Jala Moushi MPS
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[post_content] => On 1 July 2025, new vaping standards came into force for all therapeutic vaping products for smoking cessation and nicotine dependence.
The Therapeutic Goods Administration's (TGA’s) strengthened standards, designed to reduce harm from vape use, are the culmination of the national vaping reforms, said PSA Project Manager Nikita Dalla Venezia, who worked closely on the PSA’s Professional practice guidelines for pharmacists: nicotine dependence support.
‘Because the changes were fairly substantial, my understanding is that they were staggered,’ she said. ‘This is just the next step of that comprehensive approach to mitigating risk for people who use therapeutic vapes.’
The principal purpose of the reforms is to minimise youth uptake of vaping – an objective that, according to the Cancer Council’s iterative Generation Vape study, appears to be succeeding.
‘In Wave 7 of the study, which came out after the reforms were introduced, over 50% of youths said they would decline a vape if offered one from a friend, which is a substantial increase from Wave 2 data (less than 40%) that was collected prior to the reforms,’ Ms Dalla Venezia said.
What key changes are introduced in the updated standards?
Changes to the packaging, labelling and design of vaping products have been introduced.
Vaping devices and accessories now need to appear as therapeutic products to reduce their appeal for recreational use among both adolescents and adults, Ms Dalla Venezia said.
‘The packaging needs to be plain, and the design has to be simple with very limited colours,’ she said.
New labelling, usage instructions and information leaflets are also required, along with name restrictions.
‘The permitted ingredients have changed, to now only include nicotine, propylene glycol glycerol, and water,’ she said. ‘And the only flavours allowed are mint, menthol or tobacco.’
Vaping devices and accessories must also meet stricter standards for:
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[post_content] => PSA has announced that it will develop and maintain education standards for Continued Professional Development (CPD) for pharmacists, following the retirement of the Australian Pharmacy Council (APC) accreditation standards for CPD activities on 31 December 2025.
The APC’s accreditation standards for CPD activities have been in place since 2013.
PSA, who already publish regular CPD through Australian Pharmacist and its education catalogue, will develop and maintain industry leading standards that will certify the quality and independence of CPD.
CPD education assessed against the standards will carry a PSA approval, giving pharmacists confidence that the education they access maintains the highest quality, upholds pharmacy practice standards, guidelines and ethics, and is free from commercial bias.
PSA National President Associate Professor Fei Sim FPS said: ‘As the national peak body for pharmacists in Australia and custodians of pharmacy practice standards, guidelines and ethics, PSA is developing education standards for CPD that give our profession – and our stakeholders – confidence in the quality of pharmacist education.
‘Our members tell us that PSA’s education is of high quality, a quality they can trust, and this scheme will mean that when they see third party education that is approved as meeting the PSA education standards, they can have a similar level of trust in it,’ she said.
‘PSA’s CPD planning tool takes the stress out of planning and recording CPD education, just as these standards will give pharmacists confidence that the CPD they access is “up-to-scratch”.’
PSA’s CPD standards are set to be introduced in 2026.
[post_title] => PSA to develop education standards for CPD activities
[post_excerpt] => With the Australian Pharmacy Council retiring its accreditation standards for CPD activities, PSA is set to step up.
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[post_content] => For the first time in Australian medicines history, all Queensland-based pharmacists can make the call to substitute a therapeutically appropriate medicine without prescriber authority to solve medicine-related problems.
Australian Pharmacist explains the ins and outs of this momentous change.
What’s changing?
An update to Medicines and Poisons (Medicines) Regulation 2021 (Qld) on 1 July 2025 will allow therapeutic adaptation and substitution to take place where there is a theraputic need for change.
Under section 117B of the regulation, a pharmacist dispensing a medicine may substitute an equivalent medicine for the one specified on the prescription – provided this is reasonably necessary for the patient’s therapeutic care.
An equivalent medicine is one that:
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[post_content] => This week pharmacists will see a suite of regulatory and funding changes take effect.
Here are the six key updates pharmacists need to know before tomorrow.
1. Dispensing fees will marginally rise
Under the Eighth Community Pharmacy Agreement, pharmacists’ dispensing fee – along with the Tier 1 Administration, Handling and Infrastructure fee and the Dangerous Drug fee – will be indexed by the Consumer Price Index (CPI) annually on 1 July.
Over the past 12 months to the March 2025 quarter, the CPI increased to 2.4%.
So from tomorrow, there will be a slight jump in the per script dispense fee, which will rise from $8.67 to $8.89.
2. (Dis)continued dispensing as emergency measures roll back
As of tomorrow, temporary emergency measures that expanded the range of medicines available under Pharmaceutical Benefits Scheme (PBS) Continued Dispensing arrangements will be repealed.
The emergency authority which authorised these Continued Dispensing arrangements for private and PBS prescriptions in New South Wales, will also end at 11:59 pm tonight.
Only the standard list of 149 PBS-listed molecules will be available under Continued Dispensing in most jurisdictions, covering conditions such as asthma, diabetes, heart disease, high cholesterol and HIV.
However, Continued Dispensing will continue for some. Just enacted in Queensland, the amount of medicine a pharmacist can supply to a patient as an ‘emergency supply’ is increasing from 3 days’ supply to the smallest available manufacturer’s pack of the medicine. This applies in addition to the supply provisions enabled under the Commonwealth Continued Dispensing Determination. And in Tasmania permanent regulation also allows full Continued Dispensing as private supply for all Prescription Only Medicines.
A full list of what’s happening in your state or territory is available via PSA’s Regulation Hub which will be updated overnight to reflect these changes.
The PSA has long advocated for the full measure to be made permanent across the nation.
‘We’ve seen temporary continued dispensing measures introduced during natural disasters, which is important, but there are several scenarios where a permanent policy would help patients, from personal emergencies to natural disasters,’ said PSA CEO Adjunct Associate Professor Steve Morris.
‘PSA is again urging the federal government to work with state and territory governments to permanently protect emergency access to medicines.’
3. New vaping standards will come into effect
From 1 July, the Therapeutic Goods Administration (TGA) will implement strengthened standards for all therapeutic nicotine vaping products used for smoking-cessation and nicotine-dependence. This measure is designed to mitigate risks associated with therapeutic vaping products and ensure a consistent level of safety and quality across all products supplied through pharmacies.
Under the new standards, pharmacies will only be permitted to supply vapes that satisfy defined criteria around permitted ingredients, tamper-evident and child-resistant packaging, and clear, consistent labelling.
Pharmacists should refer to the TGA’s notified vape list, which details all therapeutic vaping products approved for smoking cessation and the management of nicotine dependence.
4. Pharmacists now have longer to transition to the new MMR and ACOP credential
Until recently, pharmacists were required to meet the revised credentialing standards by 30 June 2025 – either by obtaining Recognition of Prior Learning (RPL) towards their new credential or by undertaking further education to fulfil the updated requirements.
The deadlines to achieve both credentials have now been extended to:
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[post_content] => Decision-support tools are designed to promote patient safety. But when here's a pop-up for everything, the message can be diluted.
We all know the feeling. You’re in the middle of something – maybe deep into a busy shift in the pharmacy, or on the wards in the hospital, or even scrolling on your phone at home – and another pop-up appears.
You’ve seen it before, so your instinct is to dismiss it without a second thought.
While ignoring the latest alert from your fitness app might mean falling behind on your step count, dismissing a decision-support pop-up in a healthcare setting might mean missing something crucial.
Yet, with so many alerts coming through, it can be overwhelming – and almost impossible – to sort the important information from the rest.
Why do we have popups?
Pop-ups are much like passing a sign on the road. They are meant to inform your decisions, whether this be about a hidden hazard or general navigation. In health care, they have proliferated across the increasing number of digital platforms and pieces of software health professionals use to provide patient care and nowhere more so than clinical decision-support tools.
Decision-support pop-ups take many forms, from alerts about potential drug interactions to duplicate therapy warnings and allergy information. They are intended to aid health professionals in their decision-making and, in the case of dispensing pharmacists, are there to ‘remind pharmacists to be alert and to double-check that the medicine supplied is the medicine prescribed’, says PDL Senior Professional Officer Gary West FPS (he/him).
‘It might only take half a second to view them, but the difference for a patient – and for a pharmacist – can be really significant. We’ve had multiple cases where a locum or newly registered pharmacist hasn’t realised a patient is on a staged-supply arrangement because it wasn’t clear in their profile. A warning message would have prevented that patient from getting access to a larger quantity of medicines than intended.’
Mr West says both pharmacists and dispensary technicians should understand why the alerts are there – to help mitigate risk for patients and themselves.
‘We would always encourage pharmacists to use that technology, and to ensure their dispensary technicians are well trained and alert to raising certain pop-up warnings with the pharmacist associated with the dispensing event,’ says Mr West.
The pop-up paradox
But are we currently overwhelmed by pop-ups? And are some pop-ups better than others?
University of Sydney Professor of Health Research Melissa Baysari (she/her) suggests the answer to both questions is yes. A human factors expert, she has conducted extensive research into how digital health can support medicine management. Despite their good intentions, she says there is limited evidence that alerts change practice or improve patient outcomes, particularly in the hospital setting.
In a 5-year study involving patients across five hospitals in New South Wales and Queensland, Prof Baysari’s team examined whether activating drug-drug interaction alerts reduced harm. One group of hospitals had the alerts enabled, the control group did not.
Surprising results
‘We found overall that the alerts had no impact,’ she says. ‘Having drug-drug interaction alerts did not reduce the number of clinically relevant interactions or harms experienced by patients. The study shows that if you’re going to turn all the drug interaction alerts on, they’re not going to deliver the safety benefits you expect.’
In fact, she warns that poorly designed or excessive alerts can backfire. ‘There are so many negative consequences, like wasted time, frustration for clinicians and patient safety implications, that I would not recommend turning drug-drug interaction alerts on in your systems unless you’ve got some kind of smart technology in there.’
Despite the lack of evidence about the effectiveness of alerts, organisations are often reluctant to scale them back. Prof Baysari said her team had ‘a lot of trouble’ finding hospitals that were willing to not turn on their drug interaction alerts.
‘Everyone assumed the alerts were effective and they were going to be removing an intervention that was providing a safety net for everyone,’ she says. ‘But the way I see it, if organisations just keep putting more and more alerts in, it becomes the end user’s responsibility to work out which ones are relevant and act appropriately. It’s shifting the responsibility away from the organisation, so if an incident occurs, it’s the clinician who’s to blame. I think that’s very unfair.’
Information overload
Research shows that the number of alerts a healthcare professional receives impacts how effective they are – and pharmacists see a lot, Prof Baysari says.
‘You might assume that there’s an evidence base for alerts, but we have a lot more research showing that when you implement large numbers of alerts, clinicians begin to ignore them. They’re seeing too many, and so they’re not reading the recommendations. I have a theory that this becomes a habitual response – an alert pops up, clinicians override it and move past it. It allows them to get through work quickly.’
This alert fatigue has real-world safety implications. If one alert out of 12 presented is a critical warning, and the other 11 aren’t clinically relevant for the patient, it’s likely the important alert will be missed.
‘We’re increasingly seeing incidents where alert fatigue has been identified as a contributing factor. It’s not that there wasn’t an alert in place, but that it was lost among the other alerts the clinician saw,’ Prof Baysari says.
Returning to the road-sign analogy, there comes a point where there are just too many and you just can’t process them all and they stop being useful. Or you drive past the same ones every day and stop paying attention to them.
PDL has developed its own alerts based on incidents that are frequently reported to the organisation and on medicines that are more likely to have significant consequences for patients.
‘We’re very mindful. We put in a small number of pop-ups that we think are of high importance or significance,’ Mr West says. ‘Our warnings are not theoretical. We try to prevent alert fatigue by limiting warnings to things that occur with frequency or with such consequence that they justify the pop-up. We appreciate it’s difficult when hundreds of prescriptions are dispensed every day, but we’d really encourage pharmacists to take note of them and not just tab through without any consideration.’
Making smarter systems
As pharmacists continue to expand their scope of practice, Fred IT Group Partnerships Manager Regina Cowie (she/her) says the functionality of decision-support tools will need to expand to include options like preventive care recommendations and chronic disease management tools.
‘For example, clinical decision support may be used to identify patients eligible for chronic disease screening or to assess chronic disease management,’ she says. ‘Or a vaccination prompt for eligible patients could support pharmacists to make informed decisions by dynamically changing aspects within dispensing systems to guide on healthcare opportunities, for example to improve vaccination rates.’
As well as being broader, alerts also need to become smarter. Artificial intelligence is already being used in some aspects of dispensing software, Ms Cowie says, and AI has the potential to revolutionise the way clinical decision support is used.
‘AI has the ability to analyse large amounts of patient data and provide opportunities to improve medicine safety and patient care … Fred AID (Artificial Intelligence Directions) is an optional function already in place in Fred Dispense Plus. It uses AI to predict medication directions and allows pharmacists to quickly and safely enter directions for dispensing labels, rather than typing these from scratch.
‘In future, AI may suggest treatment plans or identify patients at risk of certain diseases, based on patient population data. In health care, where time pressures are a consistent burden on clinicians, a related opportunity from AI is its ability to provide administrative support by automating documentation such as clinical notes.’
Ultimately, there isn’t anything inherently wrong with alerts, Prof Baysari says, they just need to be better. ‘We have very basic alerts at the moment. They’re not designed well, so we’re not seeing the benefits. But we could.
‘We need better design in the backend, using AI to make them smarter, and, in the frontend, we need to think about how they look on screen,’ she says. ‘If we had good interfaces and a good backend infrastructure we’d get good safety benefits. But we have a lot of work to do.’
Fred IT Government and Industry Engagement Lead and former Medicines Safety Program Director of the Australian Digital Health Agency Andrew Matthews MPS says clinical decision-support tools such as alerts can increase detection of inappropriate prescribing and dispensing, improve disease management, reduce adverse patient outcomes and enhance appropriate treatment.
Fred IT, for example, has introduced an optional prompt in its dispensing software to help improve vaccination rates for the shingles vaccine in target cohorts aligned with recommendations from the National Immunisation Program (NIP).
The prompt displays only if the patient meets the NIP criteria of the patient demographics entered in the Fred Dispense Plus patient profile.
‘With the large volumes of patient data now available in electronic medical records and pharmacy systems, especially where patient disease complexity makes it difficult to quickly assess the available data,’ Mr Matthews says, ‘clinical decision-support can present relevant patient information to the clinician to facilitate clinical problem-solving, decision-making or provide additional knowledge consistent with best practice guidelines.’
[post_title] => Are pop-ups doing more harm than good?
[post_excerpt] => Are decision-support tools the problem or the cure for patient safety? Australian Pharmacist investigates.
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[post_content] => On 1 July 2025, new vaping standards came into force for all therapeutic vaping products for smoking cessation and nicotine dependence.
The Therapeutic Goods Administration's (TGA’s) strengthened standards, designed to reduce harm from vape use, are the culmination of the national vaping reforms, said PSA Project Manager Nikita Dalla Venezia, who worked closely on the PSA’s Professional practice guidelines for pharmacists: nicotine dependence support.
‘Because the changes were fairly substantial, my understanding is that they were staggered,’ she said. ‘This is just the next step of that comprehensive approach to mitigating risk for people who use therapeutic vapes.’
The principal purpose of the reforms is to minimise youth uptake of vaping – an objective that, according to the Cancer Council’s iterative Generation Vape study, appears to be succeeding.
‘In Wave 7 of the study, which came out after the reforms were introduced, over 50% of youths said they would decline a vape if offered one from a friend, which is a substantial increase from Wave 2 data (less than 40%) that was collected prior to the reforms,’ Ms Dalla Venezia said.
What key changes are introduced in the updated standards?
Changes to the packaging, labelling and design of vaping products have been introduced.
Vaping devices and accessories now need to appear as therapeutic products to reduce their appeal for recreational use among both adolescents and adults, Ms Dalla Venezia said.
‘The packaging needs to be plain, and the design has to be simple with very limited colours,’ she said.
New labelling, usage instructions and information leaflets are also required, along with name restrictions.
‘The permitted ingredients have changed, to now only include nicotine, propylene glycol glycerol, and water,’ she said. ‘And the only flavours allowed are mint, menthol or tobacco.’
Vaping devices and accessories must also meet stricter standards for:
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[post_content] => PSA has announced that it will develop and maintain education standards for Continued Professional Development (CPD) for pharmacists, following the retirement of the Australian Pharmacy Council (APC) accreditation standards for CPD activities on 31 December 2025.
The APC’s accreditation standards for CPD activities have been in place since 2013.
PSA, who already publish regular CPD through Australian Pharmacist and its education catalogue, will develop and maintain industry leading standards that will certify the quality and independence of CPD.
CPD education assessed against the standards will carry a PSA approval, giving pharmacists confidence that the education they access maintains the highest quality, upholds pharmacy practice standards, guidelines and ethics, and is free from commercial bias.
PSA National President Associate Professor Fei Sim FPS said: ‘As the national peak body for pharmacists in Australia and custodians of pharmacy practice standards, guidelines and ethics, PSA is developing education standards for CPD that give our profession – and our stakeholders – confidence in the quality of pharmacist education.
‘Our members tell us that PSA’s education is of high quality, a quality they can trust, and this scheme will mean that when they see third party education that is approved as meeting the PSA education standards, they can have a similar level of trust in it,’ she said.
‘PSA’s CPD planning tool takes the stress out of planning and recording CPD education, just as these standards will give pharmacists confidence that the CPD they access is “up-to-scratch”.’
PSA’s CPD standards are set to be introduced in 2026.
[post_title] => PSA to develop education standards for CPD activities
[post_excerpt] => With the Australian Pharmacy Council retiring its accreditation standards for CPD activities, PSA is set to step up.
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[post_content] => For the first time in Australian medicines history, all Queensland-based pharmacists can make the call to substitute a therapeutically appropriate medicine without prescriber authority to solve medicine-related problems.
Australian Pharmacist explains the ins and outs of this momentous change.
What’s changing?
An update to Medicines and Poisons (Medicines) Regulation 2021 (Qld) on 1 July 2025 will allow therapeutic adaptation and substitution to take place where there is a theraputic need for change.
Under section 117B of the regulation, a pharmacist dispensing a medicine may substitute an equivalent medicine for the one specified on the prescription – provided this is reasonably necessary for the patient’s therapeutic care.
An equivalent medicine is one that:
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[post_content] => This week pharmacists will see a suite of regulatory and funding changes take effect.
Here are the six key updates pharmacists need to know before tomorrow.
1. Dispensing fees will marginally rise
Under the Eighth Community Pharmacy Agreement, pharmacists’ dispensing fee – along with the Tier 1 Administration, Handling and Infrastructure fee and the Dangerous Drug fee – will be indexed by the Consumer Price Index (CPI) annually on 1 July.
Over the past 12 months to the March 2025 quarter, the CPI increased to 2.4%.
So from tomorrow, there will be a slight jump in the per script dispense fee, which will rise from $8.67 to $8.89.
2. (Dis)continued dispensing as emergency measures roll back
As of tomorrow, temporary emergency measures that expanded the range of medicines available under Pharmaceutical Benefits Scheme (PBS) Continued Dispensing arrangements will be repealed.
The emergency authority which authorised these Continued Dispensing arrangements for private and PBS prescriptions in New South Wales, will also end at 11:59 pm tonight.
Only the standard list of 149 PBS-listed molecules will be available under Continued Dispensing in most jurisdictions, covering conditions such as asthma, diabetes, heart disease, high cholesterol and HIV.
However, Continued Dispensing will continue for some. Just enacted in Queensland, the amount of medicine a pharmacist can supply to a patient as an ‘emergency supply’ is increasing from 3 days’ supply to the smallest available manufacturer’s pack of the medicine. This applies in addition to the supply provisions enabled under the Commonwealth Continued Dispensing Determination. And in Tasmania permanent regulation also allows full Continued Dispensing as private supply for all Prescription Only Medicines.
A full list of what’s happening in your state or territory is available via PSA’s Regulation Hub which will be updated overnight to reflect these changes.
The PSA has long advocated for the full measure to be made permanent across the nation.
‘We’ve seen temporary continued dispensing measures introduced during natural disasters, which is important, but there are several scenarios where a permanent policy would help patients, from personal emergencies to natural disasters,’ said PSA CEO Adjunct Associate Professor Steve Morris.
‘PSA is again urging the federal government to work with state and territory governments to permanently protect emergency access to medicines.’
3. New vaping standards will come into effect
From 1 July, the Therapeutic Goods Administration (TGA) will implement strengthened standards for all therapeutic nicotine vaping products used for smoking-cessation and nicotine-dependence. This measure is designed to mitigate risks associated with therapeutic vaping products and ensure a consistent level of safety and quality across all products supplied through pharmacies.
Under the new standards, pharmacies will only be permitted to supply vapes that satisfy defined criteria around permitted ingredients, tamper-evident and child-resistant packaging, and clear, consistent labelling.
Pharmacists should refer to the TGA’s notified vape list, which details all therapeutic vaping products approved for smoking cessation and the management of nicotine dependence.
4. Pharmacists now have longer to transition to the new MMR and ACOP credential
Until recently, pharmacists were required to meet the revised credentialing standards by 30 June 2025 – either by obtaining Recognition of Prior Learning (RPL) towards their new credential or by undertaking further education to fulfil the updated requirements.
The deadlines to achieve both credentials have now been extended to:
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[post_content] => Decision-support tools are designed to promote patient safety. But when here's a pop-up for everything, the message can be diluted.
We all know the feeling. You’re in the middle of something – maybe deep into a busy shift in the pharmacy, or on the wards in the hospital, or even scrolling on your phone at home – and another pop-up appears.
You’ve seen it before, so your instinct is to dismiss it without a second thought.
While ignoring the latest alert from your fitness app might mean falling behind on your step count, dismissing a decision-support pop-up in a healthcare setting might mean missing something crucial.
Yet, with so many alerts coming through, it can be overwhelming – and almost impossible – to sort the important information from the rest.
Why do we have popups?
Pop-ups are much like passing a sign on the road. They are meant to inform your decisions, whether this be about a hidden hazard or general navigation. In health care, they have proliferated across the increasing number of digital platforms and pieces of software health professionals use to provide patient care and nowhere more so than clinical decision-support tools.
Decision-support pop-ups take many forms, from alerts about potential drug interactions to duplicate therapy warnings and allergy information. They are intended to aid health professionals in their decision-making and, in the case of dispensing pharmacists, are there to ‘remind pharmacists to be alert and to double-check that the medicine supplied is the medicine prescribed’, says PDL Senior Professional Officer Gary West FPS (he/him).
‘It might only take half a second to view them, but the difference for a patient – and for a pharmacist – can be really significant. We’ve had multiple cases where a locum or newly registered pharmacist hasn’t realised a patient is on a staged-supply arrangement because it wasn’t clear in their profile. A warning message would have prevented that patient from getting access to a larger quantity of medicines than intended.’
Mr West says both pharmacists and dispensary technicians should understand why the alerts are there – to help mitigate risk for patients and themselves.
‘We would always encourage pharmacists to use that technology, and to ensure their dispensary technicians are well trained and alert to raising certain pop-up warnings with the pharmacist associated with the dispensing event,’ says Mr West.
The pop-up paradox
But are we currently overwhelmed by pop-ups? And are some pop-ups better than others?
University of Sydney Professor of Health Research Melissa Baysari (she/her) suggests the answer to both questions is yes. A human factors expert, she has conducted extensive research into how digital health can support medicine management. Despite their good intentions, she says there is limited evidence that alerts change practice or improve patient outcomes, particularly in the hospital setting.
In a 5-year study involving patients across five hospitals in New South Wales and Queensland, Prof Baysari’s team examined whether activating drug-drug interaction alerts reduced harm. One group of hospitals had the alerts enabled, the control group did not.
Surprising results
‘We found overall that the alerts had no impact,’ she says. ‘Having drug-drug interaction alerts did not reduce the number of clinically relevant interactions or harms experienced by patients. The study shows that if you’re going to turn all the drug interaction alerts on, they’re not going to deliver the safety benefits you expect.’
In fact, she warns that poorly designed or excessive alerts can backfire. ‘There are so many negative consequences, like wasted time, frustration for clinicians and patient safety implications, that I would not recommend turning drug-drug interaction alerts on in your systems unless you’ve got some kind of smart technology in there.’
Despite the lack of evidence about the effectiveness of alerts, organisations are often reluctant to scale them back. Prof Baysari said her team had ‘a lot of trouble’ finding hospitals that were willing to not turn on their drug interaction alerts.
‘Everyone assumed the alerts were effective and they were going to be removing an intervention that was providing a safety net for everyone,’ she says. ‘But the way I see it, if organisations just keep putting more and more alerts in, it becomes the end user’s responsibility to work out which ones are relevant and act appropriately. It’s shifting the responsibility away from the organisation, so if an incident occurs, it’s the clinician who’s to blame. I think that’s very unfair.’
Information overload
Research shows that the number of alerts a healthcare professional receives impacts how effective they are – and pharmacists see a lot, Prof Baysari says.
‘You might assume that there’s an evidence base for alerts, but we have a lot more research showing that when you implement large numbers of alerts, clinicians begin to ignore them. They’re seeing too many, and so they’re not reading the recommendations. I have a theory that this becomes a habitual response – an alert pops up, clinicians override it and move past it. It allows them to get through work quickly.’
This alert fatigue has real-world safety implications. If one alert out of 12 presented is a critical warning, and the other 11 aren’t clinically relevant for the patient, it’s likely the important alert will be missed.
‘We’re increasingly seeing incidents where alert fatigue has been identified as a contributing factor. It’s not that there wasn’t an alert in place, but that it was lost among the other alerts the clinician saw,’ Prof Baysari says.
Returning to the road-sign analogy, there comes a point where there are just too many and you just can’t process them all and they stop being useful. Or you drive past the same ones every day and stop paying attention to them.
PDL has developed its own alerts based on incidents that are frequently reported to the organisation and on medicines that are more likely to have significant consequences for patients.
‘We’re very mindful. We put in a small number of pop-ups that we think are of high importance or significance,’ Mr West says. ‘Our warnings are not theoretical. We try to prevent alert fatigue by limiting warnings to things that occur with frequency or with such consequence that they justify the pop-up. We appreciate it’s difficult when hundreds of prescriptions are dispensed every day, but we’d really encourage pharmacists to take note of them and not just tab through without any consideration.’
Making smarter systems
As pharmacists continue to expand their scope of practice, Fred IT Group Partnerships Manager Regina Cowie (she/her) says the functionality of decision-support tools will need to expand to include options like preventive care recommendations and chronic disease management tools.
‘For example, clinical decision support may be used to identify patients eligible for chronic disease screening or to assess chronic disease management,’ she says. ‘Or a vaccination prompt for eligible patients could support pharmacists to make informed decisions by dynamically changing aspects within dispensing systems to guide on healthcare opportunities, for example to improve vaccination rates.’
As well as being broader, alerts also need to become smarter. Artificial intelligence is already being used in some aspects of dispensing software, Ms Cowie says, and AI has the potential to revolutionise the way clinical decision support is used.
‘AI has the ability to analyse large amounts of patient data and provide opportunities to improve medicine safety and patient care … Fred AID (Artificial Intelligence Directions) is an optional function already in place in Fred Dispense Plus. It uses AI to predict medication directions and allows pharmacists to quickly and safely enter directions for dispensing labels, rather than typing these from scratch.
‘In future, AI may suggest treatment plans or identify patients at risk of certain diseases, based on patient population data. In health care, where time pressures are a consistent burden on clinicians, a related opportunity from AI is its ability to provide administrative support by automating documentation such as clinical notes.’
Ultimately, there isn’t anything inherently wrong with alerts, Prof Baysari says, they just need to be better. ‘We have very basic alerts at the moment. They’re not designed well, so we’re not seeing the benefits. But we could.
‘We need better design in the backend, using AI to make them smarter, and, in the frontend, we need to think about how they look on screen,’ she says. ‘If we had good interfaces and a good backend infrastructure we’d get good safety benefits. But we have a lot of work to do.’
Fred IT Government and Industry Engagement Lead and former Medicines Safety Program Director of the Australian Digital Health Agency Andrew Matthews MPS says clinical decision-support tools such as alerts can increase detection of inappropriate prescribing and dispensing, improve disease management, reduce adverse patient outcomes and enhance appropriate treatment.
Fred IT, for example, has introduced an optional prompt in its dispensing software to help improve vaccination rates for the shingles vaccine in target cohorts aligned with recommendations from the National Immunisation Program (NIP).
The prompt displays only if the patient meets the NIP criteria of the patient demographics entered in the Fred Dispense Plus patient profile.
‘With the large volumes of patient data now available in electronic medical records and pharmacy systems, especially where patient disease complexity makes it difficult to quickly assess the available data,’ Mr Matthews says, ‘clinical decision-support can present relevant patient information to the clinician to facilitate clinical problem-solving, decision-making or provide additional knowledge consistent with best practice guidelines.’
[post_title] => Are pop-ups doing more harm than good?
[post_excerpt] => Are decision-support tools the problem or the cure for patient safety? Australian Pharmacist investigates.
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[post_content] => On 1 July 2025, new vaping standards came into force for all therapeutic vaping products for smoking cessation and nicotine dependence.
The Therapeutic Goods Administration's (TGA’s) strengthened standards, designed to reduce harm from vape use, are the culmination of the national vaping reforms, said PSA Project Manager Nikita Dalla Venezia, who worked closely on the PSA’s Professional practice guidelines for pharmacists: nicotine dependence support.
‘Because the changes were fairly substantial, my understanding is that they were staggered,’ she said. ‘This is just the next step of that comprehensive approach to mitigating risk for people who use therapeutic vapes.’
The principal purpose of the reforms is to minimise youth uptake of vaping – an objective that, according to the Cancer Council’s iterative Generation Vape study, appears to be succeeding.
‘In Wave 7 of the study, which came out after the reforms were introduced, over 50% of youths said they would decline a vape if offered one from a friend, which is a substantial increase from Wave 2 data (less than 40%) that was collected prior to the reforms,’ Ms Dalla Venezia said.
What key changes are introduced in the updated standards?
Changes to the packaging, labelling and design of vaping products have been introduced.
Vaping devices and accessories now need to appear as therapeutic products to reduce their appeal for recreational use among both adolescents and adults, Ms Dalla Venezia said.
‘The packaging needs to be plain, and the design has to be simple with very limited colours,’ she said.
New labelling, usage instructions and information leaflets are also required, along with name restrictions.
‘The permitted ingredients have changed, to now only include nicotine, propylene glycol glycerol, and water,’ she said. ‘And the only flavours allowed are mint, menthol or tobacco.’
Vaping devices and accessories must also meet stricter standards for:
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[post_content] => PSA has announced that it will develop and maintain education standards for Continued Professional Development (CPD) for pharmacists, following the retirement of the Australian Pharmacy Council (APC) accreditation standards for CPD activities on 31 December 2025.
The APC’s accreditation standards for CPD activities have been in place since 2013.
PSA, who already publish regular CPD through Australian Pharmacist and its education catalogue, will develop and maintain industry leading standards that will certify the quality and independence of CPD.
CPD education assessed against the standards will carry a PSA approval, giving pharmacists confidence that the education they access maintains the highest quality, upholds pharmacy practice standards, guidelines and ethics, and is free from commercial bias.
PSA National President Associate Professor Fei Sim FPS said: ‘As the national peak body for pharmacists in Australia and custodians of pharmacy practice standards, guidelines and ethics, PSA is developing education standards for CPD that give our profession – and our stakeholders – confidence in the quality of pharmacist education.
‘Our members tell us that PSA’s education is of high quality, a quality they can trust, and this scheme will mean that when they see third party education that is approved as meeting the PSA education standards, they can have a similar level of trust in it,’ she said.
‘PSA’s CPD planning tool takes the stress out of planning and recording CPD education, just as these standards will give pharmacists confidence that the CPD they access is “up-to-scratch”.’
PSA’s CPD standards are set to be introduced in 2026.
[post_title] => PSA to develop education standards for CPD activities
[post_excerpt] => With the Australian Pharmacy Council retiring its accreditation standards for CPD activities, PSA is set to step up.
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[post_content] => For the first time in Australian medicines history, all Queensland-based pharmacists can make the call to substitute a therapeutically appropriate medicine without prescriber authority to solve medicine-related problems.
Australian Pharmacist explains the ins and outs of this momentous change.
What’s changing?
An update to Medicines and Poisons (Medicines) Regulation 2021 (Qld) on 1 July 2025 will allow therapeutic adaptation and substitution to take place where there is a theraputic need for change.
Under section 117B of the regulation, a pharmacist dispensing a medicine may substitute an equivalent medicine for the one specified on the prescription – provided this is reasonably necessary for the patient’s therapeutic care.
An equivalent medicine is one that:
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[post_content] => This week pharmacists will see a suite of regulatory and funding changes take effect.
Here are the six key updates pharmacists need to know before tomorrow.
1. Dispensing fees will marginally rise
Under the Eighth Community Pharmacy Agreement, pharmacists’ dispensing fee – along with the Tier 1 Administration, Handling and Infrastructure fee and the Dangerous Drug fee – will be indexed by the Consumer Price Index (CPI) annually on 1 July.
Over the past 12 months to the March 2025 quarter, the CPI increased to 2.4%.
So from tomorrow, there will be a slight jump in the per script dispense fee, which will rise from $8.67 to $8.89.
2. (Dis)continued dispensing as emergency measures roll back
As of tomorrow, temporary emergency measures that expanded the range of medicines available under Pharmaceutical Benefits Scheme (PBS) Continued Dispensing arrangements will be repealed.
The emergency authority which authorised these Continued Dispensing arrangements for private and PBS prescriptions in New South Wales, will also end at 11:59 pm tonight.
Only the standard list of 149 PBS-listed molecules will be available under Continued Dispensing in most jurisdictions, covering conditions such as asthma, diabetes, heart disease, high cholesterol and HIV.
However, Continued Dispensing will continue for some. Just enacted in Queensland, the amount of medicine a pharmacist can supply to a patient as an ‘emergency supply’ is increasing from 3 days’ supply to the smallest available manufacturer’s pack of the medicine. This applies in addition to the supply provisions enabled under the Commonwealth Continued Dispensing Determination. And in Tasmania permanent regulation also allows full Continued Dispensing as private supply for all Prescription Only Medicines.
A full list of what’s happening in your state or territory is available via PSA’s Regulation Hub which will be updated overnight to reflect these changes.
The PSA has long advocated for the full measure to be made permanent across the nation.
‘We’ve seen temporary continued dispensing measures introduced during natural disasters, which is important, but there are several scenarios where a permanent policy would help patients, from personal emergencies to natural disasters,’ said PSA CEO Adjunct Associate Professor Steve Morris.
‘PSA is again urging the federal government to work with state and territory governments to permanently protect emergency access to medicines.’
3. New vaping standards will come into effect
From 1 July, the Therapeutic Goods Administration (TGA) will implement strengthened standards for all therapeutic nicotine vaping products used for smoking-cessation and nicotine-dependence. This measure is designed to mitigate risks associated with therapeutic vaping products and ensure a consistent level of safety and quality across all products supplied through pharmacies.
Under the new standards, pharmacies will only be permitted to supply vapes that satisfy defined criteria around permitted ingredients, tamper-evident and child-resistant packaging, and clear, consistent labelling.
Pharmacists should refer to the TGA’s notified vape list, which details all therapeutic vaping products approved for smoking cessation and the management of nicotine dependence.
4. Pharmacists now have longer to transition to the new MMR and ACOP credential
Until recently, pharmacists were required to meet the revised credentialing standards by 30 June 2025 – either by obtaining Recognition of Prior Learning (RPL) towards their new credential or by undertaking further education to fulfil the updated requirements.
The deadlines to achieve both credentials have now been extended to:
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[post_content] => Decision-support tools are designed to promote patient safety. But when here's a pop-up for everything, the message can be diluted.
We all know the feeling. You’re in the middle of something – maybe deep into a busy shift in the pharmacy, or on the wards in the hospital, or even scrolling on your phone at home – and another pop-up appears.
You’ve seen it before, so your instinct is to dismiss it without a second thought.
While ignoring the latest alert from your fitness app might mean falling behind on your step count, dismissing a decision-support pop-up in a healthcare setting might mean missing something crucial.
Yet, with so many alerts coming through, it can be overwhelming – and almost impossible – to sort the important information from the rest.
Why do we have popups?
Pop-ups are much like passing a sign on the road. They are meant to inform your decisions, whether this be about a hidden hazard or general navigation. In health care, they have proliferated across the increasing number of digital platforms and pieces of software health professionals use to provide patient care and nowhere more so than clinical decision-support tools.
Decision-support pop-ups take many forms, from alerts about potential drug interactions to duplicate therapy warnings and allergy information. They are intended to aid health professionals in their decision-making and, in the case of dispensing pharmacists, are there to ‘remind pharmacists to be alert and to double-check that the medicine supplied is the medicine prescribed’, says PDL Senior Professional Officer Gary West FPS (he/him).
‘It might only take half a second to view them, but the difference for a patient – and for a pharmacist – can be really significant. We’ve had multiple cases where a locum or newly registered pharmacist hasn’t realised a patient is on a staged-supply arrangement because it wasn’t clear in their profile. A warning message would have prevented that patient from getting access to a larger quantity of medicines than intended.’
Mr West says both pharmacists and dispensary technicians should understand why the alerts are there – to help mitigate risk for patients and themselves.
‘We would always encourage pharmacists to use that technology, and to ensure their dispensary technicians are well trained and alert to raising certain pop-up warnings with the pharmacist associated with the dispensing event,’ says Mr West.
The pop-up paradox
But are we currently overwhelmed by pop-ups? And are some pop-ups better than others?
University of Sydney Professor of Health Research Melissa Baysari (she/her) suggests the answer to both questions is yes. A human factors expert, she has conducted extensive research into how digital health can support medicine management. Despite their good intentions, she says there is limited evidence that alerts change practice or improve patient outcomes, particularly in the hospital setting.
In a 5-year study involving patients across five hospitals in New South Wales and Queensland, Prof Baysari’s team examined whether activating drug-drug interaction alerts reduced harm. One group of hospitals had the alerts enabled, the control group did not.
Surprising results
‘We found overall that the alerts had no impact,’ she says. ‘Having drug-drug interaction alerts did not reduce the number of clinically relevant interactions or harms experienced by patients. The study shows that if you’re going to turn all the drug interaction alerts on, they’re not going to deliver the safety benefits you expect.’
In fact, she warns that poorly designed or excessive alerts can backfire. ‘There are so many negative consequences, like wasted time, frustration for clinicians and patient safety implications, that I would not recommend turning drug-drug interaction alerts on in your systems unless you’ve got some kind of smart technology in there.’
Despite the lack of evidence about the effectiveness of alerts, organisations are often reluctant to scale them back. Prof Baysari said her team had ‘a lot of trouble’ finding hospitals that were willing to not turn on their drug interaction alerts.
‘Everyone assumed the alerts were effective and they were going to be removing an intervention that was providing a safety net for everyone,’ she says. ‘But the way I see it, if organisations just keep putting more and more alerts in, it becomes the end user’s responsibility to work out which ones are relevant and act appropriately. It’s shifting the responsibility away from the organisation, so if an incident occurs, it’s the clinician who’s to blame. I think that’s very unfair.’
Information overload
Research shows that the number of alerts a healthcare professional receives impacts how effective they are – and pharmacists see a lot, Prof Baysari says.
‘You might assume that there’s an evidence base for alerts, but we have a lot more research showing that when you implement large numbers of alerts, clinicians begin to ignore them. They’re seeing too many, and so they’re not reading the recommendations. I have a theory that this becomes a habitual response – an alert pops up, clinicians override it and move past it. It allows them to get through work quickly.’
This alert fatigue has real-world safety implications. If one alert out of 12 presented is a critical warning, and the other 11 aren’t clinically relevant for the patient, it’s likely the important alert will be missed.
‘We’re increasingly seeing incidents where alert fatigue has been identified as a contributing factor. It’s not that there wasn’t an alert in place, but that it was lost among the other alerts the clinician saw,’ Prof Baysari says.
Returning to the road-sign analogy, there comes a point where there are just too many and you just can’t process them all and they stop being useful. Or you drive past the same ones every day and stop paying attention to them.
PDL has developed its own alerts based on incidents that are frequently reported to the organisation and on medicines that are more likely to have significant consequences for patients.
‘We’re very mindful. We put in a small number of pop-ups that we think are of high importance or significance,’ Mr West says. ‘Our warnings are not theoretical. We try to prevent alert fatigue by limiting warnings to things that occur with frequency or with such consequence that they justify the pop-up. We appreciate it’s difficult when hundreds of prescriptions are dispensed every day, but we’d really encourage pharmacists to take note of them and not just tab through without any consideration.’
Making smarter systems
As pharmacists continue to expand their scope of practice, Fred IT Group Partnerships Manager Regina Cowie (she/her) says the functionality of decision-support tools will need to expand to include options like preventive care recommendations and chronic disease management tools.
‘For example, clinical decision support may be used to identify patients eligible for chronic disease screening or to assess chronic disease management,’ she says. ‘Or a vaccination prompt for eligible patients could support pharmacists to make informed decisions by dynamically changing aspects within dispensing systems to guide on healthcare opportunities, for example to improve vaccination rates.’
As well as being broader, alerts also need to become smarter. Artificial intelligence is already being used in some aspects of dispensing software, Ms Cowie says, and AI has the potential to revolutionise the way clinical decision support is used.
‘AI has the ability to analyse large amounts of patient data and provide opportunities to improve medicine safety and patient care … Fred AID (Artificial Intelligence Directions) is an optional function already in place in Fred Dispense Plus. It uses AI to predict medication directions and allows pharmacists to quickly and safely enter directions for dispensing labels, rather than typing these from scratch.
‘In future, AI may suggest treatment plans or identify patients at risk of certain diseases, based on patient population data. In health care, where time pressures are a consistent burden on clinicians, a related opportunity from AI is its ability to provide administrative support by automating documentation such as clinical notes.’
Ultimately, there isn’t anything inherently wrong with alerts, Prof Baysari says, they just need to be better. ‘We have very basic alerts at the moment. They’re not designed well, so we’re not seeing the benefits. But we could.
‘We need better design in the backend, using AI to make them smarter, and, in the frontend, we need to think about how they look on screen,’ she says. ‘If we had good interfaces and a good backend infrastructure we’d get good safety benefits. But we have a lot of work to do.’
Fred IT Government and Industry Engagement Lead and former Medicines Safety Program Director of the Australian Digital Health Agency Andrew Matthews MPS says clinical decision-support tools such as alerts can increase detection of inappropriate prescribing and dispensing, improve disease management, reduce adverse patient outcomes and enhance appropriate treatment.
Fred IT, for example, has introduced an optional prompt in its dispensing software to help improve vaccination rates for the shingles vaccine in target cohorts aligned with recommendations from the National Immunisation Program (NIP).
The prompt displays only if the patient meets the NIP criteria of the patient demographics entered in the Fred Dispense Plus patient profile.
‘With the large volumes of patient data now available in electronic medical records and pharmacy systems, especially where patient disease complexity makes it difficult to quickly assess the available data,’ Mr Matthews says, ‘clinical decision-support can present relevant patient information to the clinician to facilitate clinical problem-solving, decision-making or provide additional knowledge consistent with best practice guidelines.’
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[post_content] => On 1 July 2025, new vaping standards came into force for all therapeutic vaping products for smoking cessation and nicotine dependence.
The Therapeutic Goods Administration's (TGA’s) strengthened standards, designed to reduce harm from vape use, are the culmination of the national vaping reforms, said PSA Project Manager Nikita Dalla Venezia, who worked closely on the PSA’s Professional practice guidelines for pharmacists: nicotine dependence support.
‘Because the changes were fairly substantial, my understanding is that they were staggered,’ she said. ‘This is just the next step of that comprehensive approach to mitigating risk for people who use therapeutic vapes.’
The principal purpose of the reforms is to minimise youth uptake of vaping – an objective that, according to the Cancer Council’s iterative Generation Vape study, appears to be succeeding.
‘In Wave 7 of the study, which came out after the reforms were introduced, over 50% of youths said they would decline a vape if offered one from a friend, which is a substantial increase from Wave 2 data (less than 40%) that was collected prior to the reforms,’ Ms Dalla Venezia said.
What key changes are introduced in the updated standards?
Changes to the packaging, labelling and design of vaping products have been introduced.
Vaping devices and accessories now need to appear as therapeutic products to reduce their appeal for recreational use among both adolescents and adults, Ms Dalla Venezia said.
‘The packaging needs to be plain, and the design has to be simple with very limited colours,’ she said.
New labelling, usage instructions and information leaflets are also required, along with name restrictions.
‘The permitted ingredients have changed, to now only include nicotine, propylene glycol glycerol, and water,’ she said. ‘And the only flavours allowed are mint, menthol or tobacco.’
Vaping devices and accessories must also meet stricter standards for:
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[post_content] => PSA has announced that it will develop and maintain education standards for Continued Professional Development (CPD) for pharmacists, following the retirement of the Australian Pharmacy Council (APC) accreditation standards for CPD activities on 31 December 2025.
The APC’s accreditation standards for CPD activities have been in place since 2013.
PSA, who already publish regular CPD through Australian Pharmacist and its education catalogue, will develop and maintain industry leading standards that will certify the quality and independence of CPD.
CPD education assessed against the standards will carry a PSA approval, giving pharmacists confidence that the education they access maintains the highest quality, upholds pharmacy practice standards, guidelines and ethics, and is free from commercial bias.
PSA National President Associate Professor Fei Sim FPS said: ‘As the national peak body for pharmacists in Australia and custodians of pharmacy practice standards, guidelines and ethics, PSA is developing education standards for CPD that give our profession – and our stakeholders – confidence in the quality of pharmacist education.
‘Our members tell us that PSA’s education is of high quality, a quality they can trust, and this scheme will mean that when they see third party education that is approved as meeting the PSA education standards, they can have a similar level of trust in it,’ she said.
‘PSA’s CPD planning tool takes the stress out of planning and recording CPD education, just as these standards will give pharmacists confidence that the CPD they access is “up-to-scratch”.’
PSA’s CPD standards are set to be introduced in 2026.
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[post_date_gmt] => 2025-07-02 01:54:36
[post_content] => For the first time in Australian medicines history, all Queensland-based pharmacists can make the call to substitute a therapeutically appropriate medicine without prescriber authority to solve medicine-related problems.
Australian Pharmacist explains the ins and outs of this momentous change.
What’s changing?
An update to Medicines and Poisons (Medicines) Regulation 2021 (Qld) on 1 July 2025 will allow therapeutic adaptation and substitution to take place where there is a theraputic need for change.
Under section 117B of the regulation, a pharmacist dispensing a medicine may substitute an equivalent medicine for the one specified on the prescription – provided this is reasonably necessary for the patient’s therapeutic care.
An equivalent medicine is one that:
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[post_date] => 2025-06-30 12:58:25
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[post_content] => This week pharmacists will see a suite of regulatory and funding changes take effect.
Here are the six key updates pharmacists need to know before tomorrow.
1. Dispensing fees will marginally rise
Under the Eighth Community Pharmacy Agreement, pharmacists’ dispensing fee – along with the Tier 1 Administration, Handling and Infrastructure fee and the Dangerous Drug fee – will be indexed by the Consumer Price Index (CPI) annually on 1 July.
Over the past 12 months to the March 2025 quarter, the CPI increased to 2.4%.
So from tomorrow, there will be a slight jump in the per script dispense fee, which will rise from $8.67 to $8.89.
2. (Dis)continued dispensing as emergency measures roll back
As of tomorrow, temporary emergency measures that expanded the range of medicines available under Pharmaceutical Benefits Scheme (PBS) Continued Dispensing arrangements will be repealed.
The emergency authority which authorised these Continued Dispensing arrangements for private and PBS prescriptions in New South Wales, will also end at 11:59 pm tonight.
Only the standard list of 149 PBS-listed molecules will be available under Continued Dispensing in most jurisdictions, covering conditions such as asthma, diabetes, heart disease, high cholesterol and HIV.
However, Continued Dispensing will continue for some. Just enacted in Queensland, the amount of medicine a pharmacist can supply to a patient as an ‘emergency supply’ is increasing from 3 days’ supply to the smallest available manufacturer’s pack of the medicine. This applies in addition to the supply provisions enabled under the Commonwealth Continued Dispensing Determination. And in Tasmania permanent regulation also allows full Continued Dispensing as private supply for all Prescription Only Medicines.
A full list of what’s happening in your state or territory is available via PSA’s Regulation Hub which will be updated overnight to reflect these changes.
The PSA has long advocated for the full measure to be made permanent across the nation.
‘We’ve seen temporary continued dispensing measures introduced during natural disasters, which is important, but there are several scenarios where a permanent policy would help patients, from personal emergencies to natural disasters,’ said PSA CEO Adjunct Associate Professor Steve Morris.
‘PSA is again urging the federal government to work with state and territory governments to permanently protect emergency access to medicines.’
3. New vaping standards will come into effect
From 1 July, the Therapeutic Goods Administration (TGA) will implement strengthened standards for all therapeutic nicotine vaping products used for smoking-cessation and nicotine-dependence. This measure is designed to mitigate risks associated with therapeutic vaping products and ensure a consistent level of safety and quality across all products supplied through pharmacies.
Under the new standards, pharmacies will only be permitted to supply vapes that satisfy defined criteria around permitted ingredients, tamper-evident and child-resistant packaging, and clear, consistent labelling.
Pharmacists should refer to the TGA’s notified vape list, which details all therapeutic vaping products approved for smoking cessation and the management of nicotine dependence.
4. Pharmacists now have longer to transition to the new MMR and ACOP credential
Until recently, pharmacists were required to meet the revised credentialing standards by 30 June 2025 – either by obtaining Recognition of Prior Learning (RPL) towards their new credential or by undertaking further education to fulfil the updated requirements.
The deadlines to achieve both credentials have now been extended to:
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[post_date] => 2025-06-27 09:36:24
[post_date_gmt] => 2025-06-26 23:36:24
[post_content] => Decision-support tools are designed to promote patient safety. But when here's a pop-up for everything, the message can be diluted.
We all know the feeling. You’re in the middle of something – maybe deep into a busy shift in the pharmacy, or on the wards in the hospital, or even scrolling on your phone at home – and another pop-up appears.
You’ve seen it before, so your instinct is to dismiss it without a second thought.
While ignoring the latest alert from your fitness app might mean falling behind on your step count, dismissing a decision-support pop-up in a healthcare setting might mean missing something crucial.
Yet, with so many alerts coming through, it can be overwhelming – and almost impossible – to sort the important information from the rest.
Why do we have popups?
Pop-ups are much like passing a sign on the road. They are meant to inform your decisions, whether this be about a hidden hazard or general navigation. In health care, they have proliferated across the increasing number of digital platforms and pieces of software health professionals use to provide patient care and nowhere more so than clinical decision-support tools.
Decision-support pop-ups take many forms, from alerts about potential drug interactions to duplicate therapy warnings and allergy information. They are intended to aid health professionals in their decision-making and, in the case of dispensing pharmacists, are there to ‘remind pharmacists to be alert and to double-check that the medicine supplied is the medicine prescribed’, says PDL Senior Professional Officer Gary West FPS (he/him).
‘It might only take half a second to view them, but the difference for a patient – and for a pharmacist – can be really significant. We’ve had multiple cases where a locum or newly registered pharmacist hasn’t realised a patient is on a staged-supply arrangement because it wasn’t clear in their profile. A warning message would have prevented that patient from getting access to a larger quantity of medicines than intended.’
Mr West says both pharmacists and dispensary technicians should understand why the alerts are there – to help mitigate risk for patients and themselves.
‘We would always encourage pharmacists to use that technology, and to ensure their dispensary technicians are well trained and alert to raising certain pop-up warnings with the pharmacist associated with the dispensing event,’ says Mr West.
The pop-up paradox
But are we currently overwhelmed by pop-ups? And are some pop-ups better than others?
University of Sydney Professor of Health Research Melissa Baysari (she/her) suggests the answer to both questions is yes. A human factors expert, she has conducted extensive research into how digital health can support medicine management. Despite their good intentions, she says there is limited evidence that alerts change practice or improve patient outcomes, particularly in the hospital setting.
In a 5-year study involving patients across five hospitals in New South Wales and Queensland, Prof Baysari’s team examined whether activating drug-drug interaction alerts reduced harm. One group of hospitals had the alerts enabled, the control group did not.
Surprising results
‘We found overall that the alerts had no impact,’ she says. ‘Having drug-drug interaction alerts did not reduce the number of clinically relevant interactions or harms experienced by patients. The study shows that if you’re going to turn all the drug interaction alerts on, they’re not going to deliver the safety benefits you expect.’
In fact, she warns that poorly designed or excessive alerts can backfire. ‘There are so many negative consequences, like wasted time, frustration for clinicians and patient safety implications, that I would not recommend turning drug-drug interaction alerts on in your systems unless you’ve got some kind of smart technology in there.’
Despite the lack of evidence about the effectiveness of alerts, organisations are often reluctant to scale them back. Prof Baysari said her team had ‘a lot of trouble’ finding hospitals that were willing to not turn on their drug interaction alerts.
‘Everyone assumed the alerts were effective and they were going to be removing an intervention that was providing a safety net for everyone,’ she says. ‘But the way I see it, if organisations just keep putting more and more alerts in, it becomes the end user’s responsibility to work out which ones are relevant and act appropriately. It’s shifting the responsibility away from the organisation, so if an incident occurs, it’s the clinician who’s to blame. I think that’s very unfair.’
Information overload
Research shows that the number of alerts a healthcare professional receives impacts how effective they are – and pharmacists see a lot, Prof Baysari says.
‘You might assume that there’s an evidence base for alerts, but we have a lot more research showing that when you implement large numbers of alerts, clinicians begin to ignore them. They’re seeing too many, and so they’re not reading the recommendations. I have a theory that this becomes a habitual response – an alert pops up, clinicians override it and move past it. It allows them to get through work quickly.’
This alert fatigue has real-world safety implications. If one alert out of 12 presented is a critical warning, and the other 11 aren’t clinically relevant for the patient, it’s likely the important alert will be missed.
‘We’re increasingly seeing incidents where alert fatigue has been identified as a contributing factor. It’s not that there wasn’t an alert in place, but that it was lost among the other alerts the clinician saw,’ Prof Baysari says.
Returning to the road-sign analogy, there comes a point where there are just too many and you just can’t process them all and they stop being useful. Or you drive past the same ones every day and stop paying attention to them.
PDL has developed its own alerts based on incidents that are frequently reported to the organisation and on medicines that are more likely to have significant consequences for patients.
‘We’re very mindful. We put in a small number of pop-ups that we think are of high importance or significance,’ Mr West says. ‘Our warnings are not theoretical. We try to prevent alert fatigue by limiting warnings to things that occur with frequency or with such consequence that they justify the pop-up. We appreciate it’s difficult when hundreds of prescriptions are dispensed every day, but we’d really encourage pharmacists to take note of them and not just tab through without any consideration.’
Making smarter systems
As pharmacists continue to expand their scope of practice, Fred IT Group Partnerships Manager Regina Cowie (she/her) says the functionality of decision-support tools will need to expand to include options like preventive care recommendations and chronic disease management tools.
‘For example, clinical decision support may be used to identify patients eligible for chronic disease screening or to assess chronic disease management,’ she says. ‘Or a vaccination prompt for eligible patients could support pharmacists to make informed decisions by dynamically changing aspects within dispensing systems to guide on healthcare opportunities, for example to improve vaccination rates.’
As well as being broader, alerts also need to become smarter. Artificial intelligence is already being used in some aspects of dispensing software, Ms Cowie says, and AI has the potential to revolutionise the way clinical decision support is used.
‘AI has the ability to analyse large amounts of patient data and provide opportunities to improve medicine safety and patient care … Fred AID (Artificial Intelligence Directions) is an optional function already in place in Fred Dispense Plus. It uses AI to predict medication directions and allows pharmacists to quickly and safely enter directions for dispensing labels, rather than typing these from scratch.
‘In future, AI may suggest treatment plans or identify patients at risk of certain diseases, based on patient population data. In health care, where time pressures are a consistent burden on clinicians, a related opportunity from AI is its ability to provide administrative support by automating documentation such as clinical notes.’
Ultimately, there isn’t anything inherently wrong with alerts, Prof Baysari says, they just need to be better. ‘We have very basic alerts at the moment. They’re not designed well, so we’re not seeing the benefits. But we could.
‘We need better design in the backend, using AI to make them smarter, and, in the frontend, we need to think about how they look on screen,’ she says. ‘If we had good interfaces and a good backend infrastructure we’d get good safety benefits. But we have a lot of work to do.’
Fred IT Government and Industry Engagement Lead and former Medicines Safety Program Director of the Australian Digital Health Agency Andrew Matthews MPS says clinical decision-support tools such as alerts can increase detection of inappropriate prescribing and dispensing, improve disease management, reduce adverse patient outcomes and enhance appropriate treatment.
Fred IT, for example, has introduced an optional prompt in its dispensing software to help improve vaccination rates for the shingles vaccine in target cohorts aligned with recommendations from the National Immunisation Program (NIP).
The prompt displays only if the patient meets the NIP criteria of the patient demographics entered in the Fred Dispense Plus patient profile.
‘With the large volumes of patient data now available in electronic medical records and pharmacy systems, especially where patient disease complexity makes it difficult to quickly assess the available data,’ Mr Matthews says, ‘clinical decision-support can present relevant patient information to the clinician to facilitate clinical problem-solving, decision-making or provide additional knowledge consistent with best practice guidelines.’
[post_title] => Are pop-ups doing more harm than good?
[post_excerpt] => Are decision-support tools the problem or the cure for patient safety? Australian Pharmacist investigates.
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Australian Pharmacist is the official journal for Pharmaceutical Society of Australia Ltd.
