Alison Duncan, Kate Mackie and Stav Mantas
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[post_content] => In a significant advancement for patient-centred care, a team of pharmacists from the University of Tasmania is reshaping the landscape of antidepressant deprescribing.
Their latest research aims to close a long-standing clinical gap by making easy-to-prepare, cost-effective oral liquid formulations of commonly prescribed antidepressants accessible to every Australian pharmacist.
[caption id="attachment_29732" align="alignright" width="263"]
Natalie Cooper[/caption]
These new formulas will help to ensure that patients have options to access safe and effective medications when deprescribing antidepressants, said Natalie Cooper, Research Project Lead at the University of Tasmania’s School of Pharmacy and Pharmacology.
‘Prescribers can also have confidence that when they are prescribing these formulas and suggesting a deprescribing regime, the patient is going to receive an accurate and effective dose,’ she said.
Long-term use with limited tapering options
Each year, over 3.5 million Australians are prescribed antidepressants. Half of these patients become long-term users, with average treatment durations reaching 4 years – well beyond the recommended 6–12 month course to treat a single depressive episode. While these medicines play a critical role in managing mental health, extended use can result in adverse effects, particularly in older adults. Yet safely discontinuing antidepressants remains a challenge.
Key among the hurdles is dose inflexibility.
‘With the lack of commercially available liquid antidepressant formulations available in Australia, there are limited dosing options for people to withdraw from antidepressant medications,’ Ms Cooper said.
The recently released Maudsley Deprescribing Guidelines recommend a hyperbolic tapering method – small, incremental decreases in dose over time – to minimise withdrawal symptoms and support the body’s physiological adjustment. However, this method often requires doses lower than commercially available tablet strengths.
In Australia, the lowest available strength of citalopram – the most commonly prescribed antidepressant – is a 10 mg tablet, which can make safe and effective tapering difficult.
Seeking safer deprescribing methods
When tapering antidepressants, current guidelines often suggest that low doses of certain formulations can be crushed up and dispersed in water, Ms Cooper said.
‘Getting patients to do this imprecise method at home didn’t sound safe to me,’ she said. ‘So I reached out to the Wilson Foundation and asked “why don't we utilise liquid formulations to [deprescribe] in a safe and effective way?’”
In response, the Wilson Foundation funded an 18-month project aimed at producing professional, evidence-based formulation alternatives that all registered pharmacists can readily compound.
‘By creating easy-to-prepare, cost-effective liquid antidepressant formulations that any pharmacy can compound, we’re tackling a major barrier to antidepressant discontinuation,’ Ms Cooper said.
Choosing the right antidepressants for compounding
The research team selected 11 antidepressants for development, targeting those most commonly prescribed in Australia, including mirtazapine, paroxetine and fluoxetine.
‘There are some that aren't as commonly prescribed, but if there’s a patient who needs to come off them, they have an option available,’ Ms Cooper said.
Out of 15 antidepressants listed in the Maudsley Deprescribing Guidelines, four were identified as controlled-release formulations – such as venlafaxine – that can’t be easily transformed into liquid forms.
‘We have gone with the antidepressants we know are immediate release and can be formulated into liquid formulations,’ she said.
The formulations that have sustained-release properties will still require a compounding pharmacist’s expertise to formulate alternate dosage forms.
Developing evidence-based liquid formulations
Designed for ease and accessibility, the proposed liquid formulations can be compounded using standard equipment and readily available ingredients.
‘We're conducting stability testing on these liquid formulations using the commercially available tablets and accessible bases such as ORA-Sweet and ORA-Plus,’ Ms Cooper said. ‘So pharmacists can compound them when they get a prescription from a GP for individual patient supply.’
Once stability and microbial safety are confirmed, the formulations will be submitted to the Australian Pharmaceutical Formulary and Handbook (APF) to be considered for inclusion.
If they are in the APF, they will be available to every single pharmacist and pharmacy in Australia to compound.
The rollout will be incremental, with three formulations submitted each quarter until all 11 are included by the project’s completion.
Bridging gaps in access and affordability
Compounded formulations of antidepressants have traditionally only been available through specialised pharmacies. For patients and prescribers alike, this has presented a barrier to optimal care.
‘Some people may be getting specialised compounded fluoxetine capsules in a low dose through a compounding pharmacy, for example. But they can be quite expensive,’ Ms Cooper said. ‘Accessing a compounding pharmacy also can be quite difficult.’
Dr Anna Seth, a Tasmanian GP, echoed these concerns from the prescriber’s perspective.
‘Existing options for gradual discontinuation of antidepressants are very limited, creating a barrier for patients and the doctors who support them,’ she said. ‘The cost of compounding these medications is prohibitive for many of my patients who are then stuck with either trying to crush and disperse tablets at home or stopping medications more abruptly and risking unpleasant withdrawal effects.’
The new liquid formulations will allow prescribers to instruct patients in volume-based dosing, simplifying the regimen.
Pharmacists’ role in interdisciplinary care
Beyond compounding, pharmacists will play a crucial role in patient and prescriber education.
‘It’s important to get it out through networks to let prescribers know that these formulas are available for pharmacists to compound,’ Ms Cooper said. ‘Communication between the doctor and the pharmacist will help patients be able to achieve effective withdrawal from antidepressants.’
Joanne Gross, President of PSA’s Tasmania Branch, reinforced the importance of pharmacist leadership in deprescribing initiatives.
‘Antidepressant deprescribing remains a challenge, particularly for long-term users experiencing withdrawal symptoms,’ she said.
‘PSA looks forward to continuing to work with the University to potentially make their findings accessible to all Australian pharmacists through the APF, supporting flexible, individualised tapering regimens and improving patient outcomes.’
To find out more about when and how pharmacists can compound and the compliance obligations required, attend the ‘Compounding essentials for 2025’ session at PSA25 held in Sydney from 1–3 August. Register here to attend.
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[post_content] => As vaccine-preventable diseases resurface, pharmacies must lead proactive, informed conversations that close gaps and restore community protection.
Despite a world-class immunisation framework and high levels of public trust, Australia has seen vaccination coverage fall short of its 95% target across most cohorts since 2020, said Professor Michael Kidd at the 9th Annual Immunisation Forum 2025, in his first speech Australia's new Chief Medical Officer.
[caption id="attachment_29704" align="alignright" width="281"]
Professor Michael Kidd[/caption]
‘If we don't halt the decline in vaccination rates and improve our vaccination coverage … we're risking more disease outbreaks, more serious illness and death among members of our most vulnerable populations, including our children and older people,’ he said.
It’s a troubling trend, especially with the re-emergence of measles both locally and globally, the increase in reported cases of influenza and pertussis, and the outbreak of polio just to our north in Papua New Guinea.
The good news? Pharmacists, as the most accessible health professionals, have already proven themselves to be a trusted, convenient and indispensable vaccination workforce. But there are ways to harness this accessibility, credibility and community reach to increase vaccination uptake – particularly as expanded scopes of practice and new immunisation programs roll out nationwide.
Taking every opportunity
The key to improving vaccination rates is proactive engagement, particularly during patient interactions, said pharmacist Bec Rogers.
‘One of the most effective strategies is the identification of eligible patients during dispensing,’ she said. Whether it’s offering an influenza shot to a patient collecting an asthma inhaler, or recommending a shingles vaccine to an older adult – the opportunities are endless.
‘Opportunistic conversations at the counter or in a consultation room prompt patients to take action that they may not have considered before, because the recommendation is coming from their trusted and respected health professional,’ she said.
For example, in areas with a high proportion of young families, offering family-friendly vaccination clinics – which could mean extended hours or group appointments – can help remove barriers and boost participation.
Other appointment types, such as medication reviews, health checks or minor ailment consultations, can be leveraged as an opportunity to identify recommended vaccines.
‘For instance, if you're in the consult room talking to someone about their cardiovascular risk, it's a great time to bring up what vaccinations they might need, such as influenza or pneumococcal vaccination,’ Ms Rogers said. ‘Our software enables us to check their immunisation history through integration with AIR to really streamline that process.’
Employing marketing and communication strategies
A strong digital marketing strategy can make all the difference in driving vaccination uptake. ‘Automated SMS reminders are one of the most effective tools,’ Ms Rogers said. ‘They can be used to remind patients about upcoming appointments, boosters that might be due, or seasonal campaigns.’
Email campaigns offer another channel to reach patients who may not visit regularly. ‘They can provide more detailed information about available vaccines, eligibility criteria and also how to book,’ she said. ‘They're particularly useful for engaging with patients who may not be visiting your pharmacy as frequently as others.’
Social media platforms such as Facebook and Instagram extend community reach – allowing pharmacists to share timely updates, highlight new services and showcase the accessibility and professionalism of pharmacy teams.
In-store signage also plays a vital role. ‘Posters, window decals and digital screens really help reinforce the message for walk-in customers,’ Ms Rogers said.
As pharmacists expand their service offerings, it's crucial to promote new programs – including new NIP vaccines and travel health services.
‘This not only broadens the scope of pharmacy-based vaccination, but also creates new touchpoints for engaging with patients and improving public health outcomes,’ she said.
Staying on top of legislation changes
As pharmacists administer more and more vaccinations, it’s crucial to keep pace with evolving legislation and vaccine eligibility, said immunisation nurse Georgina Lewis, manager of Victoria’s Vaccine Safety Service.
‘The NIP is forever changing,’ she said. ‘Even if you're not delivering them, you need to be able to engage with families who are interested in vaccines and be opportunistic in your recommendations.’
RSV vaccine eligibility is a particularly dynamic space. ‘We’ve got two vaccines recommended for older adults, Arexy and Abrysvo,’ Ms Lewis said. ‘Both can be given at any time of year, but there's seasonality in some states and for others, it's all year round – particularly in tropical regions.’
Expanding service offering through travel vaccinations
There's an expanded role for some pharmacists to provide travel vaccines, Ms Lewis said.
‘You need to be cognisant of what your legislative requirements are, and in some circumstances [these vaccinations] will be in collaboration with other healthcare providers,’ Ms Rogers said. ‘There may be a scenario where a family or individual comes in with a prescription from a GP for Hepatitis A for example, so you dispense the vaccine and then realise that perhaps you have an opportunity to administer it … which is more convenient for the patient and prevents potential cold chain issues.’
However, a conversation needs to occur with the patient's GP. ‘You also need to make sure it’s recorded in AIR so we don’t get double-ups,’ she said.
Travel advice might be sought through pharmacists, which presents further vaccination opportunities when within scope. ‘It’s important to check vaccination status as part of those discussions, as you may identify gaps and opportunities to catch individuals up,’ she said. ‘And then always refer back to a GP or travel specialist as appropriate. Key questions include: Are you going somewhere? Have you had your travel vaccines? Have you spoken to your GP or a travel specialist?
Co-administration and avoiding common errors
As pharmacists take on a greater role in immunisation, it’s essential to approach co-administration of vaccines with care and clinical confidence, Ms Lewis said.
‘If you're not comfortable doing more than one injection, don't do it,’ she said. ‘You're better off doing them separately or sending them somewhere where they are more confident to do that, because we don't want people coming away with the incorrect technique leading to something like a shoulder injury related to vaccine administration.”
The Vaccine Safety Service has received reports of shoulder injuries occurring in both pharmacy and general practice settings due to improper injection technique.
‘So it's really important you know your anatomical sites if you're going for co-administration, focusing on the deltoid which is recommended [for patients] over 12 months of age,’ Ms Lewis said. ‘Injecting too high into the shoulder area can cause restricted movement and ongoing pain and suffering for individuals.’
Common vaccine errors reported to the Vaccine Safety Service also underscore the importance of vigilance. Confusion between RSV vaccine products has been observed, particularly during the initial rollout phases. ‘[There was] a bit of inadvertent administration of Arexy in pregnancy when Abrysvo wasn't on the NIP, which has settled down now,’ Ms Lewis noted. ‘But it's been replaced by Abrysvo being given to infants instead of the monoclonal antibody.’
Another avoidable issue is the administration of expired vaccines. ‘We get a lot of expired vaccine [reports],’ she said. ‘So it's another opportunity to check and get your products and storage right.’
Looking ahead
The National Immunisation Strategy for Australia 2025–2030, released on Thursday 12 June, outlines national consistency and public trust as key pillars in increasing vaccination rates – recommending an expanded vaccination scope for pharmacists that encompasses more NIP vaccines.
This is something PSA has long advocated for.
‘Harmonising the regulation of pharmacist-administered vaccines is overdue. It just makes sense. Now it has been recommended by a number of policy leaders from the Interim Australian Centre for Disease Control to the Grattan Institute,’ said PSA National President Associate Professor Fei Sim FPS.
‘PSA has said previously that the Australian Immunisation Handbook should be the national standard for defining vaccine formularies, instead of relying on complex regulatory instruments unique to each state and territory. The National Immunisation Strategy has supported this approach. Now it’s time for action.
In the meantime, the message for pharmacists is clear: continue doing what you do best – connect with your community, provide trusted care, and stay informed.
‘You're all in a fantastic position to do something about this,’ Prof Kidd said. ‘Please continue to do all you can.’
[post_title] => How pharmacists can stop the slide in immunisation coverage
[post_excerpt] => As vaccine-preventable diseases resurface, pharmacies must lead informed conversations that close gaps and restore community protection.
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[post_content] => Chastina Heck MPS finds solace at sea when off-duty from roles as a hospital pharmacist and the new Aboriginal and Torres Strait Islander Pharmacy Practice Community of Specialty Interest (CSI) Chair.
What drew you to hospital pharmacy?
When I was studying, I didn’t have a strong pull towards either community or hospital practice. For me, it was an opportunistic conversation with the Director of Pharmacy who approached me after presenting at a university showcase on my Quality Use of Medicines project.
It discussed how I saw pharmacists contributing to Aboriginal Medical Services. Looking back, I struggled to see myself in the pharmacy profession. But it was those relationships and connections that influenced my choice to apply for a hospital pharmacy pre-registration position (as it was called back then).
What do you aim to achieve as PSA’s Aboriginal and Torres Strait Islander Pharmacy Practice CSI Lead?
I’m really excited to be supported by other First Nations pharmacists as we move forward. As Chair, it is really important that Aboriginal and Torres Strait Islander voices influence policy on a national platform and give voice to our communities to create space for change. I’d like the power of our CSI to be utilised to its full extent by both the National Aboriginal Community Controlled Health Organisation and PSA, and empowering individuals to take action locally.
How do you translate insights between your hospital role and the classroom?
My motivation and teaching at the University of Queensland School of Pharmacy is grounded in the original concept of Medicare – equity of access to health care no matter where you live.
My teaching is also delivered through Aboriginal ways of teaching and information sharing such as storytelling. I share my own stories of cultural reflexivity and learnings with students to demonstrate that I, too, am on a continuous learning journey – with the purpose of cultural safety not just about reaching a destination. I also share real-world examples of culturally safe practice such as being able to facilitate a few days of continuous infusions of effective antibiotics on Country in Arnhem Land to allow a person to complete family sorry business prior to the patient flying out to Darwin to complete other investigations for melioidosis, a rare, tropical bacterial disease that can be life-threatening if antibiotics are not prescribed promptly. Very real harm could have resulted if either the antibiotics weren’t given with the frequency and dose required, or harm for the patient and family’s wellbeing if cultural protocol wasn’t fulfilled.
How could Aboriginal and Torres Strait Islander care improve in the future?
Our healthcare system is incredibly complex. And, depending on where you access care, the rules are different. Even for a healthcare professional, it’s hard to navigate and understand.
Better health care is well-connected, timely and efficient, with patients’ rights and individual beliefs respected and incorporated into care. A value of my culture is generational thinking and our healthcare system sometimes invests dollars more heavily to fix things when they’ve already gone wrong. I’d like to see greater investment in preventive health and keeping people out of hospital. Embedding pharmacists in Aboriginal Medical Services is a way to achieve this.
What would you tell your younger self?
You absolutely belong in the pharmacy profession and enjoy your time at university. They are truly some of the best times of your life.
What’s your favourite water leisure?
I enjoy the saltwater, sunshine and stars, which leads me to spending time on the water boating, fishing and getting out of the city to see the dark skies in all their sparkly glory. I’ve swum with manta rays up on the Bromby Island, offshore from Nhulunbuy and I also love the clear waters off Mulgumpin (Moreton Island).
[post_title] => Meet the new Aboriginal and Torres Strait Islander CSI lead
[post_excerpt] => The new Aboriginal and Torres Strait Islander Pharmacy Practice CSI lead will guide reform through culturally safe practice.
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[post_content] => In this year’s King’s Birthday Honours, five pharmacists have been awarded prestigious Orders of Australia Medals in recognition of their outstanding contributions to the profession and their local communities.
PSA congratulated the pharmacists recognised in Monday’s honours list, including:
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[post_content] => Following several incident reports, the Therapeutic Goods Administration (TGA) has issued new preoperative precautions linked to these popular therapies.
Last week, the TGA issued an alert over use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dual glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 RAs) before procedures involving general anaesthesia or deep sedation.
This warning extends to all medicines in these classes approved for diabetes and/or chronic weight management, including:
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[post_content] => In a significant advancement for patient-centred care, a team of pharmacists from the University of Tasmania is reshaping the landscape of antidepressant deprescribing.
Their latest research aims to close a long-standing clinical gap by making easy-to-prepare, cost-effective oral liquid formulations of commonly prescribed antidepressants accessible to every Australian pharmacist.
[caption id="attachment_29732" align="alignright" width="263"] Natalie Cooper[/caption]
These new formulas will help to ensure that patients have options to access safe and effective medications when deprescribing antidepressants, said Natalie Cooper, Research Project Lead at the University of Tasmania’s School of Pharmacy and Pharmacology.
‘Prescribers can also have confidence that when they are prescribing these formulas and suggesting a deprescribing regime, the patient is going to receive an accurate and effective dose,’ she said.
Long-term use with limited tapering options
Each year, over 3.5 million Australians are prescribed antidepressants. Half of these patients become long-term users, with average treatment durations reaching 4 years – well beyond the recommended 6–12 month course to treat a single depressive episode. While these medicines play a critical role in managing mental health, extended use can result in adverse effects, particularly in older adults. Yet safely discontinuing antidepressants remains a challenge.
Key among the hurdles is dose inflexibility.
‘With the lack of commercially available liquid antidepressant formulations available in Australia, there are limited dosing options for people to withdraw from antidepressant medications,’ Ms Cooper said.
The recently released Maudsley Deprescribing Guidelines recommend a hyperbolic tapering method – small, incremental decreases in dose over time – to minimise withdrawal symptoms and support the body’s physiological adjustment. However, this method often requires doses lower than commercially available tablet strengths.
In Australia, the lowest available strength of citalopram – the most commonly prescribed antidepressant – is a 10 mg tablet, which can make safe and effective tapering difficult.
Seeking safer deprescribing methods
When tapering antidepressants, current guidelines often suggest that low doses of certain formulations can be crushed up and dispersed in water, Ms Cooper said.
‘Getting patients to do this imprecise method at home didn’t sound safe to me,’ she said. ‘So I reached out to the Wilson Foundation and asked “why don't we utilise liquid formulations to [deprescribe] in a safe and effective way?’”
In response, the Wilson Foundation funded an 18-month project aimed at producing professional, evidence-based formulation alternatives that all registered pharmacists can readily compound.
‘By creating easy-to-prepare, cost-effective liquid antidepressant formulations that any pharmacy can compound, we’re tackling a major barrier to antidepressant discontinuation,’ Ms Cooper said.
Choosing the right antidepressants for compounding
The research team selected 11 antidepressants for development, targeting those most commonly prescribed in Australia, including mirtazapine, paroxetine and fluoxetine.
‘There are some that aren't as commonly prescribed, but if there’s a patient who needs to come off them, they have an option available,’ Ms Cooper said.
Out of 15 antidepressants listed in the Maudsley Deprescribing Guidelines, four were identified as controlled-release formulations – such as venlafaxine – that can’t be easily transformed into liquid forms.
‘We have gone with the antidepressants we know are immediate release and can be formulated into liquid formulations,’ she said.
The formulations that have sustained-release properties will still require a compounding pharmacist’s expertise to formulate alternate dosage forms.
Developing evidence-based liquid formulations
Designed for ease and accessibility, the proposed liquid formulations can be compounded using standard equipment and readily available ingredients.
‘We're conducting stability testing on these liquid formulations using the commercially available tablets and accessible bases such as ORA-Sweet and ORA-Plus,’ Ms Cooper said. ‘So pharmacists can compound them when they get a prescription from a GP for individual patient supply.’
Once stability and microbial safety are confirmed, the formulations will be submitted to the Australian Pharmaceutical Formulary and Handbook (APF) to be considered for inclusion.
If they are in the APF, they will be available to every single pharmacist and pharmacy in Australia to compound.
The rollout will be incremental, with three formulations submitted each quarter until all 11 are included by the project’s completion.
Bridging gaps in access and affordability
Compounded formulations of antidepressants have traditionally only been available through specialised pharmacies. For patients and prescribers alike, this has presented a barrier to optimal care.
‘Some people may be getting specialised compounded fluoxetine capsules in a low dose through a compounding pharmacy, for example. But they can be quite expensive,’ Ms Cooper said. ‘Accessing a compounding pharmacy also can be quite difficult.’
Dr Anna Seth, a Tasmanian GP, echoed these concerns from the prescriber’s perspective.
‘Existing options for gradual discontinuation of antidepressants are very limited, creating a barrier for patients and the doctors who support them,’ she said. ‘The cost of compounding these medications is prohibitive for many of my patients who are then stuck with either trying to crush and disperse tablets at home or stopping medications more abruptly and risking unpleasant withdrawal effects.’
The new liquid formulations will allow prescribers to instruct patients in volume-based dosing, simplifying the regimen.
Pharmacists’ role in interdisciplinary care
Beyond compounding, pharmacists will play a crucial role in patient and prescriber education.
‘It’s important to get it out through networks to let prescribers know that these formulas are available for pharmacists to compound,’ Ms Cooper said. ‘Communication between the doctor and the pharmacist will help patients be able to achieve effective withdrawal from antidepressants.’
Joanne Gross, President of PSA’s Tasmania Branch, reinforced the importance of pharmacist leadership in deprescribing initiatives.
‘Antidepressant deprescribing remains a challenge, particularly for long-term users experiencing withdrawal symptoms,’ she said.
‘PSA looks forward to continuing to work with the University to potentially make their findings accessible to all Australian pharmacists through the APF, supporting flexible, individualised tapering regimens and improving patient outcomes.’
To find out more about when and how pharmacists can compound and the compliance obligations required, attend the ‘Compounding essentials for 2025’ session at PSA25 held in Sydney from 1–3 August. Register here to attend.
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[post_excerpt] => In a significant advancement for patient-centred care, a team of pharmacists is reshaping the landscape of antidepressant deprescribing.
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[post_content] => As vaccine-preventable diseases resurface, pharmacies must lead proactive, informed conversations that close gaps and restore community protection.
Despite a world-class immunisation framework and high levels of public trust, Australia has seen vaccination coverage fall short of its 95% target across most cohorts since 2020, said Professor Michael Kidd at the 9th Annual Immunisation Forum 2025, in his first speech Australia's new Chief Medical Officer.
[caption id="attachment_29704" align="alignright" width="281"] Professor Michael Kidd[/caption]
‘If we don't halt the decline in vaccination rates and improve our vaccination coverage … we're risking more disease outbreaks, more serious illness and death among members of our most vulnerable populations, including our children and older people,’ he said.
It’s a troubling trend, especially with the re-emergence of measles both locally and globally, the increase in reported cases of influenza and pertussis, and the outbreak of polio just to our north in Papua New Guinea.
The good news? Pharmacists, as the most accessible health professionals, have already proven themselves to be a trusted, convenient and indispensable vaccination workforce. But there are ways to harness this accessibility, credibility and community reach to increase vaccination uptake – particularly as expanded scopes of practice and new immunisation programs roll out nationwide.
Taking every opportunity
The key to improving vaccination rates is proactive engagement, particularly during patient interactions, said pharmacist Bec Rogers.
‘One of the most effective strategies is the identification of eligible patients during dispensing,’ she said. Whether it’s offering an influenza shot to a patient collecting an asthma inhaler, or recommending a shingles vaccine to an older adult – the opportunities are endless.
‘Opportunistic conversations at the counter or in a consultation room prompt patients to take action that they may not have considered before, because the recommendation is coming from their trusted and respected health professional,’ she said.
For example, in areas with a high proportion of young families, offering family-friendly vaccination clinics – which could mean extended hours or group appointments – can help remove barriers and boost participation.
Other appointment types, such as medication reviews, health checks or minor ailment consultations, can be leveraged as an opportunity to identify recommended vaccines.
‘For instance, if you're in the consult room talking to someone about their cardiovascular risk, it's a great time to bring up what vaccinations they might need, such as influenza or pneumococcal vaccination,’ Ms Rogers said. ‘Our software enables us to check their immunisation history through integration with AIR to really streamline that process.’
Employing marketing and communication strategies
A strong digital marketing strategy can make all the difference in driving vaccination uptake. ‘Automated SMS reminders are one of the most effective tools,’ Ms Rogers said. ‘They can be used to remind patients about upcoming appointments, boosters that might be due, or seasonal campaigns.’
Email campaigns offer another channel to reach patients who may not visit regularly. ‘They can provide more detailed information about available vaccines, eligibility criteria and also how to book,’ she said. ‘They're particularly useful for engaging with patients who may not be visiting your pharmacy as frequently as others.’
Social media platforms such as Facebook and Instagram extend community reach – allowing pharmacists to share timely updates, highlight new services and showcase the accessibility and professionalism of pharmacy teams.
In-store signage also plays a vital role. ‘Posters, window decals and digital screens really help reinforce the message for walk-in customers,’ Ms Rogers said.
As pharmacists expand their service offerings, it's crucial to promote new programs – including new NIP vaccines and travel health services.
‘This not only broadens the scope of pharmacy-based vaccination, but also creates new touchpoints for engaging with patients and improving public health outcomes,’ she said.
Staying on top of legislation changes
As pharmacists administer more and more vaccinations, it’s crucial to keep pace with evolving legislation and vaccine eligibility, said immunisation nurse Georgina Lewis, manager of Victoria’s Vaccine Safety Service.
‘The NIP is forever changing,’ she said. ‘Even if you're not delivering them, you need to be able to engage with families who are interested in vaccines and be opportunistic in your recommendations.’
RSV vaccine eligibility is a particularly dynamic space. ‘We’ve got two vaccines recommended for older adults, Arexy and Abrysvo,’ Ms Lewis said. ‘Both can be given at any time of year, but there's seasonality in some states and for others, it's all year round – particularly in tropical regions.’
Expanding service offering through travel vaccinations
There's an expanded role for some pharmacists to provide travel vaccines, Ms Lewis said.
‘You need to be cognisant of what your legislative requirements are, and in some circumstances [these vaccinations] will be in collaboration with other healthcare providers,’ Ms Rogers said. ‘There may be a scenario where a family or individual comes in with a prescription from a GP for Hepatitis A for example, so you dispense the vaccine and then realise that perhaps you have an opportunity to administer it … which is more convenient for the patient and prevents potential cold chain issues.’
However, a conversation needs to occur with the patient's GP. ‘You also need to make sure it’s recorded in AIR so we don’t get double-ups,’ she said.
Travel advice might be sought through pharmacists, which presents further vaccination opportunities when within scope. ‘It’s important to check vaccination status as part of those discussions, as you may identify gaps and opportunities to catch individuals up,’ she said. ‘And then always refer back to a GP or travel specialist as appropriate. Key questions include: Are you going somewhere? Have you had your travel vaccines? Have you spoken to your GP or a travel specialist?
Co-administration and avoiding common errors
As pharmacists take on a greater role in immunisation, it’s essential to approach co-administration of vaccines with care and clinical confidence, Ms Lewis said.
‘If you're not comfortable doing more than one injection, don't do it,’ she said. ‘You're better off doing them separately or sending them somewhere where they are more confident to do that, because we don't want people coming away with the incorrect technique leading to something like a shoulder injury related to vaccine administration.”
The Vaccine Safety Service has received reports of shoulder injuries occurring in both pharmacy and general practice settings due to improper injection technique.
‘So it's really important you know your anatomical sites if you're going for co-administration, focusing on the deltoid which is recommended [for patients] over 12 months of age,’ Ms Lewis said. ‘Injecting too high into the shoulder area can cause restricted movement and ongoing pain and suffering for individuals.’
Common vaccine errors reported to the Vaccine Safety Service also underscore the importance of vigilance. Confusion between RSV vaccine products has been observed, particularly during the initial rollout phases. ‘[There was] a bit of inadvertent administration of Arexy in pregnancy when Abrysvo wasn't on the NIP, which has settled down now,’ Ms Lewis noted. ‘But it's been replaced by Abrysvo being given to infants instead of the monoclonal antibody.’
Another avoidable issue is the administration of expired vaccines. ‘We get a lot of expired vaccine [reports],’ she said. ‘So it's another opportunity to check and get your products and storage right.’
Looking ahead
The National Immunisation Strategy for Australia 2025–2030, released on Thursday 12 June, outlines national consistency and public trust as key pillars in increasing vaccination rates – recommending an expanded vaccination scope for pharmacists that encompasses more NIP vaccines.
This is something PSA has long advocated for.
‘Harmonising the regulation of pharmacist-administered vaccines is overdue. It just makes sense. Now it has been recommended by a number of policy leaders from the Interim Australian Centre for Disease Control to the Grattan Institute,’ said PSA National President Associate Professor Fei Sim FPS.
‘PSA has said previously that the Australian Immunisation Handbook should be the national standard for defining vaccine formularies, instead of relying on complex regulatory instruments unique to each state and territory. The National Immunisation Strategy has supported this approach. Now it’s time for action.
In the meantime, the message for pharmacists is clear: continue doing what you do best – connect with your community, provide trusted care, and stay informed.
‘You're all in a fantastic position to do something about this,’ Prof Kidd said. ‘Please continue to do all you can.’
[post_title] => How pharmacists can stop the slide in immunisation coverage
[post_excerpt] => As vaccine-preventable diseases resurface, pharmacies must lead informed conversations that close gaps and restore community protection.
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[post_content] => Chastina Heck MPS finds solace at sea when off-duty from roles as a hospital pharmacist and the new Aboriginal and Torres Strait Islander Pharmacy Practice Community of Specialty Interest (CSI) Chair.
What drew you to hospital pharmacy?
When I was studying, I didn’t have a strong pull towards either community or hospital practice. For me, it was an opportunistic conversation with the Director of Pharmacy who approached me after presenting at a university showcase on my Quality Use of Medicines project.
It discussed how I saw pharmacists contributing to Aboriginal Medical Services. Looking back, I struggled to see myself in the pharmacy profession. But it was those relationships and connections that influenced my choice to apply for a hospital pharmacy pre-registration position (as it was called back then).
What do you aim to achieve as PSA’s Aboriginal and Torres Strait Islander Pharmacy Practice CSI Lead?
I’m really excited to be supported by other First Nations pharmacists as we move forward. As Chair, it is really important that Aboriginal and Torres Strait Islander voices influence policy on a national platform and give voice to our communities to create space for change. I’d like the power of our CSI to be utilised to its full extent by both the National Aboriginal Community Controlled Health Organisation and PSA, and empowering individuals to take action locally.
How do you translate insights between your hospital role and the classroom?
My motivation and teaching at the University of Queensland School of Pharmacy is grounded in the original concept of Medicare – equity of access to health care no matter where you live.
My teaching is also delivered through Aboriginal ways of teaching and information sharing such as storytelling. I share my own stories of cultural reflexivity and learnings with students to demonstrate that I, too, am on a continuous learning journey – with the purpose of cultural safety not just about reaching a destination. I also share real-world examples of culturally safe practice such as being able to facilitate a few days of continuous infusions of effective antibiotics on Country in Arnhem Land to allow a person to complete family sorry business prior to the patient flying out to Darwin to complete other investigations for melioidosis, a rare, tropical bacterial disease that can be life-threatening if antibiotics are not prescribed promptly. Very real harm could have resulted if either the antibiotics weren’t given with the frequency and dose required, or harm for the patient and family’s wellbeing if cultural protocol wasn’t fulfilled.
How could Aboriginal and Torres Strait Islander care improve in the future?
Our healthcare system is incredibly complex. And, depending on where you access care, the rules are different. Even for a healthcare professional, it’s hard to navigate and understand.
Better health care is well-connected, timely and efficient, with patients’ rights and individual beliefs respected and incorporated into care. A value of my culture is generational thinking and our healthcare system sometimes invests dollars more heavily to fix things when they’ve already gone wrong. I’d like to see greater investment in preventive health and keeping people out of hospital. Embedding pharmacists in Aboriginal Medical Services is a way to achieve this.
What would you tell your younger self?
You absolutely belong in the pharmacy profession and enjoy your time at university. They are truly some of the best times of your life.
What’s your favourite water leisure?
I enjoy the saltwater, sunshine and stars, which leads me to spending time on the water boating, fishing and getting out of the city to see the dark skies in all their sparkly glory. I’ve swum with manta rays up on the Bromby Island, offshore from Nhulunbuy and I also love the clear waters off Mulgumpin (Moreton Island).
[post_title] => Meet the new Aboriginal and Torres Strait Islander CSI lead
[post_excerpt] => The new Aboriginal and Torres Strait Islander Pharmacy Practice CSI lead will guide reform through culturally safe practice.
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[post_content] => In this year’s King’s Birthday Honours, five pharmacists have been awarded prestigious Orders of Australia Medals in recognition of their outstanding contributions to the profession and their local communities.
PSA congratulated the pharmacists recognised in Monday’s honours list, including:
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[post_content] => Following several incident reports, the Therapeutic Goods Administration (TGA) has issued new preoperative precautions linked to these popular therapies.
Last week, the TGA issued an alert over use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dual glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 RAs) before procedures involving general anaesthesia or deep sedation.
This warning extends to all medicines in these classes approved for diabetes and/or chronic weight management, including:
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[post_content] => In a significant advancement for patient-centred care, a team of pharmacists from the University of Tasmania is reshaping the landscape of antidepressant deprescribing.
Their latest research aims to close a long-standing clinical gap by making easy-to-prepare, cost-effective oral liquid formulations of commonly prescribed antidepressants accessible to every Australian pharmacist.
[caption id="attachment_29732" align="alignright" width="263"] Natalie Cooper[/caption]
These new formulas will help to ensure that patients have options to access safe and effective medications when deprescribing antidepressants, said Natalie Cooper, Research Project Lead at the University of Tasmania’s School of Pharmacy and Pharmacology.
‘Prescribers can also have confidence that when they are prescribing these formulas and suggesting a deprescribing regime, the patient is going to receive an accurate and effective dose,’ she said.
Long-term use with limited tapering options
Each year, over 3.5 million Australians are prescribed antidepressants. Half of these patients become long-term users, with average treatment durations reaching 4 years – well beyond the recommended 6–12 month course to treat a single depressive episode. While these medicines play a critical role in managing mental health, extended use can result in adverse effects, particularly in older adults. Yet safely discontinuing antidepressants remains a challenge.
Key among the hurdles is dose inflexibility.
‘With the lack of commercially available liquid antidepressant formulations available in Australia, there are limited dosing options for people to withdraw from antidepressant medications,’ Ms Cooper said.
The recently released Maudsley Deprescribing Guidelines recommend a hyperbolic tapering method – small, incremental decreases in dose over time – to minimise withdrawal symptoms and support the body’s physiological adjustment. However, this method often requires doses lower than commercially available tablet strengths.
In Australia, the lowest available strength of citalopram – the most commonly prescribed antidepressant – is a 10 mg tablet, which can make safe and effective tapering difficult.
Seeking safer deprescribing methods
When tapering antidepressants, current guidelines often suggest that low doses of certain formulations can be crushed up and dispersed in water, Ms Cooper said.
‘Getting patients to do this imprecise method at home didn’t sound safe to me,’ she said. ‘So I reached out to the Wilson Foundation and asked “why don't we utilise liquid formulations to [deprescribe] in a safe and effective way?’”
In response, the Wilson Foundation funded an 18-month project aimed at producing professional, evidence-based formulation alternatives that all registered pharmacists can readily compound.
‘By creating easy-to-prepare, cost-effective liquid antidepressant formulations that any pharmacy can compound, we’re tackling a major barrier to antidepressant discontinuation,’ Ms Cooper said.
Choosing the right antidepressants for compounding
The research team selected 11 antidepressants for development, targeting those most commonly prescribed in Australia, including mirtazapine, paroxetine and fluoxetine.
‘There are some that aren't as commonly prescribed, but if there’s a patient who needs to come off them, they have an option available,’ Ms Cooper said.
Out of 15 antidepressants listed in the Maudsley Deprescribing Guidelines, four were identified as controlled-release formulations – such as venlafaxine – that can’t be easily transformed into liquid forms.
‘We have gone with the antidepressants we know are immediate release and can be formulated into liquid formulations,’ she said.
The formulations that have sustained-release properties will still require a compounding pharmacist’s expertise to formulate alternate dosage forms.
Developing evidence-based liquid formulations
Designed for ease and accessibility, the proposed liquid formulations can be compounded using standard equipment and readily available ingredients.
‘We're conducting stability testing on these liquid formulations using the commercially available tablets and accessible bases such as ORA-Sweet and ORA-Plus,’ Ms Cooper said. ‘So pharmacists can compound them when they get a prescription from a GP for individual patient supply.’
Once stability and microbial safety are confirmed, the formulations will be submitted to the Australian Pharmaceutical Formulary and Handbook (APF) to be considered for inclusion.
If they are in the APF, they will be available to every single pharmacist and pharmacy in Australia to compound.
The rollout will be incremental, with three formulations submitted each quarter until all 11 are included by the project’s completion.
Bridging gaps in access and affordability
Compounded formulations of antidepressants have traditionally only been available through specialised pharmacies. For patients and prescribers alike, this has presented a barrier to optimal care.
‘Some people may be getting specialised compounded fluoxetine capsules in a low dose through a compounding pharmacy, for example. But they can be quite expensive,’ Ms Cooper said. ‘Accessing a compounding pharmacy also can be quite difficult.’
Dr Anna Seth, a Tasmanian GP, echoed these concerns from the prescriber’s perspective.
‘Existing options for gradual discontinuation of antidepressants are very limited, creating a barrier for patients and the doctors who support them,’ she said. ‘The cost of compounding these medications is prohibitive for many of my patients who are then stuck with either trying to crush and disperse tablets at home or stopping medications more abruptly and risking unpleasant withdrawal effects.’
The new liquid formulations will allow prescribers to instruct patients in volume-based dosing, simplifying the regimen.
Pharmacists’ role in interdisciplinary care
Beyond compounding, pharmacists will play a crucial role in patient and prescriber education.
‘It’s important to get it out through networks to let prescribers know that these formulas are available for pharmacists to compound,’ Ms Cooper said. ‘Communication between the doctor and the pharmacist will help patients be able to achieve effective withdrawal from antidepressants.’
Joanne Gross, President of PSA’s Tasmania Branch, reinforced the importance of pharmacist leadership in deprescribing initiatives.
‘Antidepressant deprescribing remains a challenge, particularly for long-term users experiencing withdrawal symptoms,’ she said.
‘PSA looks forward to continuing to work with the University to potentially make their findings accessible to all Australian pharmacists through the APF, supporting flexible, individualised tapering regimens and improving patient outcomes.’
To find out more about when and how pharmacists can compound and the compliance obligations required, attend the ‘Compounding essentials for 2025’ session at PSA25 held in Sydney from 1–3 August. Register here to attend.
[post_title] => Making antidepressant tapering safer and easier
[post_excerpt] => In a significant advancement for patient-centred care, a team of pharmacists is reshaping the landscape of antidepressant deprescribing.
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[post_content] => As vaccine-preventable diseases resurface, pharmacies must lead proactive, informed conversations that close gaps and restore community protection.
Despite a world-class immunisation framework and high levels of public trust, Australia has seen vaccination coverage fall short of its 95% target across most cohorts since 2020, said Professor Michael Kidd at the 9th Annual Immunisation Forum 2025, in his first speech Australia's new Chief Medical Officer.
[caption id="attachment_29704" align="alignright" width="281"] Professor Michael Kidd[/caption]
‘If we don't halt the decline in vaccination rates and improve our vaccination coverage … we're risking more disease outbreaks, more serious illness and death among members of our most vulnerable populations, including our children and older people,’ he said.
It’s a troubling trend, especially with the re-emergence of measles both locally and globally, the increase in reported cases of influenza and pertussis, and the outbreak of polio just to our north in Papua New Guinea.
The good news? Pharmacists, as the most accessible health professionals, have already proven themselves to be a trusted, convenient and indispensable vaccination workforce. But there are ways to harness this accessibility, credibility and community reach to increase vaccination uptake – particularly as expanded scopes of practice and new immunisation programs roll out nationwide.
Taking every opportunity
The key to improving vaccination rates is proactive engagement, particularly during patient interactions, said pharmacist Bec Rogers.
‘One of the most effective strategies is the identification of eligible patients during dispensing,’ she said. Whether it’s offering an influenza shot to a patient collecting an asthma inhaler, or recommending a shingles vaccine to an older adult – the opportunities are endless.
‘Opportunistic conversations at the counter or in a consultation room prompt patients to take action that they may not have considered before, because the recommendation is coming from their trusted and respected health professional,’ she said.
For example, in areas with a high proportion of young families, offering family-friendly vaccination clinics – which could mean extended hours or group appointments – can help remove barriers and boost participation.
Other appointment types, such as medication reviews, health checks or minor ailment consultations, can be leveraged as an opportunity to identify recommended vaccines.
‘For instance, if you're in the consult room talking to someone about their cardiovascular risk, it's a great time to bring up what vaccinations they might need, such as influenza or pneumococcal vaccination,’ Ms Rogers said. ‘Our software enables us to check their immunisation history through integration with AIR to really streamline that process.’
Employing marketing and communication strategies
A strong digital marketing strategy can make all the difference in driving vaccination uptake. ‘Automated SMS reminders are one of the most effective tools,’ Ms Rogers said. ‘They can be used to remind patients about upcoming appointments, boosters that might be due, or seasonal campaigns.’
Email campaigns offer another channel to reach patients who may not visit regularly. ‘They can provide more detailed information about available vaccines, eligibility criteria and also how to book,’ she said. ‘They're particularly useful for engaging with patients who may not be visiting your pharmacy as frequently as others.’
Social media platforms such as Facebook and Instagram extend community reach – allowing pharmacists to share timely updates, highlight new services and showcase the accessibility and professionalism of pharmacy teams.
In-store signage also plays a vital role. ‘Posters, window decals and digital screens really help reinforce the message for walk-in customers,’ Ms Rogers said.
As pharmacists expand their service offerings, it's crucial to promote new programs – including new NIP vaccines and travel health services.
‘This not only broadens the scope of pharmacy-based vaccination, but also creates new touchpoints for engaging with patients and improving public health outcomes,’ she said.
Staying on top of legislation changes
As pharmacists administer more and more vaccinations, it’s crucial to keep pace with evolving legislation and vaccine eligibility, said immunisation nurse Georgina Lewis, manager of Victoria’s Vaccine Safety Service.
‘The NIP is forever changing,’ she said. ‘Even if you're not delivering them, you need to be able to engage with families who are interested in vaccines and be opportunistic in your recommendations.’
RSV vaccine eligibility is a particularly dynamic space. ‘We’ve got two vaccines recommended for older adults, Arexy and Abrysvo,’ Ms Lewis said. ‘Both can be given at any time of year, but there's seasonality in some states and for others, it's all year round – particularly in tropical regions.’
Expanding service offering through travel vaccinations
There's an expanded role for some pharmacists to provide travel vaccines, Ms Lewis said.
‘You need to be cognisant of what your legislative requirements are, and in some circumstances [these vaccinations] will be in collaboration with other healthcare providers,’ Ms Rogers said. ‘There may be a scenario where a family or individual comes in with a prescription from a GP for Hepatitis A for example, so you dispense the vaccine and then realise that perhaps you have an opportunity to administer it … which is more convenient for the patient and prevents potential cold chain issues.’
However, a conversation needs to occur with the patient's GP. ‘You also need to make sure it’s recorded in AIR so we don’t get double-ups,’ she said.
Travel advice might be sought through pharmacists, which presents further vaccination opportunities when within scope. ‘It’s important to check vaccination status as part of those discussions, as you may identify gaps and opportunities to catch individuals up,’ she said. ‘And then always refer back to a GP or travel specialist as appropriate. Key questions include: Are you going somewhere? Have you had your travel vaccines? Have you spoken to your GP or a travel specialist?
Co-administration and avoiding common errors
As pharmacists take on a greater role in immunisation, it’s essential to approach co-administration of vaccines with care and clinical confidence, Ms Lewis said.
‘If you're not comfortable doing more than one injection, don't do it,’ she said. ‘You're better off doing them separately or sending them somewhere where they are more confident to do that, because we don't want people coming away with the incorrect technique leading to something like a shoulder injury related to vaccine administration.”
The Vaccine Safety Service has received reports of shoulder injuries occurring in both pharmacy and general practice settings due to improper injection technique.
‘So it's really important you know your anatomical sites if you're going for co-administration, focusing on the deltoid which is recommended [for patients] over 12 months of age,’ Ms Lewis said. ‘Injecting too high into the shoulder area can cause restricted movement and ongoing pain and suffering for individuals.’
Common vaccine errors reported to the Vaccine Safety Service also underscore the importance of vigilance. Confusion between RSV vaccine products has been observed, particularly during the initial rollout phases. ‘[There was] a bit of inadvertent administration of Arexy in pregnancy when Abrysvo wasn't on the NIP, which has settled down now,’ Ms Lewis noted. ‘But it's been replaced by Abrysvo being given to infants instead of the monoclonal antibody.’
Another avoidable issue is the administration of expired vaccines. ‘We get a lot of expired vaccine [reports],’ she said. ‘So it's another opportunity to check and get your products and storage right.’
Looking ahead
The National Immunisation Strategy for Australia 2025–2030, released on Thursday 12 June, outlines national consistency and public trust as key pillars in increasing vaccination rates – recommending an expanded vaccination scope for pharmacists that encompasses more NIP vaccines.
This is something PSA has long advocated for.
‘Harmonising the regulation of pharmacist-administered vaccines is overdue. It just makes sense. Now it has been recommended by a number of policy leaders from the Interim Australian Centre for Disease Control to the Grattan Institute,’ said PSA National President Associate Professor Fei Sim FPS.
‘PSA has said previously that the Australian Immunisation Handbook should be the national standard for defining vaccine formularies, instead of relying on complex regulatory instruments unique to each state and territory. The National Immunisation Strategy has supported this approach. Now it’s time for action.
In the meantime, the message for pharmacists is clear: continue doing what you do best – connect with your community, provide trusted care, and stay informed.
‘You're all in a fantastic position to do something about this,’ Prof Kidd said. ‘Please continue to do all you can.’
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[post_content] => Chastina Heck MPS finds solace at sea when off-duty from roles as a hospital pharmacist and the new Aboriginal and Torres Strait Islander Pharmacy Practice Community of Specialty Interest (CSI) Chair.
What drew you to hospital pharmacy?
When I was studying, I didn’t have a strong pull towards either community or hospital practice. For me, it was an opportunistic conversation with the Director of Pharmacy who approached me after presenting at a university showcase on my Quality Use of Medicines project.
It discussed how I saw pharmacists contributing to Aboriginal Medical Services. Looking back, I struggled to see myself in the pharmacy profession. But it was those relationships and connections that influenced my choice to apply for a hospital pharmacy pre-registration position (as it was called back then).
What do you aim to achieve as PSA’s Aboriginal and Torres Strait Islander Pharmacy Practice CSI Lead?
I’m really excited to be supported by other First Nations pharmacists as we move forward. As Chair, it is really important that Aboriginal and Torres Strait Islander voices influence policy on a national platform and give voice to our communities to create space for change. I’d like the power of our CSI to be utilised to its full extent by both the National Aboriginal Community Controlled Health Organisation and PSA, and empowering individuals to take action locally.
How do you translate insights between your hospital role and the classroom?
My motivation and teaching at the University of Queensland School of Pharmacy is grounded in the original concept of Medicare – equity of access to health care no matter where you live.
My teaching is also delivered through Aboriginal ways of teaching and information sharing such as storytelling. I share my own stories of cultural reflexivity and learnings with students to demonstrate that I, too, am on a continuous learning journey – with the purpose of cultural safety not just about reaching a destination. I also share real-world examples of culturally safe practice such as being able to facilitate a few days of continuous infusions of effective antibiotics on Country in Arnhem Land to allow a person to complete family sorry business prior to the patient flying out to Darwin to complete other investigations for melioidosis, a rare, tropical bacterial disease that can be life-threatening if antibiotics are not prescribed promptly. Very real harm could have resulted if either the antibiotics weren’t given with the frequency and dose required, or harm for the patient and family’s wellbeing if cultural protocol wasn’t fulfilled.
How could Aboriginal and Torres Strait Islander care improve in the future?
Our healthcare system is incredibly complex. And, depending on where you access care, the rules are different. Even for a healthcare professional, it’s hard to navigate and understand.
Better health care is well-connected, timely and efficient, with patients’ rights and individual beliefs respected and incorporated into care. A value of my culture is generational thinking and our healthcare system sometimes invests dollars more heavily to fix things when they’ve already gone wrong. I’d like to see greater investment in preventive health and keeping people out of hospital. Embedding pharmacists in Aboriginal Medical Services is a way to achieve this.
What would you tell your younger self?
You absolutely belong in the pharmacy profession and enjoy your time at university. They are truly some of the best times of your life.
What’s your favourite water leisure?
I enjoy the saltwater, sunshine and stars, which leads me to spending time on the water boating, fishing and getting out of the city to see the dark skies in all their sparkly glory. I’ve swum with manta rays up on the Bromby Island, offshore from Nhulunbuy and I also love the clear waters off Mulgumpin (Moreton Island).
[post_title] => Meet the new Aboriginal and Torres Strait Islander CSI lead
[post_excerpt] => The new Aboriginal and Torres Strait Islander Pharmacy Practice CSI lead will guide reform through culturally safe practice.
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[post_content] => In this year’s King’s Birthday Honours, five pharmacists have been awarded prestigious Orders of Australia Medals in recognition of their outstanding contributions to the profession and their local communities.
PSA congratulated the pharmacists recognised in Monday’s honours list, including:
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[post_content] => Following several incident reports, the Therapeutic Goods Administration (TGA) has issued new preoperative precautions linked to these popular therapies.
Last week, the TGA issued an alert over use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dual glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 RAs) before procedures involving general anaesthesia or deep sedation.
This warning extends to all medicines in these classes approved for diabetes and/or chronic weight management, including:
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[post_content] => In a significant advancement for patient-centred care, a team of pharmacists from the University of Tasmania is reshaping the landscape of antidepressant deprescribing.
Their latest research aims to close a long-standing clinical gap by making easy-to-prepare, cost-effective oral liquid formulations of commonly prescribed antidepressants accessible to every Australian pharmacist.
[caption id="attachment_29732" align="alignright" width="263"] Natalie Cooper[/caption]
These new formulas will help to ensure that patients have options to access safe and effective medications when deprescribing antidepressants, said Natalie Cooper, Research Project Lead at the University of Tasmania’s School of Pharmacy and Pharmacology.
‘Prescribers can also have confidence that when they are prescribing these formulas and suggesting a deprescribing regime, the patient is going to receive an accurate and effective dose,’ she said.
Long-term use with limited tapering options
Each year, over 3.5 million Australians are prescribed antidepressants. Half of these patients become long-term users, with average treatment durations reaching 4 years – well beyond the recommended 6–12 month course to treat a single depressive episode. While these medicines play a critical role in managing mental health, extended use can result in adverse effects, particularly in older adults. Yet safely discontinuing antidepressants remains a challenge.
Key among the hurdles is dose inflexibility.
‘With the lack of commercially available liquid antidepressant formulations available in Australia, there are limited dosing options for people to withdraw from antidepressant medications,’ Ms Cooper said.
The recently released Maudsley Deprescribing Guidelines recommend a hyperbolic tapering method – small, incremental decreases in dose over time – to minimise withdrawal symptoms and support the body’s physiological adjustment. However, this method often requires doses lower than commercially available tablet strengths.
In Australia, the lowest available strength of citalopram – the most commonly prescribed antidepressant – is a 10 mg tablet, which can make safe and effective tapering difficult.
Seeking safer deprescribing methods
When tapering antidepressants, current guidelines often suggest that low doses of certain formulations can be crushed up and dispersed in water, Ms Cooper said.
‘Getting patients to do this imprecise method at home didn’t sound safe to me,’ she said. ‘So I reached out to the Wilson Foundation and asked “why don't we utilise liquid formulations to [deprescribe] in a safe and effective way?’”
In response, the Wilson Foundation funded an 18-month project aimed at producing professional, evidence-based formulation alternatives that all registered pharmacists can readily compound.
‘By creating easy-to-prepare, cost-effective liquid antidepressant formulations that any pharmacy can compound, we’re tackling a major barrier to antidepressant discontinuation,’ Ms Cooper said.
Choosing the right antidepressants for compounding
The research team selected 11 antidepressants for development, targeting those most commonly prescribed in Australia, including mirtazapine, paroxetine and fluoxetine.
‘There are some that aren't as commonly prescribed, but if there’s a patient who needs to come off them, they have an option available,’ Ms Cooper said.
Out of 15 antidepressants listed in the Maudsley Deprescribing Guidelines, four were identified as controlled-release formulations – such as venlafaxine – that can’t be easily transformed into liquid forms.
‘We have gone with the antidepressants we know are immediate release and can be formulated into liquid formulations,’ she said.
The formulations that have sustained-release properties will still require a compounding pharmacist’s expertise to formulate alternate dosage forms.
Developing evidence-based liquid formulations
Designed for ease and accessibility, the proposed liquid formulations can be compounded using standard equipment and readily available ingredients.
‘We're conducting stability testing on these liquid formulations using the commercially available tablets and accessible bases such as ORA-Sweet and ORA-Plus,’ Ms Cooper said. ‘So pharmacists can compound them when they get a prescription from a GP for individual patient supply.’
Once stability and microbial safety are confirmed, the formulations will be submitted to the Australian Pharmaceutical Formulary and Handbook (APF) to be considered for inclusion.
If they are in the APF, they will be available to every single pharmacist and pharmacy in Australia to compound.
The rollout will be incremental, with three formulations submitted each quarter until all 11 are included by the project’s completion.
Bridging gaps in access and affordability
Compounded formulations of antidepressants have traditionally only been available through specialised pharmacies. For patients and prescribers alike, this has presented a barrier to optimal care.
‘Some people may be getting specialised compounded fluoxetine capsules in a low dose through a compounding pharmacy, for example. But they can be quite expensive,’ Ms Cooper said. ‘Accessing a compounding pharmacy also can be quite difficult.’
Dr Anna Seth, a Tasmanian GP, echoed these concerns from the prescriber’s perspective.
‘Existing options for gradual discontinuation of antidepressants are very limited, creating a barrier for patients and the doctors who support them,’ she said. ‘The cost of compounding these medications is prohibitive for many of my patients who are then stuck with either trying to crush and disperse tablets at home or stopping medications more abruptly and risking unpleasant withdrawal effects.’
The new liquid formulations will allow prescribers to instruct patients in volume-based dosing, simplifying the regimen.
Pharmacists’ role in interdisciplinary care
Beyond compounding, pharmacists will play a crucial role in patient and prescriber education.
‘It’s important to get it out through networks to let prescribers know that these formulas are available for pharmacists to compound,’ Ms Cooper said. ‘Communication between the doctor and the pharmacist will help patients be able to achieve effective withdrawal from antidepressants.’
Joanne Gross, President of PSA’s Tasmania Branch, reinforced the importance of pharmacist leadership in deprescribing initiatives.
‘Antidepressant deprescribing remains a challenge, particularly for long-term users experiencing withdrawal symptoms,’ she said.
‘PSA looks forward to continuing to work with the University to potentially make their findings accessible to all Australian pharmacists through the APF, supporting flexible, individualised tapering regimens and improving patient outcomes.’
To find out more about when and how pharmacists can compound and the compliance obligations required, attend the ‘Compounding essentials for 2025’ session at PSA25 held in Sydney from 1–3 August. Register here to attend.
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[post_content] => As vaccine-preventable diseases resurface, pharmacies must lead proactive, informed conversations that close gaps and restore community protection.
Despite a world-class immunisation framework and high levels of public trust, Australia has seen vaccination coverage fall short of its 95% target across most cohorts since 2020, said Professor Michael Kidd at the 9th Annual Immunisation Forum 2025, in his first speech Australia's new Chief Medical Officer.
[caption id="attachment_29704" align="alignright" width="281"] Professor Michael Kidd[/caption]
‘If we don't halt the decline in vaccination rates and improve our vaccination coverage … we're risking more disease outbreaks, more serious illness and death among members of our most vulnerable populations, including our children and older people,’ he said.
It’s a troubling trend, especially with the re-emergence of measles both locally and globally, the increase in reported cases of influenza and pertussis, and the outbreak of polio just to our north in Papua New Guinea.
The good news? Pharmacists, as the most accessible health professionals, have already proven themselves to be a trusted, convenient and indispensable vaccination workforce. But there are ways to harness this accessibility, credibility and community reach to increase vaccination uptake – particularly as expanded scopes of practice and new immunisation programs roll out nationwide.
Taking every opportunity
The key to improving vaccination rates is proactive engagement, particularly during patient interactions, said pharmacist Bec Rogers.
‘One of the most effective strategies is the identification of eligible patients during dispensing,’ she said. Whether it’s offering an influenza shot to a patient collecting an asthma inhaler, or recommending a shingles vaccine to an older adult – the opportunities are endless.
‘Opportunistic conversations at the counter or in a consultation room prompt patients to take action that they may not have considered before, because the recommendation is coming from their trusted and respected health professional,’ she said.
For example, in areas with a high proportion of young families, offering family-friendly vaccination clinics – which could mean extended hours or group appointments – can help remove barriers and boost participation.
Other appointment types, such as medication reviews, health checks or minor ailment consultations, can be leveraged as an opportunity to identify recommended vaccines.
‘For instance, if you're in the consult room talking to someone about their cardiovascular risk, it's a great time to bring up what vaccinations they might need, such as influenza or pneumococcal vaccination,’ Ms Rogers said. ‘Our software enables us to check their immunisation history through integration with AIR to really streamline that process.’
Employing marketing and communication strategies
A strong digital marketing strategy can make all the difference in driving vaccination uptake. ‘Automated SMS reminders are one of the most effective tools,’ Ms Rogers said. ‘They can be used to remind patients about upcoming appointments, boosters that might be due, or seasonal campaigns.’
Email campaigns offer another channel to reach patients who may not visit regularly. ‘They can provide more detailed information about available vaccines, eligibility criteria and also how to book,’ she said. ‘They're particularly useful for engaging with patients who may not be visiting your pharmacy as frequently as others.’
Social media platforms such as Facebook and Instagram extend community reach – allowing pharmacists to share timely updates, highlight new services and showcase the accessibility and professionalism of pharmacy teams.
In-store signage also plays a vital role. ‘Posters, window decals and digital screens really help reinforce the message for walk-in customers,’ Ms Rogers said.
As pharmacists expand their service offerings, it's crucial to promote new programs – including new NIP vaccines and travel health services.
‘This not only broadens the scope of pharmacy-based vaccination, but also creates new touchpoints for engaging with patients and improving public health outcomes,’ she said.
Staying on top of legislation changes
As pharmacists administer more and more vaccinations, it’s crucial to keep pace with evolving legislation and vaccine eligibility, said immunisation nurse Georgina Lewis, manager of Victoria’s Vaccine Safety Service.
‘The NIP is forever changing,’ she said. ‘Even if you're not delivering them, you need to be able to engage with families who are interested in vaccines and be opportunistic in your recommendations.’
RSV vaccine eligibility is a particularly dynamic space. ‘We’ve got two vaccines recommended for older adults, Arexy and Abrysvo,’ Ms Lewis said. ‘Both can be given at any time of year, but there's seasonality in some states and for others, it's all year round – particularly in tropical regions.’
Expanding service offering through travel vaccinations
There's an expanded role for some pharmacists to provide travel vaccines, Ms Lewis said.
‘You need to be cognisant of what your legislative requirements are, and in some circumstances [these vaccinations] will be in collaboration with other healthcare providers,’ Ms Rogers said. ‘There may be a scenario where a family or individual comes in with a prescription from a GP for Hepatitis A for example, so you dispense the vaccine and then realise that perhaps you have an opportunity to administer it … which is more convenient for the patient and prevents potential cold chain issues.’
However, a conversation needs to occur with the patient's GP. ‘You also need to make sure it’s recorded in AIR so we don’t get double-ups,’ she said.
Travel advice might be sought through pharmacists, which presents further vaccination opportunities when within scope. ‘It’s important to check vaccination status as part of those discussions, as you may identify gaps and opportunities to catch individuals up,’ she said. ‘And then always refer back to a GP or travel specialist as appropriate. Key questions include: Are you going somewhere? Have you had your travel vaccines? Have you spoken to your GP or a travel specialist?
Co-administration and avoiding common errors
As pharmacists take on a greater role in immunisation, it’s essential to approach co-administration of vaccines with care and clinical confidence, Ms Lewis said.
‘If you're not comfortable doing more than one injection, don't do it,’ she said. ‘You're better off doing them separately or sending them somewhere where they are more confident to do that, because we don't want people coming away with the incorrect technique leading to something like a shoulder injury related to vaccine administration.”
The Vaccine Safety Service has received reports of shoulder injuries occurring in both pharmacy and general practice settings due to improper injection technique.
‘So it's really important you know your anatomical sites if you're going for co-administration, focusing on the deltoid which is recommended [for patients] over 12 months of age,’ Ms Lewis said. ‘Injecting too high into the shoulder area can cause restricted movement and ongoing pain and suffering for individuals.’
Common vaccine errors reported to the Vaccine Safety Service also underscore the importance of vigilance. Confusion between RSV vaccine products has been observed, particularly during the initial rollout phases. ‘[There was] a bit of inadvertent administration of Arexy in pregnancy when Abrysvo wasn't on the NIP, which has settled down now,’ Ms Lewis noted. ‘But it's been replaced by Abrysvo being given to infants instead of the monoclonal antibody.’
Another avoidable issue is the administration of expired vaccines. ‘We get a lot of expired vaccine [reports],’ she said. ‘So it's another opportunity to check and get your products and storage right.’
Looking ahead
The National Immunisation Strategy for Australia 2025–2030, released on Thursday 12 June, outlines national consistency and public trust as key pillars in increasing vaccination rates – recommending an expanded vaccination scope for pharmacists that encompasses more NIP vaccines.
This is something PSA has long advocated for.
‘Harmonising the regulation of pharmacist-administered vaccines is overdue. It just makes sense. Now it has been recommended by a number of policy leaders from the Interim Australian Centre for Disease Control to the Grattan Institute,’ said PSA National President Associate Professor Fei Sim FPS.
‘PSA has said previously that the Australian Immunisation Handbook should be the national standard for defining vaccine formularies, instead of relying on complex regulatory instruments unique to each state and territory. The National Immunisation Strategy has supported this approach. Now it’s time for action.
In the meantime, the message for pharmacists is clear: continue doing what you do best – connect with your community, provide trusted care, and stay informed.
‘You're all in a fantastic position to do something about this,’ Prof Kidd said. ‘Please continue to do all you can.’
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[post_content] => Chastina Heck MPS finds solace at sea when off-duty from roles as a hospital pharmacist and the new Aboriginal and Torres Strait Islander Pharmacy Practice Community of Specialty Interest (CSI) Chair.
What drew you to hospital pharmacy?
When I was studying, I didn’t have a strong pull towards either community or hospital practice. For me, it was an opportunistic conversation with the Director of Pharmacy who approached me after presenting at a university showcase on my Quality Use of Medicines project.
It discussed how I saw pharmacists contributing to Aboriginal Medical Services. Looking back, I struggled to see myself in the pharmacy profession. But it was those relationships and connections that influenced my choice to apply for a hospital pharmacy pre-registration position (as it was called back then).
What do you aim to achieve as PSA’s Aboriginal and Torres Strait Islander Pharmacy Practice CSI Lead?
I’m really excited to be supported by other First Nations pharmacists as we move forward. As Chair, it is really important that Aboriginal and Torres Strait Islander voices influence policy on a national platform and give voice to our communities to create space for change. I’d like the power of our CSI to be utilised to its full extent by both the National Aboriginal Community Controlled Health Organisation and PSA, and empowering individuals to take action locally.
How do you translate insights between your hospital role and the classroom?
My motivation and teaching at the University of Queensland School of Pharmacy is grounded in the original concept of Medicare – equity of access to health care no matter where you live.
My teaching is also delivered through Aboriginal ways of teaching and information sharing such as storytelling. I share my own stories of cultural reflexivity and learnings with students to demonstrate that I, too, am on a continuous learning journey – with the purpose of cultural safety not just about reaching a destination. I also share real-world examples of culturally safe practice such as being able to facilitate a few days of continuous infusions of effective antibiotics on Country in Arnhem Land to allow a person to complete family sorry business prior to the patient flying out to Darwin to complete other investigations for melioidosis, a rare, tropical bacterial disease that can be life-threatening if antibiotics are not prescribed promptly. Very real harm could have resulted if either the antibiotics weren’t given with the frequency and dose required, or harm for the patient and family’s wellbeing if cultural protocol wasn’t fulfilled.
How could Aboriginal and Torres Strait Islander care improve in the future?
Our healthcare system is incredibly complex. And, depending on where you access care, the rules are different. Even for a healthcare professional, it’s hard to navigate and understand.
Better health care is well-connected, timely and efficient, with patients’ rights and individual beliefs respected and incorporated into care. A value of my culture is generational thinking and our healthcare system sometimes invests dollars more heavily to fix things when they’ve already gone wrong. I’d like to see greater investment in preventive health and keeping people out of hospital. Embedding pharmacists in Aboriginal Medical Services is a way to achieve this.
What would you tell your younger self?
You absolutely belong in the pharmacy profession and enjoy your time at university. They are truly some of the best times of your life.
What’s your favourite water leisure?
I enjoy the saltwater, sunshine and stars, which leads me to spending time on the water boating, fishing and getting out of the city to see the dark skies in all their sparkly glory. I’ve swum with manta rays up on the Bromby Island, offshore from Nhulunbuy and I also love the clear waters off Mulgumpin (Moreton Island).
[post_title] => Meet the new Aboriginal and Torres Strait Islander CSI lead
[post_excerpt] => The new Aboriginal and Torres Strait Islander Pharmacy Practice CSI lead will guide reform through culturally safe practice.
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[post_content] => In this year’s King’s Birthday Honours, five pharmacists have been awarded prestigious Orders of Australia Medals in recognition of their outstanding contributions to the profession and their local communities.
PSA congratulated the pharmacists recognised in Monday’s honours list, including:
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[post_content] => Following several incident reports, the Therapeutic Goods Administration (TGA) has issued new preoperative precautions linked to these popular therapies.
Last week, the TGA issued an alert over use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dual glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 RAs) before procedures involving general anaesthesia or deep sedation.
This warning extends to all medicines in these classes approved for diabetes and/or chronic weight management, including:
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