations, pharmacists can and should engage with the APF.
‘Pharmacists did say that if that situation did occur with a transgender or gender- diverse person that they would be honest and say to them, “Do you mind if I consult my resources?”’
Another reason the APF is a mandatory text for all community pharmacists
Despite lack of guideline use, pharmacists acknowledged how essential guidelines
such as the APF are, Ms Nona said.
‘And when pharmacists did use them, they found the information provided was invaluable.’
‘[But] a lot of the challenges stemmed from lack of time and, in some cases, a lack of up-to-date knowledge. We have so many things to do, and we need more time to do everything and to keep ourselves up to date.’
For Ms Nona, the solution lies in supporting pharmacists to use guidelines confidently and consistently in real-world conditions.
Some pharmacists report to PSA that they will often bring up the APF digital on the screen in the consultation room in emergency contraception discussions, particularly in situations which are new or unfamiliar.
Delivering a critical intervention
The key to emergency contraception provision is recognising the stakes.
‘The whole picture of providing emergency contraception is to make sure we are preventing pregnancies when people don't want to get pregnant – whatever the reason may be,’ Ms Nona said. ‘That’s why they come to see a pharmacist – to ensure the person has the best possible chance of preventing an unintended pregnancy.’
When pharmacists are supported to provide full information and informed choice, patients respond accordingly.
The Australian Pharmaceutical Formulary and Handbook (APF) chapter on ‘Emergency Contraception’, provides essential guidance on:
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[post_content] => Rapidly evolving scope of practice means that traditional community pharmacy workflows need review. What works (and what doesn’t)?
The range of professional services delivered by community pharmacists has expanded rapidly in recent years, from vaccination to UTI prescribing and beyond. As
these services increase in popularity, they are shifting from ancillary service to core business.
This widening scope is forcing community pharmacies to review how they conduct their business and the way front-of-house staff interact with patients.
No longer is dispensing prescriptions on a first come, first served basis sustainable. With adjustments to workflow, vaccinations and other booked services have been prioritised and run simultaneously, says Queensland-based prescribing pharmacist Kate Gunthorpe MPS.
‘We are moving away from the mindset that dispensing always comes first. We need to triage effectively and manage expectations, so every patient feels seen and cared for,’ she says.
And it isn’t just about sequential processes. Workflow changes also require a shift of communication approaches and pre-existing mindsets around professional service provision.
‘The biggest pitfall I’ve discovered is apologising for charging or determining that the consultation wasn’t worth charging for,’ Ms Gunthorpe says. ‘That instantly undermines the service’s value. Every consultation, whether the outcome is a prescription, advice or reassurance, involves clinical reasoning, professional judgement and patient care.’
So, how should the profession move forward? The PSA’s foundation documents are clear that all services must remain patient-centric.
That means redesigning workflows on the floor, developing new communication strategies for staff and providing additional training for pharmacy assistants to ensure a consistent, professional patient experience.
AP spoke with Ms Gunthorpe and pharmacy assistant Madison Low about adapting workflow to integrate services without disrupting dispensing. product or medicines transaction. I now explain that I will assess their presentation, then create a unique shared management plan for them – which may or may not involve a prescription. Setting that expectation upfront helps enormously.
Case 1 Kate Gunthorpe MPS
Pharmacist prescriber, Implementation and Change Specialist, TerryWhite Chemmart, Samford, Queensland
[caption id="attachment_31312" align="alignright" width="185"] Kate Gunthorpe MPS[/caption]
Our team started by mapping our busiest times to understand where bottlenecks occurred. We then built clear workflows – for example, using a booking system for consultations where possible, and ensuring at least one pharmacist remained consult-focused during every day.
We trained our assistants to triage appropriately and use consistent language, such as ‘the pharmacist will see you shortly for your consultation’, which helped the process feel deliberate rather than disruptive. Once the team understood that consultations were core services, not interruptions, the process flowed more smoothly.
Patients often expect a prescription outcome from a consultation, so I changed the framework, ensuring the consultation became a clinical one, not a product or medicines transaction. I now explain that I will assess their presentation, then create a unique shared management plan for them – which may or may not involve a prescription. Setting that expectation upfront helps enormously.
When we changed our front-of-shop language, patients stopped viewing consultations as waiting in a queue. That one shift in language lifted the professionalism of the whole process; patients were more patient, staff felt more confident explaining the service, and we saw an improvement in how people valued the pharmacist’s time.
One thing I would advise other pharmacists about charging appropriately for their time, even when the consultation doesn’t end with a script, is to start valuing their expertise. The consultation is the service, not the outcome. We’re expertly trained to assess, diagnose and provide evidence-based care. That deserves to be remunerated. Once pharmacists stop apologising and start consistently charging for their time and expertise, patients begin to respect that boundary too.
I find it is better to be transparent and consistent with pricing. I explain what’s included in the consultation, so patients understand what they’re paying for. Most importantly, I believe in it myself. If you hesitate to charge, your team and patients will pick up on that.
The work floor also needs redesigning to normalise consulting services as part of everyday care. It starts with the physical layout and staffing models. Pharmacies should expect consultations to happen and allocate dedicated private spaces, clear booking systems and enough pharmacist coverage, so that one can focus on clinical care, while others oversee dispensing and other services. Culturally, it’s all been about mindset: we stopped treating services as extra and started treating them as central to what we do.
That meant redistributing roles, upskilling support staff with more autonomy to triage and manage appointments, and introducing appointment blocks.
The effect of all these new processes has resulted in major change. Our pharmacy assistants are our front line, and their language is setting the tone for the entire patient experience. We have invested time in scripting and role-playing, so that the assistants feel comfortable discussing new services. The staff have learned to understand what each service involves, how long it typically takes, and when to book or triage patients.
Scripts no longer automatically take priority over walk-up service requests. They are both core services. Pharmacies are healthcare hubs where patients can expect to have a prescription filled but also be able to discuss their health concerns.
Patients also value honesty and clarity. If a medication is not appropriate, explaining why builds understanding and trust – especially when you provide alternative options or safety net advice.
Because pharmacy staff use consistent, confident language and understand the workflow, everything runs much more smoothly. It has also empowered the staff to take pride in being responsible for a part of the patient care process, not just the retail side.
When staff describe services as core health care, not as ‘extras’ or ‘add-ons’, patients have started to see the pharmacist as a clinician involved in their primary care.
It’s a subtle but powerful mindset shift that’s transforming how the pharmacy is perceived.
Case 2 Madison Low
Retail manager, TerryWhite Chemmart, Arana Hills, Queensland
[caption id="attachment_31313" align="alignright" width="277"] Madison Low[/caption]
Since we started offering services like UTI consultations and vaccinations, my role has expanded significantly. We no longer just provide products; we’re delivering a more complete healthcare solution.
A person recently came to the counter, visibly frustrated because they had symptoms of a urinary tract infection but couldn’t get in to see their doctor. They were holding a box of Ural.
Rather than just selling them the product, I suggested they talk to the pharmacist, assuring them that in many cases the pharmacist can provide a full treatment without needing a doctor’s visit.
I asked a few questions about their symptoms, then checked with the pharmacist to confirm a consultation was possible immediately. It was, and not long afterwards the patient went away happy.
Asthma management is one of the most common chronic conditions we see. Many patients believe they understand how to manage the condition, especially because they can access inhalers over the counter. But often that’s not the case. One of my roles is to let patients know there may be better solutions. Our pharmacists can review their current treatment and provide an improved management plan.
Since becoming more mindful of the language I use with patients, I’ve noticed a positive change in how they respond to me.
By communicating in a more empathetic and approachable way, I’ve found patients are more comfortable asking questions and discussing their concerns. This has made it easier to identify when a patient might benefit from a review with one of our pharmacists.
This change in language has also strengthened trust between patients and the pharmacy team. Patients seem more engaged and confident in the care they receive, and I feel more confident in my role as a link between them and our pharmacists.
The biggest challenge has been balancing our time – especially during busy periods like the flu season, when there are lots of vaccines to administer, prescriptions to dispense and consultations to organise. I’m proud of how our team works together to ensure our patients are looked after promptly and get the attention they need.
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[post_content] => Case scenario
Alicia, 27, visits your pharmacy regularly for naproxen and heat patches to manage period pain. She confides that her pain has worsened over the past 2 years, radiates down her legs, interferes with work and affects intimacy.
Her periods are heavy, lasting around 9 days, and leave her feeling exhausted and sometimes even bedridden. Alicia has seen several GPs, who told her it was ‘normal for your age’. She says, ‘It feels like someone’s wringing out my insides – nothing helps much. Is this really normal?’
Learning objectivesAfter reading this article, pharmacists should be able to:
|
References: Therapeutic Guidelines1, Buggio et al12, Rossi13 Hornstein26, Vercellini27
Note: Bone mineral density typically recovers within two years of cessation of GnRH therapies.27
Drospirenone currently off-label for endometriosis in Australia.1
The addition of Ryeqo (relugolix, estradiol, norethisterone) (July 2022) and Visanne (dienogest) (December 2024) to the PBS expands accessible hormonal therapy options for endometriosis.29
Case scenario continuedYou reassure Alicia that severe period pain is not something she has to accept and suggest tracking her symptoms with a menstrual diary and consulting a women’s health GP. You also provide advice on safe NSAID use and non-pharmacological strategies. Alicia returns 2 months later, now diagnosed with endometriosis and receiving hormonal therapy and pelvic physiotherapy. She continues to experience chronic pelvic pain and questions her medicines, so you organise a Home Medicines Review, identifying potential naproxen overuse and interactions with her sertraline, prompting treatment adjustments. You also recommend a local endometriosis support group, which Alicia joins, and she has since referred two friends with similar symptoms. Through ongoing support, she feels more empowered to manage her condition. |
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[post_content] => New Pharmaceutical Benefits Advisory Committee (PBAC) recommendations could significantly change who can access funded COVID-19 and RSV vaccines.
At its December 2025 meeting, PBAC considered applications for funding COVID-19 vaccines and RSV vaccines on the National Immunisation Program (NIP). While both recommendations were positive, how would they apply in practice?
Smaller cohort recommended for COVID-19 vaccine eligibility
PBAC recommended significantly tighter eligibility criteria for COVID-19 vaccines going forward.
The National COVID-19 Vaccination Program – including the community pharmacy program is scheduled to end on 30 June 2026. While no announcements have yet been made, the PBAC outcomes signal COVID-19 vaccination will be incorporated into the NIP. PBAC recommendation is an important step to enable this NIP listing.
PBAC considered a proposal to fund Pfizer’s Comirnaty COVID-19 vaccines in a smaller population cohort. The proposal has been supported by PBAC, recommending NIP funding for four cohorts of adults as requested by Pfizer, the product sponsor.
Who would be eligible for funded COVID-19 vaccination?
For current and future Comirnaty COVID-19 vaccines, PBAC’s recommendation supports NIP funding in specific age and risk groups only.
Under this framework, NIP-funded doses would only be available for patients who are:
There’s no clear timeframe. PBAC recommendations for vaccines require price negotiation, government approval, procurement and regulatory listing to become funded on the NIP.
Given the expiry of COVID-19 immunisation program funding, 1 July 2026 could be a potential implementation date for the COVID-19 NIP funding. Current COVID-19 vaccine program eligibility is based on ATAGI advice, so changes could happen at any time ATAGI chooses to provide updated advice.
And as for patients asking when the RSV vaccine may be funded on the NIP? They probably could be encouraged to keep their eye on the TV news for any future announcements!
Upskill in vaccination administration and legislation by visiting the PSA Vaccination (immunisation) Education Hub. [post_title] => PBAC recommends new NIP adult vaccine listings [post_excerpt] => [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => pbac-recommends-new-nip-adult-vaccine-listings [to_ping] => [pinged] => [post_modified] => 2026-02-04 15:42:54 [post_modified_gmt] => 2026-02-04 04:42:54 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=31280 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => PBAC recommends new NIP adult vaccine listings [title] => PBAC recommends new NIP adult vaccine listings [href] => https://www.australianpharmacist.com.au/pbac-recommends-new-nip-adult-vaccine-listings/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 31282 [authorType] => )td_module_mega_menu Object
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[post_content] => Genevieve Adamo MPS did not set out to work in poisons information. After beginning her career in community pharmacy as an assistant pharmacist and progressing into management, Ms Adamo joined the New South Wales Poisons Information Centre in 2004.
‘I sort of fell into poisons,’ she said. ‘After having a few children, I had some time off and wanted to do something where I was learning again.’
Each call is different, providing a continuous learning opportunity, said Ms Adamo, who took on a role with the National Poisons Register in 2023.
‘You don’t know what you’re going to get at the end of the phone when you pick it up,’ she added.
Because so many of the calls to the poisons centre related to medicines poisoning, whether overdoses or errors, being a pharmacist is a distinct advantage.
‘We have really extensive knowledge of the drugs, as well as a really good base in physiology and pharmacology,’ Ms Adamo said.
[caption id="attachment_18818" align="aligncenter" width="600"] Genevieve Adamo MPS (Image: Steve Christo Photography)[/caption]
Here, she outlines what’s needed to enter and flourish in the space, as told to delegates at PSA’s Voices of Pharmacy – Passion, Purpose and Possibility webinar, held on 26 November 2025.
Core skills for poisons information practice
Poisons information demands a distinct skill set, combining deep scientific knowledge with the ability to work confidently under pressure. Calls are often urgent, information may be incomplete and decisions must be made quickly.
‘Every call provides a clinical problem that you’ve got to solve. Many of which there’s no clear answer,’ Ms Adamo said. ‘And we can't always look something up in a reference [because] not everything is listed there.’
Because it’s neither ethical nor feasible to conduct controlled trials in poisoning, evidence gaps are common.
‘We can’t go and poison a whole lot of people to create clinical trials to find the answers for poisoning questions. We have to wait until these situations happen and then turn those into research themselves,’ she said. ‘So because of that, we often have to go back to basics, and use those pharmacology principles we learned way back in uni.’
This includes:
‘You’ve got to get all the history, work out what you know, look things up and provide advice all within about 5 minutes.' Genevieve Adamo MPS‘We all have the ability to be involved in research, because we're recruiting patients through our calls,’ Ms Adamo said. ‘Our staff also create new guidelines for education and training, supporting both external poisoning prevention initiatives and the ongoing training of new and existing staff.’ Another major function is toxicovigilance – the systematic monitoring of poisoning trends with a focus on prevention and risk reduction. ‘That can involve all sorts of things [including] media and education,’ she said. ‘There’s often a lot of number crunching as well, and then working with regulators to change the laws to restrict access, because we know that one of the best ways to minimise harm and exposures is to restrict access.’ A key scheduling change Ms Adamo and her team were involved in was the changes to paracetamol regulations that were ushered in early last year. ‘We were contracted by the TGA to collect extra information about all the paracetamol calls we got,’ Ms Adamo said. ‘Paracetamol calls are the most common call to the poison centre every year, and all of that information was collated by our Head of Research and our consultant toxicologists – with the report used as the basis for the proposed scheduling changes that occurred.’ Sometimes individual cases can lead to broader system change. ‘I was involved in a case with a mum whose little one got really sick, and it was eventually worked out that it was a chronic choline salicylate toxicity,’ she said. ‘She couldn’t believe she’d been giving this poison to her kid and didn’t realise it was poisonous, because she bought it from [a supermarket] and thought it must be safe.’ In response, Adamo submitted an application to reschedule choline salicylate to Schedule 2. ‘Now it has to have more labelling, and it can only be available in a pharmacy,’ she said. ‘Those are the really interesting and rewarding aspects of poisoning work.’ For pharmacists considering the field, Ms Adamo believes the appeal lies in its tangible public health impact – shaping national safety standards and preventing future harm, particularly among children. ‘You know the work you’re doing actually changes outcomes.’ Read PSA’s Medicine Safety: Child and adolescent care report to understand the key poisoning risks and how pharmacists can help mitigate them. [post_title] => How pharmacists can prepare for poisons information roles [post_excerpt] => Poisons information pharmacists turn individual calls into population-level insights that inform regulatory and scheduling decisions. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => how-pharmacists-can-prepare-for-poisons-information-roles [to_ping] => [pinged] => [post_modified] => 2026-02-02 18:25:34 [post_modified_gmt] => 2026-02-02 07:25:34 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=31254 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => How pharmacists can prepare for poisons information roles [title] => How pharmacists can prepare for poisons information roles [href] => https://www.australianpharmacist.com.au/how-pharmacists-can-prepare-for-poisons-information-roles/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 31258 [authorType] => )
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Australian Pharmacist is the official journal for Pharmaceutical Society of Australia Ltd.
