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AUSTRALIAN PHARMACIST
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    • td_module_mega_menu Object
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          [post] => WP_Post Object
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                  [ID] => 32191
                  [post_author] => 12483
                  [post_date] => 2026-05-27 13:27:14
                  [post_date_gmt] => 2026-05-27 03:27:14
                  [post_content] => Honey may offer safer, more effective and yummier cough relief than many over-the-counter (OTC) medicines.
      
      As winter inches closer, pharmacists are seeing more patients seeking relief from coughs associated with cold and flu season, often asking for an OTC cough syrup or suppressant, or the Pharmacist Only medicine dihydrocodeine (Rikodeine).
      
      But mounting evidence suggests the best therapeutic recommendation might come from the pantry rather than the dispensary. 
      

      1. Efficacy and safety of cough medicine called into question

      The evidence for oral OTC cough preparations for acute cough is, at best, inconclusive – with clinical trials failing to demonstrate efficacy. Cough medicines are contraindicated in children under 6 years of age, and use in older children discouraged – with product labels emphasising they should only be used in children aged 6–11 on the advice of a health professional (e.g. pharmacist, nurse, medical practitioner).  They should only be considered if the benefit of their use outweighs the risk, noting that the Therapeutic Goods Administration review that informed these changes highlighted significant safety and efficacy concerns.  Cough medicines are also not appropriate for many adult patients due to medicine interactions, risk of abuse, adverse effects, and other co-existing medical conditions (e.g. asthma, Chronic Obstructive Pulmonary Disease). Additionally, the Australian Pharmaceutical Formulary and Handbook (APF) advises against combination cough products that mix an antitussive with an expectorant, an antihistamine, or both.  These products tend to contain subtherapeutic doses of each ingredient, and can increase the risk of adverse effects without adding meaningful therapeutic benefit.

      2. Honey goes down more than a treat

      Most acute coughs are self-limiting, and non-pharmacological management can be recommended, with the aim of chronic cough management being identifying and treating the underlying cause. Honey is often the superior clinical choice if symptomatic relief is needed. According to the APF, honey relieves cough symptoms in children better than no treatment or placebo, acting as a demulcent by forming a soothing, bioadhesive film over irritated pharyngeal mucosa to blunt the sensory tickle that triggers a cough.  Interestingly, it is thought that the high placebo response seen in trials of cough medicines may be related to the demulcent content (or syrup) of the cough mixture. A 2022 systematic review found honey to be an effective treatment for cough in children above 12 months of age, with a 2010 randomised controlled trial even finding it to be more effective than dextromethorphan or diphenhydramine at relieving nocturnal cough in children related to upper respiratory tract infections. The 2023 Cough in Children and Adults: Diagnosis, Assessment and Management (CICADA) Australian Chronic Cough Position Statement Update also strongly recommends minimising the use of other medications for nonspecific or refractory cough in children other than demulcents (i.e. honey). While honey is a safe first-line recommendation for many patients, including children, it must not be given to infants under 12 months of age due to the risk of infant botulism from Clostridium botulinum spores. Demulcents like honey are also a safe treatment option for: 
      • older patients
      • those on multiple medications (honey carries no clinically significant drug interactions) 
      • pregnant or breastfeeding patients, for whom honey is considered safe in normal food amounts. 
      However, pharmacists should advise patients with known pollen allergies to use honey carefully, and it should be used judiciously in patients with diabetes.

      3. When a spoonful of sugar is the medicine

      When honey is the chosen path, advise patients or caregivers that 1–2 teaspoons before bed – taken undiluted or dissolved in liquid (e.g. juice) – is an effective, comforting dose. Pair the recommendation with evidence-based non-pharmacological strategies, including:
      • plenty of water and warm fluids to help thin mucus and soothe an irritated throat
      • steam inhalation during a hot shower to promote expectoration. 
      Brush up on your knowledge about managing and treating cough by reading the APF ‘Cough’ Treatment Guideline for Pharmacists. [post_title] => Finding the sweet spot in cough management [post_excerpt] => Honey may offer safer, more effective and yummier cough relief than many over-the-counter (OTC) medicines. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => finding-the-sweet-spot-in-cough-management [to_ping] => [pinged] => [post_modified] => 2026-05-27 15:58:10 [post_modified_gmt] => 2026-05-27 05:58:10 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=32191 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Finding the sweet spot in cough management [title] => Finding the sweet spot in cough management [href] => https://www.australianpharmacist.com.au/finding-the-sweet-spot-in-cough-management/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 32192 [authorType] => )

      Finding the sweet spot in cough management

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          [post] => WP_Post Object
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                  [ID] => 32120
                  [post_author] => 12074
                  [post_date] => 2026-05-25 10:53:09
                  [post_date_gmt] => 2026-05-25 00:53:09
                  [post_content] => With the expansion of pharmacy vaccination services across Australia, pharmacists are navigating an increasingly layered set of challenges. 
      
      Bill Wallace, PSA Pharmacist – Professional Support Adviser, outlines the most common vaccine-related questions that have come through this year.
      

      1. Who can administer FluMist?

      The introduction of intranasal influenza vaccine, FluMist, has prompted a wave of questions surrounding eligibility, prescribing and administration requirements.  Funding and eligibility differences between each state and territory are driving many of the inquiries. ‘We have had quite a few inquiries about whether [pharmacists] can administer FluMist to someone under 5 if they've got a prescription, which they can,’ said Mr Wallace. State differences apply for initiation– Pharmacists in VIC, TAS, NT, and ACT are generally restricted to authorising and administering vaccines only to children aged 5 years and older. Whereas In NSW, WA, QLD, and SA, pharmacists can authorise and administer the influenza vaccine to children aged 2 and older. Another recurring question is whether pharmacists who are not qualified immunisers can administer FluMist – given it’s administered nasally rather than via an intramuscular injection.  Mr Wallace noted that any vaccine administered by a pharmacist must be delivered by a qualified immuniser. ‘You need to be a qualified immuniser to meet the requirements for administering that particular medication. You'd be hard pressed to justify why you did it if something went wrong,’ said Mr Wallace. The responsibility extends beyond simple administrative practices, and relates to professional accountability and emergency management responsibilities. Mr Wallace noted that while serious reactions are rare, pharmacists still need to be prepared for any situation at hand. ‘If you weren't qualified and a claim was made, your insurer and The Australian Health Practitioner Regulation Agency (Ahpra) would have many questions for you about your practice.’

      2. Can pharmacists co-administer vaccines?

      As Australia’s adult vaccination schedules get more complex, co-administration queries are becoming increasingly common. ‘Timing intervals and co-administration of vaccines is probably one of the more common clinical inquiries,’ Mr Wallace said. Questions to the advice line often relate to whether vaccines can be given together, which vaccines require spacing, and whether they should be administered in one arm or both. The National Centre for Immunisation Research and Surveillance guideline for vaccine co-administration and Australian Immunisation Handbook state that while most vaccines can generally be co-administered, separate injection sites should be used where possible,  ensuring a distance of 2.5 cm between. But Mr Wallace suggests pharmacists should also take additional care when reviewing Australian Immunisation Register (AIR) records and confirming patient histories to avoid inadvertent duplication Particularly for older Australians, co-administration will be increasingly normalised for  routine adult vaccinations (e.g. RSV, shingles, pneumoccocal, DTPa etc). 

      3. Can pharmacists vaccinate interstate?

      Interstate practice continues to create a point of tension for pharmacist immunisers as requirements differ significantly between jurisdictions.  There are discrepancies between patient age eligibility, refresher requirements and additional accreditation, meaning pharmacists cannot automatically assume their qualifications transfer across all states and territories. There are also differences between state and territory legislations which govern interstate pharmacists’ eligibility to administer vaccines, introducing barriers to interstate practice, according to the Immunisation Coalition. ‘Certain states, Tasmania, Victoria, and WA have slightly different training requirements … you need to ensure that you meet local state immunisation requirements prior to providing vaccinations,’ Mr Wallace said. He stresses the importance of ‘checking what the differences are, and referring to resources like the local state pharmacist vaccination guidelines before administering vaccines’. In some cases, pharmacists may need to complete an additional online module, although requirements vary. For example, the ACT has a Japanese encephalitis module that is required, and Victoria requires extra training to be able to provide certain travel vaccines. Complicating matters further, immunisation requirements and eligibility for state and territory programs may change.

      4. How do pharmacists maintain immunisation credentials?

      Is it a matter of once a pharmacist immuniser, always a pharmacist immuniser?  Not quite. According to Ahpra and state regulators, pharmacists must undertake annual immunisation-related CPD activities to maintain their currency. ‘Pharmacists must also maintain first aid every 3 years and CPR every 12 months,’ Mr Wallace said.  The PSA offers an online refresher training course which aligns with the current immunisation training. The training program consists of online modules to ensure a pharmacists’ accredited training remains up to date. ‘Some pharmacists did their vaccination courses a long time ago, with a much limited range of vaccines,’ he said. ‘There is also an Immunisation Practical Refresher Workshop that pharmacists can do if they've had a break in practice or want to refresh their technique.’ The online immunisation refresher course allows pharmacists to expand their training to cover all vaccines. Looking for any answers to your queries? Hit up the Pharmacist Advice Line here. [post_title] => Top 4 vaccine queries to the P2P Advice Line [post_excerpt] => With the expansion of pharmacy vaccination services across Australia, pharmacists are navigating an increasingly layered set of challenges.  [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => top-4-vaccine-queries-to-the-p2p-advice-line [to_ping] => [pinged] => [post_modified] => 2026-05-25 16:11:16 [post_modified_gmt] => 2026-05-25 06:11:16 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=32120 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Top 4 vaccine queries to the P2P Advice Line [title] => Top 4 vaccine queries to the P2P Advice Line [href] => https://www.australianpharmacist.com.au/top-4-vaccine-queries-to-the-p2p-advice-line/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 32124 [authorType] => )

      Top 4 vaccine queries to the P2P Advice Line

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                  [ID] => 32111
                  [post_author] => 3387
                  [post_date] => 2026-05-20 13:03:36
                  [post_date_gmt] => 2026-05-20 03:03:36
                  [post_content] => Once a disease of the past, diphtheria is rapidly re-emerging across Australia. Here’s what pharmacists need to know.
      

      What is diphtheria?

      A potentially deadly and highly contagious  bacterial disease, diphtheria can infect the nose and throat, cause skin sores, and spread toxin through the body; in severe cases it can cause airway blockage, heart damage and nerve damage.  Respiratory diphtheria is the more deadly variant, and is typically spread through respiratory droplets, often when people cough and sneeze. Cutaneous diphtheria can spread through touching skin sores.

      What are the symptoms?

      Signs and symptoms of diphtheria include:
      • sore throat
      • fever 
      • swollen neck glands
      • weakness.
      Post-exposure to the bacteria, symptoms typically appear within 2–5 days. And within 2–3 days of illness onset, dead tissue can form a thick grey membrane in the respiratory tract, covering the nose, tonsils and throat, which can make breathing and swallowing difficult. In unvaccinated people who do not receive appropriate treatment, diphtheria is fatal in up to 30% of cases.

      How dangerous is the disease?

      Before vaccination, diphtheria was a leading cause of childhood death in Australia. Between 1926 and 1935, there were more than 4,000 diphtheria-related childhood deaths recorded. Once vaccination programs rolled out in the 1940s, cases of diphtheria significantly reduced.

      Was it once eradicated in Australia?

      Not entirely. While Australia has largely managed to control diphtheria through vaccination, surveillance data show cases continued to occur at low levels. Until recently, there have been no recorded respiratory childhood cases since 1992. Between 2011 and 2019, 38 cases of cutaneous diphtheria were reported in both children and adults, along with seven cases of respiratory diphtheria, all in adults. Two adults who were not vaccinated against the disease died from respiratory diphtheria in 2011 and 2018. But post-COVID-19, the disease made a resurgence – with the National Centre for Immunisation Research and Surveillance announcing in 2022 that ‘Diphtheria is back’.

      Why has there been a resurgence?

      Likely because vaccination coverage has declined since the COVID-19 pandemic. While Australia's vaccination rates are still considered high by global standards, recent national data show full immunisation coverage of 91.54% at 1 year, 89.57% at 2 years, and 93.17% at 5 years of age, which is well below the 95% target in older age groups.

      Can diphtheria be treated?

      While diphtheria can be treated with antibiotics, they may have little effect once the infection takes hold. Another treatment, diphtheria antitoxin (DAT), can neutralise the effects of the toxin, but it needs to be administered within 48 hours of infection.  And because diphtheria had been largely eradicated, low production of DAT has led to global shortages. Even when this treatment is administered, the Australian Centre for Disease Control has cautioned that up to 1 in 10 people with respiratory diphtheria will die.

      Who is most at risk?

      Children under 5 years of age are at particularly high risk of death. Other at-risk groups include:
      • those who are unvaccinated or not up to date with diphtheria boosters doses
      • travellers to outbreak areas or countries where diphtheria is more common such as Nigeria, Guinea, Niger, Mauritania, Algeria, Chad, Mali, and South Africa
      • immunocompromised people
      • Aboriginal and Torres Strait Islander people in affected communities.

      What are the risks of an outbreak here?

      Pretty high when coverage is low, health experts have warned. ‘There was an outbreak of diphtheria between 2022 and 2024 in North Queensland, and also in the Kimberley in 2025,’ said Northern Territory Chief Health Officer Paul Burgess. So far this year, more than 220 cases of diphtheria have been reported across Australia. While most cases have been recorded in the Northern Territory, the disease has spread to Western Australia, South Australia and Queensland. Internationally, the World Health Organization reported over 29,000 suspected diphtheria cases and 1,420 deaths in the African Region from the beginning of 2025 to 1 March 2026.

      How often are booster doses required?

      Routine diphtheria boosters are generally recommended every 10 years for adults to maintain immunity. For travellers to higher-risk settings, booster timing may be more frequent depending on exposure risk and destination.

      What can pharmacists do?

      When patients come in for routine vaccinations, pharmacists should check the Australian Immunisation Register, suggesting catch up vaccinations for children who are behind with routine immunisations, and booster doses for adults who require them. Pharmacists can also counsel patients on travel-related boosters, reminding adults that protection wanes. ‘There are new diphtheria guidelines produced by the Northern Territory government to cover this outbreak, and pharmacists need to be aware of the new guidelines,’ said Helen Stone, PSA SA & NT State and Territory Manager. ‘All frontline workers in the Northern Territory need to be protected. This includes ensuring that they've been vaccinated and reminding people to check their immunisation records. ‘As 69% of cases are actually cutaneous diphtheria, the message I would really like to get out is that in its early stages, the skin infection could be confused with other skin infections, e.g. a fungal skin infection. Pharmacists should be very cautious and ensure that they are referring to skin infections for further investigation, particularly in areas of the outbreak.’ [post_title] => Another vaccine-preventable disease makes a resurgence [post_excerpt] => Once a disease of the past, diphtheria is rapidly re-emerging across Australia. Here’s what pharmacists need to know. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => another-vaccine-preventable-disease-makes-a-resurgence [to_ping] => [pinged] => [post_modified] => 2026-05-20 15:15:03 [post_modified_gmt] => 2026-05-20 05:15:03 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=32111 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Another vaccine-preventable disease makes a resurgence [title] => Another vaccine-preventable disease makes a resurgence [href] => https://www.australianpharmacist.com.au/another-vaccine-preventable-disease-makes-a-resurgence/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 32112 [authorType] => )

      Another vaccine-preventable disease makes a resurgence

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          [post] => WP_Post Object
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                  [ID] => 32107
                  [post_author] => 3387
                  [post_date] => 2026-05-18 12:59:24
                  [post_date_gmt] => 2026-05-18 02:59:24
                  [post_content] => AI is transforming pharmacy practice — but without the right safeguards, it can also put your registration at risk.
      
      AI is no longer an emerging consideration for pharmacists – it’s already embedded in practice.
      
      Using large language models (LLMs) such as ChatGPT to answer clinical questions and AI scribes like Heidi Health to capture consultation notes is becoming more commonplace. With agentic AI – systems that act autonomously on a patient’s behalf – now growing in popularity, the pace of AI adoption is only set to increase.
      
      But these opportunities come with obligations – and without a distinct regulatory framework. Here, PSA Digital Health Lead and Victorian state manager Jarrod McMaugh MPS outlines the sixAI traps pharmacists need to avoid.
      

      1. Entering identifiable patient information into AI platforms

      One of the most significant risks pharmacists face when using AI is entering patients’ health information into AI platforms. Regardless of the purpose or the pharmacist’s intent, it may constitute a breach of Australian privacy law.  ‘Let's say you were providing a Home Medicines Review (HMR) and you put the patient’s details into ChatGPT and asked, “What medicines is this person missing for their diagnosed conditions?” That would be a breach of privacy regulations,’ Mr McMaugh said. ‘Any information put into AI is stored. And therefore, where it is stored must adhere to the Australian privacy requirements.’ However, pharmacists who use LLMs to check for missed medicines or potential interactions can do so legitimately, provided no identifying information is included. And while taking out a patient's name and address is a good first step, this may not adequately deidentify them. ‘You could prompt an LLM by saying, “I have a person who is taking medicines, x, y, z, and they have these diagnoses. Can you identify any missed medicines or any interactions?”’ Mr McMaugh said. ‘As long as there's no way to identify the individual, and it's just down to what is clinically appropriate, it's not a breach of any privacy matters.’ 2. Assuming a business account equals compliance You may think that moving from a free AI account to a paid business subscription resolves any compliance concerns. But to be compliant, business or enterprise AI subscriptions must explicitly confirm that the platform meets Australian privacy regulations in the delivery of that service. 'You would need to be satisfied that the LLM, under contract, specifically states that it meets Australian privacy regulations,’ Mr McMaugh said. ‘It's similar to the agreement you have with your dispensing software [provider] or the clinical platform you use to record scope of practice work.’

      3. Using AI scribes without proper consent

      For pharmacists conducting clinical consultations, such as accredited and prescribing pharmacists, AI scribes can be incredibly useful for collecting and collating patient information. But deploying them without meeting the required consent obligations creates significant professional risk. ‘You must get consent from the person whose session is being recorded by the AI tool,’ Mr McMaugh said. ‘And you must have the ability to turn it off if somebody says, “I want the service, but I don't want the AI tool recording our discussion”.’ For pharmacists uncertain about what adequate consent looks like in practice, he suggests the following approach: 'I'm going to use an AI scribe in this session. It will record our conversation and take notes on our behalf. It will create a copy that I'll keep on record, and you have the right to access that record any time you request it. Are you comfortable with me proceeding?’ Pharmacists should also ensure that the AI tool is not in an active learning phase, with systems that continue to learn from patient interactions requiring an additional layer of consent. ‘For the vast majority of pharmacists, that shouldn't be a scenario they find themselves in – unless they're involved in clinical research about an intervention or research about the AI tool,’ he said. ‘For the vast majority of pharmacists, that shouldn't be a scenario they find themselves in – unless they're involved in clinical research about an intervention or research about the AI tool,’ he said. Pharmacists should confirm that AI dictation tools don't record voice snippets or retain details to improve the quality of their systems. Utilising AI models that are actively learning is generally not appropriate outside of a clinical trial with the accompanying level of consent seen in a trial setting.  Using an ‘active learning’ AI requires well documented consent for the person's health information to be used in this way, and is usually out of scope for most clinical settings.

      4. Failing to check transcription accuracy

      The second area of risk when using AI scribes is accuracy. While generally reliable, they can make mistakes; and the professional obligation to maintain accurate records rests with the pharmacist, not the AI tool. To prevent errors, pharmacists should still take notes while the AI scribe is working in the background, particularly around critical details such as dosing. 'If you were in a position in the future where something has gone wrong and you're in front of AHPRA or another regulator, and they say, “Why are your notes incorrect?”  just assuming that the digital scribe was doing its job is not sufficient for meeting your professional obligations,’ Mr McMaugh said. AI and handwritten notes should also be reviewed at the end of each session, while details of the consultation are still fresh. 'If you use an AI scribe during an HMR interview and you don't review the transcript until a week later, how are you going to correct the information that it got wrong?’ Mr McMaugh said. ‘From a workflow perspective, and to adhere to professional obligations, you need to make sure it's accurate.’

      5. Trusting AI output without checking the references

      AI platforms can produce clinical responses that are well structured, but are actually incorrect. These AI ‘hallucinations’, where LLMs return fabricated or inconsistent information, are commonplace. Another, more subtle risk is when LLMs draw on international sources rather than Australian-specific guidelines. ‘If you ask what the standard dose of a medication is, you might get a generally acceptable dose that's not applicable to specific Australian scenarios,’ Mr McMaugh said. Antibiotic selection is a clear example, with resistance patterns varying between countries, meaning recommendations based on international data may be inappropriate or inadequate for an Australian patient. 'You should therefore always ask LLMs for references so you can confirm the information is correct,’ he added. And don’t forget to check these references also, which aren’t immune to AI hallucinations. 6. Accepting an AI-generated booking as genuine patient consent Agentic AI is a system designed to act autonomously on a person's behalf, booking appointments, managing schedules and completing transactions. While these tools have the potential to streamline service appointments, such as vaccinations, pharmacists must be vigilant around digital bookings. When an AI agent books a consultation on a patient's behalf, it’s not possible to confirm at the point of booking whether the patient themselves made an informed, active decision to attend. ‘If booked online, pharmacists should double-check that a person has provided consent to have a particular service when they come in,’ Mr McMaugh said. 'This is a good way to confirm that consent has been provided by the [person] receiving the service – not the AI that is booking on their behalf.’ To close any gaps in the consent chain, he suggests:
      • confirming the service to be received i.e. ‘I will be administering an influenza vaccine for you today’
      • asking whether the patient booked the service themselves and whether they are comfortable proceeding.
      ‘It’s generally good practice to manage risk by confirming the service because an appointment also could have been booked by someone other than the patient receiving the service, such as a family member.’

      An evolving space

      While AI does not alter a pharmacist's professional obligations – it creates new contexts in which those obligations must be applied. According to Mr McMaugh, pharmacists should expect these considerations to continue evolving. ‘We might even get to a point in the future where AI is so effective at doing a certain task that if you don't use it, you may be less effective, and in turn, unethical,’ he said. ‘It’s very much a moving space.’ [post_title] => The 6 AI mistakes that could land pharmacists in hot water [post_excerpt] => AI is transforming pharmacy practice — but without the right safeguards, it can also put your registration at risk. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => the-6-ai-mistakes-that-could-land-pharmacists-in-hot-water [to_ping] => [pinged] => [post_modified] => 2026-05-18 16:52:09 [post_modified_gmt] => 2026-05-18 06:52:09 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=32107 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => The 6 AI mistakes that could land pharmacists in hot water [title] => The 6 AI mistakes that could land pharmacists in hot water [href] => https://www.australianpharmacist.com.au/the-6-ai-mistakes-that-could-land-pharmacists-in-hot-water/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 32108 [authorType] => )

      The 6 AI mistakes that could land pharmacists in hot water

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                  [ID] => 32093
                  [post_author] => 12074
                  [post_date] => 2026-05-13 11:33:26
                  [post_date_gmt] => 2026-05-13 01:33:26
                  [post_content] => A new transitions of care model is helping high-risk patients in rural and remote areas avoid medication misadventure and hospital readmission through virtual pharmacist-led care.
      
      After patients are discharged from the hospital, their transition back into the community can be high-risk, with significant potential for medicine-related harm. These risks are amplified significantly for rural communities due to sparse healthcare facilities, fragmented continuity of care and workforce shortages.  
      
      The TIC TOC program in Western NSW is tackling these issues via a virtual model designed to support patients who are struggling to access care during vulnerable post-discharge periods.
      
      The TIC TOC program will be further explored at the CPC26 conference later this month and is set to demonstrate how digital health and multidisciplinary collaboration can help bridge the gap between hospital and home. 
      
      Ahead of the program’s launch, AP spoke with Linda Krogh, the Virtual Transitions-of-Care Stewardship Pharmacist with the Western NSW Local Health District and a current PhD candidate with the University of Sydney.
      

      A virtual model of care

      ‘Transitions of care are deeply complex – even more so in remote settings due to factors such as distance, workforce, and community care,’ said Ms Krogh. The CPC26 presentation will outline how the model translates into practice, including identifying high-risk patients, virtual medication reconciliation, multidisciplinary communication, and rapid coordination of Home Medicines Reviews (HMRs). The Transitions of Care (ToC) Pharmacist role was introduced to provide virtual support across 19 towns, ensuring high-risk patients receive an optimal discharge and follow up, particularly when onsite pharmacy services are unavailable. The layout of the model means that the ‘TOCS pharmacist monitors the patient’s hospital admission and supports the onsite or virtual clinical pharmacist to ensure all required discharge activities are completed,’ Ms Krogh said. This includes reviewing electronic medical records to identify medicines that were commenced, ceased, changed, or continued during admission. ‘The role includes medication reconciliation, patient counselling, preparation of patient-friendly medication lists and direct communication with GPs and consultant pharmacists to facilitate timely post-discharge medication reviews,’ she said. Through virtual work, pharmacists can connect hospital teams, patients, carers, and primary care providers across geographically disconnected areas. 

      The risk in transitions

      The severely limited access to GP services and healthcare facilities delays crucial follow-up appointments and check-ins after discharge. In most rural communities, locum professionals make up a significant part of the primary care workforce, creating significant challenges in ensuring continuity of care. ‘Patients are often discharged from hospitals located a long distance from home, which can delay access to medicines and follow-up post-discharge,’ Ms Krogh said. Patients are identified as high risk for medicines misadventure and readmission based on criteria including  ‘use of high-risk medicines such as insulin, alongside a hospital readmission within the previous 6 months.’  ‘These factors can increase the risk of medication discrepancies, misunderstandings, and adverse events once the patient returns home,’ she added.

      Fast-tracking post-discharge HMRs

      A key feature of the program is its focus on ensuring HMRs occur when they are needed – not when they are possible. To ensure time-sensitive cases are addressed, the TOC pharmacist prepares a HMR referral for the patient’s GP before discharge. If the referral cannot be signed within a 48-hour window, the program activates the hospital-initiated HMR pathway, to avoid delays.  ‘The goal is for the post-discharge HMR to be completed within 10 days,’ Ms Krogh said. Patients can choose whether they prefer their HMR conducted face-to-face or virtually, allowing referrals to be matched to credentialed pharmacists based on patient preference and location. The TOCs pharmacist then books a GP appointment to ‘review the HMR recommendations and develop medication management plans, helping to close the loop on the patient's transition of care,’ she said. By clearly identifying patients as high-risk, reception staff are better able to triage appointment availability where demand exceeds capacity.

      Connecting hospital and community care

      A major strength of the TIC  TOC model is its ability to connect traditionally siloed parts of the healthcare system by facilitating communication between hospital clinicians, GPs, and community pharmacists – improving continuity of care throughout each patient’s journey.  ‘In rural towns where GP appointments are often booked out weeks in advance, this model ensures high-risk patients have their medications reviewed promptly by a pharmacist,’ Ms Krogh said. With post-discharge HMRs frequently identifying medication misunderstandings, the early identification of medication-related issues also allows GP appointments to focus more efficiently on clinical decision-making and care planning. The most common errors identified relate to patients’ misunderstanding of how to take their medicines following discharge, as well as short-term medicines that pose a point of confusion, such as tapered prednisolone regimens and analgesics. ‘In one case, a patient stopped taking an antihypertensive medication after overhearing nursing staff say it should be withheld during admission, not realising the change was only temporary,’ Ms Krogh said. ‘Another patient discharged with two antibiotics misunderstood the instructions and intended to take the medicines sequentially rather than concurrently.’ 

      Multidisciplinary action

      The TIC TOC model encapsulates a broader theme of multidisciplinary collaboration that will underpin CPC26.  With healthcare systems championing the importance of coordinated care, this program demonstrates how pharmacists can play a central role in ensuring patient safety during transitions of care, particularly for vulnerable rural populations where limited access to timely healthcare poses challenges. Further insights into the TIC TOC program and the virtual TOC's pharmacist role will be shared during the CPC26 conference session, held between 29 – 31 May 2026 at the RACV Royal Pines Resort, Gold Coast. Click here to register. [post_title] => Virtually easing transitions of care [post_excerpt] => A new transitions of care model is helping high-risk patients in rural and remote areas through virtual pharmacist-led care. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => virtually-easing-transitions-of-care [to_ping] => [pinged] => [post_modified] => 2026-05-13 14:51:23 [post_modified_gmt] => 2026-05-13 04:51:23 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=32093 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Virtually easing transitions of care [title] => Virtually easing transitions of care [href] => https://www.australianpharmacist.com.au/virtually-easing-transitions-of-care/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 32094 [authorType] => )

      Virtually easing transitions of care

  • Clinical
    • td_module_mega_menu Object
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          [post] => WP_Post Object
              (
                  [ID] => 32191
                  [post_author] => 12483
                  [post_date] => 2026-05-27 13:27:14
                  [post_date_gmt] => 2026-05-27 03:27:14
                  [post_content] => Honey may offer safer, more effective and yummier cough relief than many over-the-counter (OTC) medicines.
      
      As winter inches closer, pharmacists are seeing more patients seeking relief from coughs associated with cold and flu season, often asking for an OTC cough syrup or suppressant, or the Pharmacist Only medicine dihydrocodeine (Rikodeine).
      
      But mounting evidence suggests the best therapeutic recommendation might come from the pantry rather than the dispensary. 
      

      1. Efficacy and safety of cough medicine called into question

      The evidence for oral OTC cough preparations for acute cough is, at best, inconclusive – with clinical trials failing to demonstrate efficacy. Cough medicines are contraindicated in children under 6 years of age, and use in older children discouraged – with product labels emphasising they should only be used in children aged 6–11 on the advice of a health professional (e.g. pharmacist, nurse, medical practitioner).  They should only be considered if the benefit of their use outweighs the risk, noting that the Therapeutic Goods Administration review that informed these changes highlighted significant safety and efficacy concerns.  Cough medicines are also not appropriate for many adult patients due to medicine interactions, risk of abuse, adverse effects, and other co-existing medical conditions (e.g. asthma, Chronic Obstructive Pulmonary Disease). Additionally, the Australian Pharmaceutical Formulary and Handbook (APF) advises against combination cough products that mix an antitussive with an expectorant, an antihistamine, or both.  These products tend to contain subtherapeutic doses of each ingredient, and can increase the risk of adverse effects without adding meaningful therapeutic benefit.

      2. Honey goes down more than a treat

      Most acute coughs are self-limiting, and non-pharmacological management can be recommended, with the aim of chronic cough management being identifying and treating the underlying cause. Honey is often the superior clinical choice if symptomatic relief is needed. According to the APF, honey relieves cough symptoms in children better than no treatment or placebo, acting as a demulcent by forming a soothing, bioadhesive film over irritated pharyngeal mucosa to blunt the sensory tickle that triggers a cough.  Interestingly, it is thought that the high placebo response seen in trials of cough medicines may be related to the demulcent content (or syrup) of the cough mixture. A 2022 systematic review found honey to be an effective treatment for cough in children above 12 months of age, with a 2010 randomised controlled trial even finding it to be more effective than dextromethorphan or diphenhydramine at relieving nocturnal cough in children related to upper respiratory tract infections. The 2023 Cough in Children and Adults: Diagnosis, Assessment and Management (CICADA) Australian Chronic Cough Position Statement Update also strongly recommends minimising the use of other medications for nonspecific or refractory cough in children other than demulcents (i.e. honey). While honey is a safe first-line recommendation for many patients, including children, it must not be given to infants under 12 months of age due to the risk of infant botulism from Clostridium botulinum spores. Demulcents like honey are also a safe treatment option for: 
      • older patients
      • those on multiple medications (honey carries no clinically significant drug interactions) 
      • pregnant or breastfeeding patients, for whom honey is considered safe in normal food amounts. 
      However, pharmacists should advise patients with known pollen allergies to use honey carefully, and it should be used judiciously in patients with diabetes.

      3. When a spoonful of sugar is the medicine

      When honey is the chosen path, advise patients or caregivers that 1–2 teaspoons before bed – taken undiluted or dissolved in liquid (e.g. juice) – is an effective, comforting dose. Pair the recommendation with evidence-based non-pharmacological strategies, including:
      • plenty of water and warm fluids to help thin mucus and soothe an irritated throat
      • steam inhalation during a hot shower to promote expectoration. 
      Brush up on your knowledge about managing and treating cough by reading the APF ‘Cough’ Treatment Guideline for Pharmacists. [post_title] => Finding the sweet spot in cough management [post_excerpt] => Honey may offer safer, more effective and yummier cough relief than many over-the-counter (OTC) medicines. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => finding-the-sweet-spot-in-cough-management [to_ping] => [pinged] => [post_modified] => 2026-05-27 15:58:10 [post_modified_gmt] => 2026-05-27 05:58:10 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=32191 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Finding the sweet spot in cough management [title] => Finding the sweet spot in cough management [href] => https://www.australianpharmacist.com.au/finding-the-sweet-spot-in-cough-management/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 32192 [authorType] => )

      Finding the sweet spot in cough management

      td_module_mega_menu Object
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          [post] => WP_Post Object
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                  [ID] => 32120
                  [post_author] => 12074
                  [post_date] => 2026-05-25 10:53:09
                  [post_date_gmt] => 2026-05-25 00:53:09
                  [post_content] => With the expansion of pharmacy vaccination services across Australia, pharmacists are navigating an increasingly layered set of challenges. 
      
      Bill Wallace, PSA Pharmacist – Professional Support Adviser, outlines the most common vaccine-related questions that have come through this year.
      

      1. Who can administer FluMist?

      The introduction of intranasal influenza vaccine, FluMist, has prompted a wave of questions surrounding eligibility, prescribing and administration requirements.  Funding and eligibility differences between each state and territory are driving many of the inquiries. ‘We have had quite a few inquiries about whether [pharmacists] can administer FluMist to someone under 5 if they've got a prescription, which they can,’ said Mr Wallace. State differences apply for initiation– Pharmacists in VIC, TAS, NT, and ACT are generally restricted to authorising and administering vaccines only to children aged 5 years and older. Whereas In NSW, WA, QLD, and SA, pharmacists can authorise and administer the influenza vaccine to children aged 2 and older. Another recurring question is whether pharmacists who are not qualified immunisers can administer FluMist – given it’s administered nasally rather than via an intramuscular injection.  Mr Wallace noted that any vaccine administered by a pharmacist must be delivered by a qualified immuniser. ‘You need to be a qualified immuniser to meet the requirements for administering that particular medication. You'd be hard pressed to justify why you did it if something went wrong,’ said Mr Wallace. The responsibility extends beyond simple administrative practices, and relates to professional accountability and emergency management responsibilities. Mr Wallace noted that while serious reactions are rare, pharmacists still need to be prepared for any situation at hand. ‘If you weren't qualified and a claim was made, your insurer and The Australian Health Practitioner Regulation Agency (Ahpra) would have many questions for you about your practice.’

      2. Can pharmacists co-administer vaccines?

      As Australia’s adult vaccination schedules get more complex, co-administration queries are becoming increasingly common. ‘Timing intervals and co-administration of vaccines is probably one of the more common clinical inquiries,’ Mr Wallace said. Questions to the advice line often relate to whether vaccines can be given together, which vaccines require spacing, and whether they should be administered in one arm or both. The National Centre for Immunisation Research and Surveillance guideline for vaccine co-administration and Australian Immunisation Handbook state that while most vaccines can generally be co-administered, separate injection sites should be used where possible,  ensuring a distance of 2.5 cm between. But Mr Wallace suggests pharmacists should also take additional care when reviewing Australian Immunisation Register (AIR) records and confirming patient histories to avoid inadvertent duplication Particularly for older Australians, co-administration will be increasingly normalised for  routine adult vaccinations (e.g. RSV, shingles, pneumoccocal, DTPa etc). 

      3. Can pharmacists vaccinate interstate?

      Interstate practice continues to create a point of tension for pharmacist immunisers as requirements differ significantly between jurisdictions.  There are discrepancies between patient age eligibility, refresher requirements and additional accreditation, meaning pharmacists cannot automatically assume their qualifications transfer across all states and territories. There are also differences between state and territory legislations which govern interstate pharmacists’ eligibility to administer vaccines, introducing barriers to interstate practice, according to the Immunisation Coalition. ‘Certain states, Tasmania, Victoria, and WA have slightly different training requirements … you need to ensure that you meet local state immunisation requirements prior to providing vaccinations,’ Mr Wallace said. He stresses the importance of ‘checking what the differences are, and referring to resources like the local state pharmacist vaccination guidelines before administering vaccines’. In some cases, pharmacists may need to complete an additional online module, although requirements vary. For example, the ACT has a Japanese encephalitis module that is required, and Victoria requires extra training to be able to provide certain travel vaccines. Complicating matters further, immunisation requirements and eligibility for state and territory programs may change.

      4. How do pharmacists maintain immunisation credentials?

      Is it a matter of once a pharmacist immuniser, always a pharmacist immuniser?  Not quite. According to Ahpra and state regulators, pharmacists must undertake annual immunisation-related CPD activities to maintain their currency. ‘Pharmacists must also maintain first aid every 3 years and CPR every 12 months,’ Mr Wallace said.  The PSA offers an online refresher training course which aligns with the current immunisation training. The training program consists of online modules to ensure a pharmacists’ accredited training remains up to date. ‘Some pharmacists did their vaccination courses a long time ago, with a much limited range of vaccines,’ he said. ‘There is also an Immunisation Practical Refresher Workshop that pharmacists can do if they've had a break in practice or want to refresh their technique.’ The online immunisation refresher course allows pharmacists to expand their training to cover all vaccines. Looking for any answers to your queries? Hit up the Pharmacist Advice Line here. [post_title] => Top 4 vaccine queries to the P2P Advice Line [post_excerpt] => With the expansion of pharmacy vaccination services across Australia, pharmacists are navigating an increasingly layered set of challenges.  [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => top-4-vaccine-queries-to-the-p2p-advice-line [to_ping] => [pinged] => [post_modified] => 2026-05-25 16:11:16 [post_modified_gmt] => 2026-05-25 06:11:16 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=32120 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Top 4 vaccine queries to the P2P Advice Line [title] => Top 4 vaccine queries to the P2P Advice Line [href] => https://www.australianpharmacist.com.au/top-4-vaccine-queries-to-the-p2p-advice-line/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 32124 [authorType] => )

      Top 4 vaccine queries to the P2P Advice Line

      td_module_mega_menu Object
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                  [ID] => 32111
                  [post_author] => 3387
                  [post_date] => 2026-05-20 13:03:36
                  [post_date_gmt] => 2026-05-20 03:03:36
                  [post_content] => Once a disease of the past, diphtheria is rapidly re-emerging across Australia. Here’s what pharmacists need to know.
      

      What is diphtheria?

      A potentially deadly and highly contagious  bacterial disease, diphtheria can infect the nose and throat, cause skin sores, and spread toxin through the body; in severe cases it can cause airway blockage, heart damage and nerve damage.  Respiratory diphtheria is the more deadly variant, and is typically spread through respiratory droplets, often when people cough and sneeze. Cutaneous diphtheria can spread through touching skin sores.

      What are the symptoms?

      Signs and symptoms of diphtheria include:
      • sore throat
      • fever 
      • swollen neck glands
      • weakness.
      Post-exposure to the bacteria, symptoms typically appear within 2–5 days. And within 2–3 days of illness onset, dead tissue can form a thick grey membrane in the respiratory tract, covering the nose, tonsils and throat, which can make breathing and swallowing difficult. In unvaccinated people who do not receive appropriate treatment, diphtheria is fatal in up to 30% of cases.

      How dangerous is the disease?

      Before vaccination, diphtheria was a leading cause of childhood death in Australia. Between 1926 and 1935, there were more than 4,000 diphtheria-related childhood deaths recorded. Once vaccination programs rolled out in the 1940s, cases of diphtheria significantly reduced.

      Was it once eradicated in Australia?

      Not entirely. While Australia has largely managed to control diphtheria through vaccination, surveillance data show cases continued to occur at low levels. Until recently, there have been no recorded respiratory childhood cases since 1992. Between 2011 and 2019, 38 cases of cutaneous diphtheria were reported in both children and adults, along with seven cases of respiratory diphtheria, all in adults. Two adults who were not vaccinated against the disease died from respiratory diphtheria in 2011 and 2018. But post-COVID-19, the disease made a resurgence – with the National Centre for Immunisation Research and Surveillance announcing in 2022 that ‘Diphtheria is back’.

      Why has there been a resurgence?

      Likely because vaccination coverage has declined since the COVID-19 pandemic. While Australia's vaccination rates are still considered high by global standards, recent national data show full immunisation coverage of 91.54% at 1 year, 89.57% at 2 years, and 93.17% at 5 years of age, which is well below the 95% target in older age groups.

      Can diphtheria be treated?

      While diphtheria can be treated with antibiotics, they may have little effect once the infection takes hold. Another treatment, diphtheria antitoxin (DAT), can neutralise the effects of the toxin, but it needs to be administered within 48 hours of infection.  And because diphtheria had been largely eradicated, low production of DAT has led to global shortages. Even when this treatment is administered, the Australian Centre for Disease Control has cautioned that up to 1 in 10 people with respiratory diphtheria will die.

      Who is most at risk?

      Children under 5 years of age are at particularly high risk of death. Other at-risk groups include:
      • those who are unvaccinated or not up to date with diphtheria boosters doses
      • travellers to outbreak areas or countries where diphtheria is more common such as Nigeria, Guinea, Niger, Mauritania, Algeria, Chad, Mali, and South Africa
      • immunocompromised people
      • Aboriginal and Torres Strait Islander people in affected communities.

      What are the risks of an outbreak here?

      Pretty high when coverage is low, health experts have warned. ‘There was an outbreak of diphtheria between 2022 and 2024 in North Queensland, and also in the Kimberley in 2025,’ said Northern Territory Chief Health Officer Paul Burgess. So far this year, more than 220 cases of diphtheria have been reported across Australia. While most cases have been recorded in the Northern Territory, the disease has spread to Western Australia, South Australia and Queensland. Internationally, the World Health Organization reported over 29,000 suspected diphtheria cases and 1,420 deaths in the African Region from the beginning of 2025 to 1 March 2026.

      How often are booster doses required?

      Routine diphtheria boosters are generally recommended every 10 years for adults to maintain immunity. For travellers to higher-risk settings, booster timing may be more frequent depending on exposure risk and destination.

      What can pharmacists do?

      When patients come in for routine vaccinations, pharmacists should check the Australian Immunisation Register, suggesting catch up vaccinations for children who are behind with routine immunisations, and booster doses for adults who require them. Pharmacists can also counsel patients on travel-related boosters, reminding adults that protection wanes. ‘There are new diphtheria guidelines produced by the Northern Territory government to cover this outbreak, and pharmacists need to be aware of the new guidelines,’ said Helen Stone, PSA SA & NT State and Territory Manager. ‘All frontline workers in the Northern Territory need to be protected. This includes ensuring that they've been vaccinated and reminding people to check their immunisation records. ‘As 69% of cases are actually cutaneous diphtheria, the message I would really like to get out is that in its early stages, the skin infection could be confused with other skin infections, e.g. a fungal skin infection. Pharmacists should be very cautious and ensure that they are referring to skin infections for further investigation, particularly in areas of the outbreak.’ [post_title] => Another vaccine-preventable disease makes a resurgence [post_excerpt] => Once a disease of the past, diphtheria is rapidly re-emerging across Australia. Here’s what pharmacists need to know. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => another-vaccine-preventable-disease-makes-a-resurgence [to_ping] => [pinged] => [post_modified] => 2026-05-20 15:15:03 [post_modified_gmt] => 2026-05-20 05:15:03 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=32111 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Another vaccine-preventable disease makes a resurgence [title] => Another vaccine-preventable disease makes a resurgence [href] => https://www.australianpharmacist.com.au/another-vaccine-preventable-disease-makes-a-resurgence/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 32112 [authorType] => )

      Another vaccine-preventable disease makes a resurgence

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          [post] => WP_Post Object
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                  [ID] => 32107
                  [post_author] => 3387
                  [post_date] => 2026-05-18 12:59:24
                  [post_date_gmt] => 2026-05-18 02:59:24
                  [post_content] => AI is transforming pharmacy practice — but without the right safeguards, it can also put your registration at risk.
      
      AI is no longer an emerging consideration for pharmacists – it’s already embedded in practice.
      
      Using large language models (LLMs) such as ChatGPT to answer clinical questions and AI scribes like Heidi Health to capture consultation notes is becoming more commonplace. With agentic AI – systems that act autonomously on a patient’s behalf – now growing in popularity, the pace of AI adoption is only set to increase.
      
      But these opportunities come with obligations – and without a distinct regulatory framework. Here, PSA Digital Health Lead and Victorian state manager Jarrod McMaugh MPS outlines the sixAI traps pharmacists need to avoid.
      

      1. Entering identifiable patient information into AI platforms

      One of the most significant risks pharmacists face when using AI is entering patients’ health information into AI platforms. Regardless of the purpose or the pharmacist’s intent, it may constitute a breach of Australian privacy law.  ‘Let's say you were providing a Home Medicines Review (HMR) and you put the patient’s details into ChatGPT and asked, “What medicines is this person missing for their diagnosed conditions?” That would be a breach of privacy regulations,’ Mr McMaugh said. ‘Any information put into AI is stored. And therefore, where it is stored must adhere to the Australian privacy requirements.’ However, pharmacists who use LLMs to check for missed medicines or potential interactions can do so legitimately, provided no identifying information is included. And while taking out a patient's name and address is a good first step, this may not adequately deidentify them. ‘You could prompt an LLM by saying, “I have a person who is taking medicines, x, y, z, and they have these diagnoses. Can you identify any missed medicines or any interactions?”’ Mr McMaugh said. ‘As long as there's no way to identify the individual, and it's just down to what is clinically appropriate, it's not a breach of any privacy matters.’ 2. Assuming a business account equals compliance You may think that moving from a free AI account to a paid business subscription resolves any compliance concerns. But to be compliant, business or enterprise AI subscriptions must explicitly confirm that the platform meets Australian privacy regulations in the delivery of that service. 'You would need to be satisfied that the LLM, under contract, specifically states that it meets Australian privacy regulations,’ Mr McMaugh said. ‘It's similar to the agreement you have with your dispensing software [provider] or the clinical platform you use to record scope of practice work.’

      3. Using AI scribes without proper consent

      For pharmacists conducting clinical consultations, such as accredited and prescribing pharmacists, AI scribes can be incredibly useful for collecting and collating patient information. But deploying them without meeting the required consent obligations creates significant professional risk. ‘You must get consent from the person whose session is being recorded by the AI tool,’ Mr McMaugh said. ‘And you must have the ability to turn it off if somebody says, “I want the service, but I don't want the AI tool recording our discussion”.’ For pharmacists uncertain about what adequate consent looks like in practice, he suggests the following approach: 'I'm going to use an AI scribe in this session. It will record our conversation and take notes on our behalf. It will create a copy that I'll keep on record, and you have the right to access that record any time you request it. Are you comfortable with me proceeding?’ Pharmacists should also ensure that the AI tool is not in an active learning phase, with systems that continue to learn from patient interactions requiring an additional layer of consent. ‘For the vast majority of pharmacists, that shouldn't be a scenario they find themselves in – unless they're involved in clinical research about an intervention or research about the AI tool,’ he said. ‘For the vast majority of pharmacists, that shouldn't be a scenario they find themselves in – unless they're involved in clinical research about an intervention or research about the AI tool,’ he said. Pharmacists should confirm that AI dictation tools don't record voice snippets or retain details to improve the quality of their systems. Utilising AI models that are actively learning is generally not appropriate outside of a clinical trial with the accompanying level of consent seen in a trial setting.  Using an ‘active learning’ AI requires well documented consent for the person's health information to be used in this way, and is usually out of scope for most clinical settings.

      4. Failing to check transcription accuracy

      The second area of risk when using AI scribes is accuracy. While generally reliable, they can make mistakes; and the professional obligation to maintain accurate records rests with the pharmacist, not the AI tool. To prevent errors, pharmacists should still take notes while the AI scribe is working in the background, particularly around critical details such as dosing. 'If you were in a position in the future where something has gone wrong and you're in front of AHPRA or another regulator, and they say, “Why are your notes incorrect?”  just assuming that the digital scribe was doing its job is not sufficient for meeting your professional obligations,’ Mr McMaugh said. AI and handwritten notes should also be reviewed at the end of each session, while details of the consultation are still fresh. 'If you use an AI scribe during an HMR interview and you don't review the transcript until a week later, how are you going to correct the information that it got wrong?’ Mr McMaugh said. ‘From a workflow perspective, and to adhere to professional obligations, you need to make sure it's accurate.’

      5. Trusting AI output without checking the references

      AI platforms can produce clinical responses that are well structured, but are actually incorrect. These AI ‘hallucinations’, where LLMs return fabricated or inconsistent information, are commonplace. Another, more subtle risk is when LLMs draw on international sources rather than Australian-specific guidelines. ‘If you ask what the standard dose of a medication is, you might get a generally acceptable dose that's not applicable to specific Australian scenarios,’ Mr McMaugh said. Antibiotic selection is a clear example, with resistance patterns varying between countries, meaning recommendations based on international data may be inappropriate or inadequate for an Australian patient. 'You should therefore always ask LLMs for references so you can confirm the information is correct,’ he added. And don’t forget to check these references also, which aren’t immune to AI hallucinations. 6. Accepting an AI-generated booking as genuine patient consent Agentic AI is a system designed to act autonomously on a person's behalf, booking appointments, managing schedules and completing transactions. While these tools have the potential to streamline service appointments, such as vaccinations, pharmacists must be vigilant around digital bookings. When an AI agent books a consultation on a patient's behalf, it’s not possible to confirm at the point of booking whether the patient themselves made an informed, active decision to attend. ‘If booked online, pharmacists should double-check that a person has provided consent to have a particular service when they come in,’ Mr McMaugh said. 'This is a good way to confirm that consent has been provided by the [person] receiving the service – not the AI that is booking on their behalf.’ To close any gaps in the consent chain, he suggests:
      • confirming the service to be received i.e. ‘I will be administering an influenza vaccine for you today’
      • asking whether the patient booked the service themselves and whether they are comfortable proceeding.
      ‘It’s generally good practice to manage risk by confirming the service because an appointment also could have been booked by someone other than the patient receiving the service, such as a family member.’

      An evolving space

      While AI does not alter a pharmacist's professional obligations – it creates new contexts in which those obligations must be applied. According to Mr McMaugh, pharmacists should expect these considerations to continue evolving. ‘We might even get to a point in the future where AI is so effective at doing a certain task that if you don't use it, you may be less effective, and in turn, unethical,’ he said. ‘It’s very much a moving space.’ [post_title] => The 6 AI mistakes that could land pharmacists in hot water [post_excerpt] => AI is transforming pharmacy practice — but without the right safeguards, it can also put your registration at risk. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => the-6-ai-mistakes-that-could-land-pharmacists-in-hot-water [to_ping] => [pinged] => [post_modified] => 2026-05-18 16:52:09 [post_modified_gmt] => 2026-05-18 06:52:09 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=32107 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => The 6 AI mistakes that could land pharmacists in hot water [title] => The 6 AI mistakes that could land pharmacists in hot water [href] => https://www.australianpharmacist.com.au/the-6-ai-mistakes-that-could-land-pharmacists-in-hot-water/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 32108 [authorType] => )

      The 6 AI mistakes that could land pharmacists in hot water

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                  [ID] => 32093
                  [post_author] => 12074
                  [post_date] => 2026-05-13 11:33:26
                  [post_date_gmt] => 2026-05-13 01:33:26
                  [post_content] => A new transitions of care model is helping high-risk patients in rural and remote areas avoid medication misadventure and hospital readmission through virtual pharmacist-led care.
      
      After patients are discharged from the hospital, their transition back into the community can be high-risk, with significant potential for medicine-related harm. These risks are amplified significantly for rural communities due to sparse healthcare facilities, fragmented continuity of care and workforce shortages.  
      
      The TIC TOC program in Western NSW is tackling these issues via a virtual model designed to support patients who are struggling to access care during vulnerable post-discharge periods.
      
      The TIC TOC program will be further explored at the CPC26 conference later this month and is set to demonstrate how digital health and multidisciplinary collaboration can help bridge the gap between hospital and home. 
      
      Ahead of the program’s launch, AP spoke with Linda Krogh, the Virtual Transitions-of-Care Stewardship Pharmacist with the Western NSW Local Health District and a current PhD candidate with the University of Sydney.
      

      A virtual model of care

      ‘Transitions of care are deeply complex – even more so in remote settings due to factors such as distance, workforce, and community care,’ said Ms Krogh. The CPC26 presentation will outline how the model translates into practice, including identifying high-risk patients, virtual medication reconciliation, multidisciplinary communication, and rapid coordination of Home Medicines Reviews (HMRs). The Transitions of Care (ToC) Pharmacist role was introduced to provide virtual support across 19 towns, ensuring high-risk patients receive an optimal discharge and follow up, particularly when onsite pharmacy services are unavailable. The layout of the model means that the ‘TOCS pharmacist monitors the patient’s hospital admission and supports the onsite or virtual clinical pharmacist to ensure all required discharge activities are completed,’ Ms Krogh said. This includes reviewing electronic medical records to identify medicines that were commenced, ceased, changed, or continued during admission. ‘The role includes medication reconciliation, patient counselling, preparation of patient-friendly medication lists and direct communication with GPs and consultant pharmacists to facilitate timely post-discharge medication reviews,’ she said. Through virtual work, pharmacists can connect hospital teams, patients, carers, and primary care providers across geographically disconnected areas. 

      The risk in transitions

      The severely limited access to GP services and healthcare facilities delays crucial follow-up appointments and check-ins after discharge. In most rural communities, locum professionals make up a significant part of the primary care workforce, creating significant challenges in ensuring continuity of care. ‘Patients are often discharged from hospitals located a long distance from home, which can delay access to medicines and follow-up post-discharge,’ Ms Krogh said. Patients are identified as high risk for medicines misadventure and readmission based on criteria including  ‘use of high-risk medicines such as insulin, alongside a hospital readmission within the previous 6 months.’  ‘These factors can increase the risk of medication discrepancies, misunderstandings, and adverse events once the patient returns home,’ she added.

      Fast-tracking post-discharge HMRs

      A key feature of the program is its focus on ensuring HMRs occur when they are needed – not when they are possible. To ensure time-sensitive cases are addressed, the TOC pharmacist prepares a HMR referral for the patient’s GP before discharge. If the referral cannot be signed within a 48-hour window, the program activates the hospital-initiated HMR pathway, to avoid delays.  ‘The goal is for the post-discharge HMR to be completed within 10 days,’ Ms Krogh said. Patients can choose whether they prefer their HMR conducted face-to-face or virtually, allowing referrals to be matched to credentialed pharmacists based on patient preference and location. The TOCs pharmacist then books a GP appointment to ‘review the HMR recommendations and develop medication management plans, helping to close the loop on the patient's transition of care,’ she said. By clearly identifying patients as high-risk, reception staff are better able to triage appointment availability where demand exceeds capacity.

      Connecting hospital and community care

      A major strength of the TIC  TOC model is its ability to connect traditionally siloed parts of the healthcare system by facilitating communication between hospital clinicians, GPs, and community pharmacists – improving continuity of care throughout each patient’s journey.  ‘In rural towns where GP appointments are often booked out weeks in advance, this model ensures high-risk patients have their medications reviewed promptly by a pharmacist,’ Ms Krogh said. With post-discharge HMRs frequently identifying medication misunderstandings, the early identification of medication-related issues also allows GP appointments to focus more efficiently on clinical decision-making and care planning. The most common errors identified relate to patients’ misunderstanding of how to take their medicines following discharge, as well as short-term medicines that pose a point of confusion, such as tapered prednisolone regimens and analgesics. ‘In one case, a patient stopped taking an antihypertensive medication after overhearing nursing staff say it should be withheld during admission, not realising the change was only temporary,’ Ms Krogh said. ‘Another patient discharged with two antibiotics misunderstood the instructions and intended to take the medicines sequentially rather than concurrently.’ 

      Multidisciplinary action

      The TIC TOC model encapsulates a broader theme of multidisciplinary collaboration that will underpin CPC26.  With healthcare systems championing the importance of coordinated care, this program demonstrates how pharmacists can play a central role in ensuring patient safety during transitions of care, particularly for vulnerable rural populations where limited access to timely healthcare poses challenges. Further insights into the TIC TOC program and the virtual TOC's pharmacist role will be shared during the CPC26 conference session, held between 29 – 31 May 2026 at the RACV Royal Pines Resort, Gold Coast. Click here to register. [post_title] => Virtually easing transitions of care [post_excerpt] => A new transitions of care model is helping high-risk patients in rural and remote areas through virtual pharmacist-led care. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => virtually-easing-transitions-of-care [to_ping] => [pinged] => [post_modified] => 2026-05-13 14:51:23 [post_modified_gmt] => 2026-05-13 04:51:23 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=32093 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Virtually easing transitions of care [title] => Virtually easing transitions of care [href] => https://www.australianpharmacist.com.au/virtually-easing-transitions-of-care/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 32094 [authorType] => )

      Virtually easing transitions of care

  • CPD
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                  [post_date] => 2026-05-27 13:27:14
                  [post_date_gmt] => 2026-05-27 03:27:14
                  [post_content] => Honey may offer safer, more effective and yummier cough relief than many over-the-counter (OTC) medicines.
      
      As winter inches closer, pharmacists are seeing more patients seeking relief from coughs associated with cold and flu season, often asking for an OTC cough syrup or suppressant, or the Pharmacist Only medicine dihydrocodeine (Rikodeine).
      
      But mounting evidence suggests the best therapeutic recommendation might come from the pantry rather than the dispensary. 
      

      1. Efficacy and safety of cough medicine called into question

      The evidence for oral OTC cough preparations for acute cough is, at best, inconclusive – with clinical trials failing to demonstrate efficacy. Cough medicines are contraindicated in children under 6 years of age, and use in older children discouraged – with product labels emphasising they should only be used in children aged 6–11 on the advice of a health professional (e.g. pharmacist, nurse, medical practitioner).  They should only be considered if the benefit of their use outweighs the risk, noting that the Therapeutic Goods Administration review that informed these changes highlighted significant safety and efficacy concerns.  Cough medicines are also not appropriate for many adult patients due to medicine interactions, risk of abuse, adverse effects, and other co-existing medical conditions (e.g. asthma, Chronic Obstructive Pulmonary Disease). Additionally, the Australian Pharmaceutical Formulary and Handbook (APF) advises against combination cough products that mix an antitussive with an expectorant, an antihistamine, or both.  These products tend to contain subtherapeutic doses of each ingredient, and can increase the risk of adverse effects without adding meaningful therapeutic benefit.

      2. Honey goes down more than a treat

      Most acute coughs are self-limiting, and non-pharmacological management can be recommended, with the aim of chronic cough management being identifying and treating the underlying cause. Honey is often the superior clinical choice if symptomatic relief is needed. According to the APF, honey relieves cough symptoms in children better than no treatment or placebo, acting as a demulcent by forming a soothing, bioadhesive film over irritated pharyngeal mucosa to blunt the sensory tickle that triggers a cough.  Interestingly, it is thought that the high placebo response seen in trials of cough medicines may be related to the demulcent content (or syrup) of the cough mixture. A 2022 systematic review found honey to be an effective treatment for cough in children above 12 months of age, with a 2010 randomised controlled trial even finding it to be more effective than dextromethorphan or diphenhydramine at relieving nocturnal cough in children related to upper respiratory tract infections. The 2023 Cough in Children and Adults: Diagnosis, Assessment and Management (CICADA) Australian Chronic Cough Position Statement Update also strongly recommends minimising the use of other medications for nonspecific or refractory cough in children other than demulcents (i.e. honey). While honey is a safe first-line recommendation for many patients, including children, it must not be given to infants under 12 months of age due to the risk of infant botulism from Clostridium botulinum spores. Demulcents like honey are also a safe treatment option for: 
      • older patients
      • those on multiple medications (honey carries no clinically significant drug interactions) 
      • pregnant or breastfeeding patients, for whom honey is considered safe in normal food amounts. 
      However, pharmacists should advise patients with known pollen allergies to use honey carefully, and it should be used judiciously in patients with diabetes.

      3. When a spoonful of sugar is the medicine

      When honey is the chosen path, advise patients or caregivers that 1–2 teaspoons before bed – taken undiluted or dissolved in liquid (e.g. juice) – is an effective, comforting dose. Pair the recommendation with evidence-based non-pharmacological strategies, including:
      • plenty of water and warm fluids to help thin mucus and soothe an irritated throat
      • steam inhalation during a hot shower to promote expectoration. 
      Brush up on your knowledge about managing and treating cough by reading the APF ‘Cough’ Treatment Guideline for Pharmacists. [post_title] => Finding the sweet spot in cough management [post_excerpt] => Honey may offer safer, more effective and yummier cough relief than many over-the-counter (OTC) medicines. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => finding-the-sweet-spot-in-cough-management [to_ping] => [pinged] => [post_modified] => 2026-05-27 15:58:10 [post_modified_gmt] => 2026-05-27 05:58:10 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=32191 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Finding the sweet spot in cough management [title] => Finding the sweet spot in cough management [href] => https://www.australianpharmacist.com.au/finding-the-sweet-spot-in-cough-management/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 32192 [authorType] => )

      Finding the sweet spot in cough management

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                  [post_date] => 2026-05-25 10:53:09
                  [post_date_gmt] => 2026-05-25 00:53:09
                  [post_content] => With the expansion of pharmacy vaccination services across Australia, pharmacists are navigating an increasingly layered set of challenges. 
      
      Bill Wallace, PSA Pharmacist – Professional Support Adviser, outlines the most common vaccine-related questions that have come through this year.
      

      1. Who can administer FluMist?

      The introduction of intranasal influenza vaccine, FluMist, has prompted a wave of questions surrounding eligibility, prescribing and administration requirements.  Funding and eligibility differences between each state and territory are driving many of the inquiries. ‘We have had quite a few inquiries about whether [pharmacists] can administer FluMist to someone under 5 if they've got a prescription, which they can,’ said Mr Wallace. State differences apply for initiation– Pharmacists in VIC, TAS, NT, and ACT are generally restricted to authorising and administering vaccines only to children aged 5 years and older. Whereas In NSW, WA, QLD, and SA, pharmacists can authorise and administer the influenza vaccine to children aged 2 and older. Another recurring question is whether pharmacists who are not qualified immunisers can administer FluMist – given it’s administered nasally rather than via an intramuscular injection.  Mr Wallace noted that any vaccine administered by a pharmacist must be delivered by a qualified immuniser. ‘You need to be a qualified immuniser to meet the requirements for administering that particular medication. You'd be hard pressed to justify why you did it if something went wrong,’ said Mr Wallace. The responsibility extends beyond simple administrative practices, and relates to professional accountability and emergency management responsibilities. Mr Wallace noted that while serious reactions are rare, pharmacists still need to be prepared for any situation at hand. ‘If you weren't qualified and a claim was made, your insurer and The Australian Health Practitioner Regulation Agency (Ahpra) would have many questions for you about your practice.’

      2. Can pharmacists co-administer vaccines?

      As Australia’s adult vaccination schedules get more complex, co-administration queries are becoming increasingly common. ‘Timing intervals and co-administration of vaccines is probably one of the more common clinical inquiries,’ Mr Wallace said. Questions to the advice line often relate to whether vaccines can be given together, which vaccines require spacing, and whether they should be administered in one arm or both. The National Centre for Immunisation Research and Surveillance guideline for vaccine co-administration and Australian Immunisation Handbook state that while most vaccines can generally be co-administered, separate injection sites should be used where possible,  ensuring a distance of 2.5 cm between. But Mr Wallace suggests pharmacists should also take additional care when reviewing Australian Immunisation Register (AIR) records and confirming patient histories to avoid inadvertent duplication Particularly for older Australians, co-administration will be increasingly normalised for  routine adult vaccinations (e.g. RSV, shingles, pneumoccocal, DTPa etc). 

      3. Can pharmacists vaccinate interstate?

      Interstate practice continues to create a point of tension for pharmacist immunisers as requirements differ significantly between jurisdictions.  There are discrepancies between patient age eligibility, refresher requirements and additional accreditation, meaning pharmacists cannot automatically assume their qualifications transfer across all states and territories. There are also differences between state and territory legislations which govern interstate pharmacists’ eligibility to administer vaccines, introducing barriers to interstate practice, according to the Immunisation Coalition. ‘Certain states, Tasmania, Victoria, and WA have slightly different training requirements … you need to ensure that you meet local state immunisation requirements prior to providing vaccinations,’ Mr Wallace said. He stresses the importance of ‘checking what the differences are, and referring to resources like the local state pharmacist vaccination guidelines before administering vaccines’. In some cases, pharmacists may need to complete an additional online module, although requirements vary. For example, the ACT has a Japanese encephalitis module that is required, and Victoria requires extra training to be able to provide certain travel vaccines. Complicating matters further, immunisation requirements and eligibility for state and territory programs may change.

      4. How do pharmacists maintain immunisation credentials?

      Is it a matter of once a pharmacist immuniser, always a pharmacist immuniser?  Not quite. According to Ahpra and state regulators, pharmacists must undertake annual immunisation-related CPD activities to maintain their currency. ‘Pharmacists must also maintain first aid every 3 years and CPR every 12 months,’ Mr Wallace said.  The PSA offers an online refresher training course which aligns with the current immunisation training. The training program consists of online modules to ensure a pharmacists’ accredited training remains up to date. ‘Some pharmacists did their vaccination courses a long time ago, with a much limited range of vaccines,’ he said. ‘There is also an Immunisation Practical Refresher Workshop that pharmacists can do if they've had a break in practice or want to refresh their technique.’ The online immunisation refresher course allows pharmacists to expand their training to cover all vaccines. Looking for any answers to your queries? Hit up the Pharmacist Advice Line here. [post_title] => Top 4 vaccine queries to the P2P Advice Line [post_excerpt] => With the expansion of pharmacy vaccination services across Australia, pharmacists are navigating an increasingly layered set of challenges.  [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => top-4-vaccine-queries-to-the-p2p-advice-line [to_ping] => [pinged] => [post_modified] => 2026-05-25 16:11:16 [post_modified_gmt] => 2026-05-25 06:11:16 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=32120 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Top 4 vaccine queries to the P2P Advice Line [title] => Top 4 vaccine queries to the P2P Advice Line [href] => https://www.australianpharmacist.com.au/top-4-vaccine-queries-to-the-p2p-advice-line/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 32124 [authorType] => )

      Top 4 vaccine queries to the P2P Advice Line

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                  [post_date] => 2026-05-20 13:03:36
                  [post_date_gmt] => 2026-05-20 03:03:36
                  [post_content] => Once a disease of the past, diphtheria is rapidly re-emerging across Australia. Here’s what pharmacists need to know.
      

      What is diphtheria?

      A potentially deadly and highly contagious  bacterial disease, diphtheria can infect the nose and throat, cause skin sores, and spread toxin through the body; in severe cases it can cause airway blockage, heart damage and nerve damage.  Respiratory diphtheria is the more deadly variant, and is typically spread through respiratory droplets, often when people cough and sneeze. Cutaneous diphtheria can spread through touching skin sores.

      What are the symptoms?

      Signs and symptoms of diphtheria include:
      • sore throat
      • fever 
      • swollen neck glands
      • weakness.
      Post-exposure to the bacteria, symptoms typically appear within 2–5 days. And within 2–3 days of illness onset, dead tissue can form a thick grey membrane in the respiratory tract, covering the nose, tonsils and throat, which can make breathing and swallowing difficult. In unvaccinated people who do not receive appropriate treatment, diphtheria is fatal in up to 30% of cases.

      How dangerous is the disease?

      Before vaccination, diphtheria was a leading cause of childhood death in Australia. Between 1926 and 1935, there were more than 4,000 diphtheria-related childhood deaths recorded. Once vaccination programs rolled out in the 1940s, cases of diphtheria significantly reduced.

      Was it once eradicated in Australia?

      Not entirely. While Australia has largely managed to control diphtheria through vaccination, surveillance data show cases continued to occur at low levels. Until recently, there have been no recorded respiratory childhood cases since 1992. Between 2011 and 2019, 38 cases of cutaneous diphtheria were reported in both children and adults, along with seven cases of respiratory diphtheria, all in adults. Two adults who were not vaccinated against the disease died from respiratory diphtheria in 2011 and 2018. But post-COVID-19, the disease made a resurgence – with the National Centre for Immunisation Research and Surveillance announcing in 2022 that ‘Diphtheria is back’.

      Why has there been a resurgence?

      Likely because vaccination coverage has declined since the COVID-19 pandemic. While Australia's vaccination rates are still considered high by global standards, recent national data show full immunisation coverage of 91.54% at 1 year, 89.57% at 2 years, and 93.17% at 5 years of age, which is well below the 95% target in older age groups.

      Can diphtheria be treated?

      While diphtheria can be treated with antibiotics, they may have little effect once the infection takes hold. Another treatment, diphtheria antitoxin (DAT), can neutralise the effects of the toxin, but it needs to be administered within 48 hours of infection.  And because diphtheria had been largely eradicated, low production of DAT has led to global shortages. Even when this treatment is administered, the Australian Centre for Disease Control has cautioned that up to 1 in 10 people with respiratory diphtheria will die.

      Who is most at risk?

      Children under 5 years of age are at particularly high risk of death. Other at-risk groups include:
      • those who are unvaccinated or not up to date with diphtheria boosters doses
      • travellers to outbreak areas or countries where diphtheria is more common such as Nigeria, Guinea, Niger, Mauritania, Algeria, Chad, Mali, and South Africa
      • immunocompromised people
      • Aboriginal and Torres Strait Islander people in affected communities.

      What are the risks of an outbreak here?

      Pretty high when coverage is low, health experts have warned. ‘There was an outbreak of diphtheria between 2022 and 2024 in North Queensland, and also in the Kimberley in 2025,’ said Northern Territory Chief Health Officer Paul Burgess. So far this year, more than 220 cases of diphtheria have been reported across Australia. While most cases have been recorded in the Northern Territory, the disease has spread to Western Australia, South Australia and Queensland. Internationally, the World Health Organization reported over 29,000 suspected diphtheria cases and 1,420 deaths in the African Region from the beginning of 2025 to 1 March 2026.

      How often are booster doses required?

      Routine diphtheria boosters are generally recommended every 10 years for adults to maintain immunity. For travellers to higher-risk settings, booster timing may be more frequent depending on exposure risk and destination.

      What can pharmacists do?

      When patients come in for routine vaccinations, pharmacists should check the Australian Immunisation Register, suggesting catch up vaccinations for children who are behind with routine immunisations, and booster doses for adults who require them. Pharmacists can also counsel patients on travel-related boosters, reminding adults that protection wanes. ‘There are new diphtheria guidelines produced by the Northern Territory government to cover this outbreak, and pharmacists need to be aware of the new guidelines,’ said Helen Stone, PSA SA & NT State and Territory Manager. ‘All frontline workers in the Northern Territory need to be protected. This includes ensuring that they've been vaccinated and reminding people to check their immunisation records. ‘As 69% of cases are actually cutaneous diphtheria, the message I would really like to get out is that in its early stages, the skin infection could be confused with other skin infections, e.g. a fungal skin infection. Pharmacists should be very cautious and ensure that they are referring to skin infections for further investigation, particularly in areas of the outbreak.’ [post_title] => Another vaccine-preventable disease makes a resurgence [post_excerpt] => Once a disease of the past, diphtheria is rapidly re-emerging across Australia. Here’s what pharmacists need to know. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => another-vaccine-preventable-disease-makes-a-resurgence [to_ping] => [pinged] => [post_modified] => 2026-05-20 15:15:03 [post_modified_gmt] => 2026-05-20 05:15:03 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=32111 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Another vaccine-preventable disease makes a resurgence [title] => Another vaccine-preventable disease makes a resurgence [href] => https://www.australianpharmacist.com.au/another-vaccine-preventable-disease-makes-a-resurgence/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 32112 [authorType] => )

      Another vaccine-preventable disease makes a resurgence

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                  [post_date] => 2026-05-18 12:59:24
                  [post_date_gmt] => 2026-05-18 02:59:24
                  [post_content] => AI is transforming pharmacy practice — but without the right safeguards, it can also put your registration at risk.
      
      AI is no longer an emerging consideration for pharmacists – it’s already embedded in practice.
      
      Using large language models (LLMs) such as ChatGPT to answer clinical questions and AI scribes like Heidi Health to capture consultation notes is becoming more commonplace. With agentic AI – systems that act autonomously on a patient’s behalf – now growing in popularity, the pace of AI adoption is only set to increase.
      
      But these opportunities come with obligations – and without a distinct regulatory framework. Here, PSA Digital Health Lead and Victorian state manager Jarrod McMaugh MPS outlines the sixAI traps pharmacists need to avoid.
      

      1. Entering identifiable patient information into AI platforms

      One of the most significant risks pharmacists face when using AI is entering patients’ health information into AI platforms. Regardless of the purpose or the pharmacist’s intent, it may constitute a breach of Australian privacy law.  ‘Let's say you were providing a Home Medicines Review (HMR) and you put the patient’s details into ChatGPT and asked, “What medicines is this person missing for their diagnosed conditions?” That would be a breach of privacy regulations,’ Mr McMaugh said. ‘Any information put into AI is stored. And therefore, where it is stored must adhere to the Australian privacy requirements.’ However, pharmacists who use LLMs to check for missed medicines or potential interactions can do so legitimately, provided no identifying information is included. And while taking out a patient's name and address is a good first step, this may not adequately deidentify them. ‘You could prompt an LLM by saying, “I have a person who is taking medicines, x, y, z, and they have these diagnoses. Can you identify any missed medicines or any interactions?”’ Mr McMaugh said. ‘As long as there's no way to identify the individual, and it's just down to what is clinically appropriate, it's not a breach of any privacy matters.’ 2. Assuming a business account equals compliance You may think that moving from a free AI account to a paid business subscription resolves any compliance concerns. But to be compliant, business or enterprise AI subscriptions must explicitly confirm that the platform meets Australian privacy regulations in the delivery of that service. 'You would need to be satisfied that the LLM, under contract, specifically states that it meets Australian privacy regulations,’ Mr McMaugh said. ‘It's similar to the agreement you have with your dispensing software [provider] or the clinical platform you use to record scope of practice work.’

      3. Using AI scribes without proper consent

      For pharmacists conducting clinical consultations, such as accredited and prescribing pharmacists, AI scribes can be incredibly useful for collecting and collating patient information. But deploying them without meeting the required consent obligations creates significant professional risk. ‘You must get consent from the person whose session is being recorded by the AI tool,’ Mr McMaugh said. ‘And you must have the ability to turn it off if somebody says, “I want the service, but I don't want the AI tool recording our discussion”.’ For pharmacists uncertain about what adequate consent looks like in practice, he suggests the following approach: 'I'm going to use an AI scribe in this session. It will record our conversation and take notes on our behalf. It will create a copy that I'll keep on record, and you have the right to access that record any time you request it. Are you comfortable with me proceeding?’ Pharmacists should also ensure that the AI tool is not in an active learning phase, with systems that continue to learn from patient interactions requiring an additional layer of consent. ‘For the vast majority of pharmacists, that shouldn't be a scenario they find themselves in – unless they're involved in clinical research about an intervention or research about the AI tool,’ he said. ‘For the vast majority of pharmacists, that shouldn't be a scenario they find themselves in – unless they're involved in clinical research about an intervention or research about the AI tool,’ he said. Pharmacists should confirm that AI dictation tools don't record voice snippets or retain details to improve the quality of their systems. Utilising AI models that are actively learning is generally not appropriate outside of a clinical trial with the accompanying level of consent seen in a trial setting.  Using an ‘active learning’ AI requires well documented consent for the person's health information to be used in this way, and is usually out of scope for most clinical settings.

      4. Failing to check transcription accuracy

      The second area of risk when using AI scribes is accuracy. While generally reliable, they can make mistakes; and the professional obligation to maintain accurate records rests with the pharmacist, not the AI tool. To prevent errors, pharmacists should still take notes while the AI scribe is working in the background, particularly around critical details such as dosing. 'If you were in a position in the future where something has gone wrong and you're in front of AHPRA or another regulator, and they say, “Why are your notes incorrect?”  just assuming that the digital scribe was doing its job is not sufficient for meeting your professional obligations,’ Mr McMaugh said. AI and handwritten notes should also be reviewed at the end of each session, while details of the consultation are still fresh. 'If you use an AI scribe during an HMR interview and you don't review the transcript until a week later, how are you going to correct the information that it got wrong?’ Mr McMaugh said. ‘From a workflow perspective, and to adhere to professional obligations, you need to make sure it's accurate.’

      5. Trusting AI output without checking the references

      AI platforms can produce clinical responses that are well structured, but are actually incorrect. These AI ‘hallucinations’, where LLMs return fabricated or inconsistent information, are commonplace. Another, more subtle risk is when LLMs draw on international sources rather than Australian-specific guidelines. ‘If you ask what the standard dose of a medication is, you might get a generally acceptable dose that's not applicable to specific Australian scenarios,’ Mr McMaugh said. Antibiotic selection is a clear example, with resistance patterns varying between countries, meaning recommendations based on international data may be inappropriate or inadequate for an Australian patient. 'You should therefore always ask LLMs for references so you can confirm the information is correct,’ he added. And don’t forget to check these references also, which aren’t immune to AI hallucinations. 6. Accepting an AI-generated booking as genuine patient consent Agentic AI is a system designed to act autonomously on a person's behalf, booking appointments, managing schedules and completing transactions. While these tools have the potential to streamline service appointments, such as vaccinations, pharmacists must be vigilant around digital bookings. When an AI agent books a consultation on a patient's behalf, it’s not possible to confirm at the point of booking whether the patient themselves made an informed, active decision to attend. ‘If booked online, pharmacists should double-check that a person has provided consent to have a particular service when they come in,’ Mr McMaugh said. 'This is a good way to confirm that consent has been provided by the [person] receiving the service – not the AI that is booking on their behalf.’ To close any gaps in the consent chain, he suggests:
      • confirming the service to be received i.e. ‘I will be administering an influenza vaccine for you today’
      • asking whether the patient booked the service themselves and whether they are comfortable proceeding.
      ‘It’s generally good practice to manage risk by confirming the service because an appointment also could have been booked by someone other than the patient receiving the service, such as a family member.’

      An evolving space

      While AI does not alter a pharmacist's professional obligations – it creates new contexts in which those obligations must be applied. According to Mr McMaugh, pharmacists should expect these considerations to continue evolving. ‘We might even get to a point in the future where AI is so effective at doing a certain task that if you don't use it, you may be less effective, and in turn, unethical,’ he said. ‘It’s very much a moving space.’ [post_title] => The 6 AI mistakes that could land pharmacists in hot water [post_excerpt] => AI is transforming pharmacy practice — but without the right safeguards, it can also put your registration at risk. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => the-6-ai-mistakes-that-could-land-pharmacists-in-hot-water [to_ping] => [pinged] => [post_modified] => 2026-05-18 16:52:09 [post_modified_gmt] => 2026-05-18 06:52:09 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=32107 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => The 6 AI mistakes that could land pharmacists in hot water [title] => The 6 AI mistakes that could land pharmacists in hot water [href] => https://www.australianpharmacist.com.au/the-6-ai-mistakes-that-could-land-pharmacists-in-hot-water/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 32108 [authorType] => )

      The 6 AI mistakes that could land pharmacists in hot water

      td_module_mega_menu Object
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          [post] => WP_Post Object
              (
                  [ID] => 32093
                  [post_author] => 12074
                  [post_date] => 2026-05-13 11:33:26
                  [post_date_gmt] => 2026-05-13 01:33:26
                  [post_content] => A new transitions of care model is helping high-risk patients in rural and remote areas avoid medication misadventure and hospital readmission through virtual pharmacist-led care.
      
      After patients are discharged from the hospital, their transition back into the community can be high-risk, with significant potential for medicine-related harm. These risks are amplified significantly for rural communities due to sparse healthcare facilities, fragmented continuity of care and workforce shortages.  
      
      The TIC TOC program in Western NSW is tackling these issues via a virtual model designed to support patients who are struggling to access care during vulnerable post-discharge periods.
      
      The TIC TOC program will be further explored at the CPC26 conference later this month and is set to demonstrate how digital health and multidisciplinary collaboration can help bridge the gap between hospital and home. 
      
      Ahead of the program’s launch, AP spoke with Linda Krogh, the Virtual Transitions-of-Care Stewardship Pharmacist with the Western NSW Local Health District and a current PhD candidate with the University of Sydney.
      

      A virtual model of care

      ‘Transitions of care are deeply complex – even more so in remote settings due to factors such as distance, workforce, and community care,’ said Ms Krogh. The CPC26 presentation will outline how the model translates into practice, including identifying high-risk patients, virtual medication reconciliation, multidisciplinary communication, and rapid coordination of Home Medicines Reviews (HMRs). The Transitions of Care (ToC) Pharmacist role was introduced to provide virtual support across 19 towns, ensuring high-risk patients receive an optimal discharge and follow up, particularly when onsite pharmacy services are unavailable. The layout of the model means that the ‘TOCS pharmacist monitors the patient’s hospital admission and supports the onsite or virtual clinical pharmacist to ensure all required discharge activities are completed,’ Ms Krogh said. This includes reviewing electronic medical records to identify medicines that were commenced, ceased, changed, or continued during admission. ‘The role includes medication reconciliation, patient counselling, preparation of patient-friendly medication lists and direct communication with GPs and consultant pharmacists to facilitate timely post-discharge medication reviews,’ she said. Through virtual work, pharmacists can connect hospital teams, patients, carers, and primary care providers across geographically disconnected areas. 

      The risk in transitions

      The severely limited access to GP services and healthcare facilities delays crucial follow-up appointments and check-ins after discharge. In most rural communities, locum professionals make up a significant part of the primary care workforce, creating significant challenges in ensuring continuity of care. ‘Patients are often discharged from hospitals located a long distance from home, which can delay access to medicines and follow-up post-discharge,’ Ms Krogh said. Patients are identified as high risk for medicines misadventure and readmission based on criteria including  ‘use of high-risk medicines such as insulin, alongside a hospital readmission within the previous 6 months.’  ‘These factors can increase the risk of medication discrepancies, misunderstandings, and adverse events once the patient returns home,’ she added.

      Fast-tracking post-discharge HMRs

      A key feature of the program is its focus on ensuring HMRs occur when they are needed – not when they are possible. To ensure time-sensitive cases are addressed, the TOC pharmacist prepares a HMR referral for the patient’s GP before discharge. If the referral cannot be signed within a 48-hour window, the program activates the hospital-initiated HMR pathway, to avoid delays.  ‘The goal is for the post-discharge HMR to be completed within 10 days,’ Ms Krogh said. Patients can choose whether they prefer their HMR conducted face-to-face or virtually, allowing referrals to be matched to credentialed pharmacists based on patient preference and location. The TOCs pharmacist then books a GP appointment to ‘review the HMR recommendations and develop medication management plans, helping to close the loop on the patient's transition of care,’ she said. By clearly identifying patients as high-risk, reception staff are better able to triage appointment availability where demand exceeds capacity.

      Connecting hospital and community care

      A major strength of the TIC  TOC model is its ability to connect traditionally siloed parts of the healthcare system by facilitating communication between hospital clinicians, GPs, and community pharmacists – improving continuity of care throughout each patient’s journey.  ‘In rural towns where GP appointments are often booked out weeks in advance, this model ensures high-risk patients have their medications reviewed promptly by a pharmacist,’ Ms Krogh said. With post-discharge HMRs frequently identifying medication misunderstandings, the early identification of medication-related issues also allows GP appointments to focus more efficiently on clinical decision-making and care planning. The most common errors identified relate to patients’ misunderstanding of how to take their medicines following discharge, as well as short-term medicines that pose a point of confusion, such as tapered prednisolone regimens and analgesics. ‘In one case, a patient stopped taking an antihypertensive medication after overhearing nursing staff say it should be withheld during admission, not realising the change was only temporary,’ Ms Krogh said. ‘Another patient discharged with two antibiotics misunderstood the instructions and intended to take the medicines sequentially rather than concurrently.’ 

      Multidisciplinary action

      The TIC TOC model encapsulates a broader theme of multidisciplinary collaboration that will underpin CPC26.  With healthcare systems championing the importance of coordinated care, this program demonstrates how pharmacists can play a central role in ensuring patient safety during transitions of care, particularly for vulnerable rural populations where limited access to timely healthcare poses challenges. Further insights into the TIC TOC program and the virtual TOC's pharmacist role will be shared during the CPC26 conference session, held between 29 – 31 May 2026 at the RACV Royal Pines Resort, Gold Coast. Click here to register. [post_title] => Virtually easing transitions of care [post_excerpt] => A new transitions of care model is helping high-risk patients in rural and remote areas through virtual pharmacist-led care. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => virtually-easing-transitions-of-care [to_ping] => [pinged] => [post_modified] => 2026-05-13 14:51:23 [post_modified_gmt] => 2026-05-13 04:51:23 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=32093 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Virtually easing transitions of care [title] => Virtually easing transitions of care [href] => https://www.australianpharmacist.com.au/virtually-easing-transitions-of-care/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 32094 [authorType] => )

      Virtually easing transitions of care

  • People
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          [post] => WP_Post Object
              (
                  [ID] => 32191
                  [post_author] => 12483
                  [post_date] => 2026-05-27 13:27:14
                  [post_date_gmt] => 2026-05-27 03:27:14
                  [post_content] => Honey may offer safer, more effective and yummier cough relief than many over-the-counter (OTC) medicines.
      
      As winter inches closer, pharmacists are seeing more patients seeking relief from coughs associated with cold and flu season, often asking for an OTC cough syrup or suppressant, or the Pharmacist Only medicine dihydrocodeine (Rikodeine).
      
      But mounting evidence suggests the best therapeutic recommendation might come from the pantry rather than the dispensary. 
      

      1. Efficacy and safety of cough medicine called into question

      The evidence for oral OTC cough preparations for acute cough is, at best, inconclusive – with clinical trials failing to demonstrate efficacy. Cough medicines are contraindicated in children under 6 years of age, and use in older children discouraged – with product labels emphasising they should only be used in children aged 6–11 on the advice of a health professional (e.g. pharmacist, nurse, medical practitioner).  They should only be considered if the benefit of their use outweighs the risk, noting that the Therapeutic Goods Administration review that informed these changes highlighted significant safety and efficacy concerns.  Cough medicines are also not appropriate for many adult patients due to medicine interactions, risk of abuse, adverse effects, and other co-existing medical conditions (e.g. asthma, Chronic Obstructive Pulmonary Disease). Additionally, the Australian Pharmaceutical Formulary and Handbook (APF) advises against combination cough products that mix an antitussive with an expectorant, an antihistamine, or both.  These products tend to contain subtherapeutic doses of each ingredient, and can increase the risk of adverse effects without adding meaningful therapeutic benefit.

      2. Honey goes down more than a treat

      Most acute coughs are self-limiting, and non-pharmacological management can be recommended, with the aim of chronic cough management being identifying and treating the underlying cause. Honey is often the superior clinical choice if symptomatic relief is needed. According to the APF, honey relieves cough symptoms in children better than no treatment or placebo, acting as a demulcent by forming a soothing, bioadhesive film over irritated pharyngeal mucosa to blunt the sensory tickle that triggers a cough.  Interestingly, it is thought that the high placebo response seen in trials of cough medicines may be related to the demulcent content (or syrup) of the cough mixture. A 2022 systematic review found honey to be an effective treatment for cough in children above 12 months of age, with a 2010 randomised controlled trial even finding it to be more effective than dextromethorphan or diphenhydramine at relieving nocturnal cough in children related to upper respiratory tract infections. The 2023 Cough in Children and Adults: Diagnosis, Assessment and Management (CICADA) Australian Chronic Cough Position Statement Update also strongly recommends minimising the use of other medications for nonspecific or refractory cough in children other than demulcents (i.e. honey). While honey is a safe first-line recommendation for many patients, including children, it must not be given to infants under 12 months of age due to the risk of infant botulism from Clostridium botulinum spores. Demulcents like honey are also a safe treatment option for: 
      • older patients
      • those on multiple medications (honey carries no clinically significant drug interactions) 
      • pregnant or breastfeeding patients, for whom honey is considered safe in normal food amounts. 
      However, pharmacists should advise patients with known pollen allergies to use honey carefully, and it should be used judiciously in patients with diabetes.

      3. When a spoonful of sugar is the medicine

      When honey is the chosen path, advise patients or caregivers that 1–2 teaspoons before bed – taken undiluted or dissolved in liquid (e.g. juice) – is an effective, comforting dose. Pair the recommendation with evidence-based non-pharmacological strategies, including:
      • plenty of water and warm fluids to help thin mucus and soothe an irritated throat
      • steam inhalation during a hot shower to promote expectoration. 
      Brush up on your knowledge about managing and treating cough by reading the APF ‘Cough’ Treatment Guideline for Pharmacists. [post_title] => Finding the sweet spot in cough management [post_excerpt] => Honey may offer safer, more effective and yummier cough relief than many over-the-counter (OTC) medicines. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => finding-the-sweet-spot-in-cough-management [to_ping] => [pinged] => [post_modified] => 2026-05-27 15:58:10 [post_modified_gmt] => 2026-05-27 05:58:10 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=32191 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Finding the sweet spot in cough management [title] => Finding the sweet spot in cough management [href] => https://www.australianpharmacist.com.au/finding-the-sweet-spot-in-cough-management/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 32192 [authorType] => )

      Finding the sweet spot in cough management

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          [post] => WP_Post Object
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                  [ID] => 32120
                  [post_author] => 12074
                  [post_date] => 2026-05-25 10:53:09
                  [post_date_gmt] => 2026-05-25 00:53:09
                  [post_content] => With the expansion of pharmacy vaccination services across Australia, pharmacists are navigating an increasingly layered set of challenges. 
      
      Bill Wallace, PSA Pharmacist – Professional Support Adviser, outlines the most common vaccine-related questions that have come through this year.
      

      1. Who can administer FluMist?

      The introduction of intranasal influenza vaccine, FluMist, has prompted a wave of questions surrounding eligibility, prescribing and administration requirements.  Funding and eligibility differences between each state and territory are driving many of the inquiries. ‘We have had quite a few inquiries about whether [pharmacists] can administer FluMist to someone under 5 if they've got a prescription, which they can,’ said Mr Wallace. State differences apply for initiation– Pharmacists in VIC, TAS, NT, and ACT are generally restricted to authorising and administering vaccines only to children aged 5 years and older. Whereas In NSW, WA, QLD, and SA, pharmacists can authorise and administer the influenza vaccine to children aged 2 and older. Another recurring question is whether pharmacists who are not qualified immunisers can administer FluMist – given it’s administered nasally rather than via an intramuscular injection.  Mr Wallace noted that any vaccine administered by a pharmacist must be delivered by a qualified immuniser. ‘You need to be a qualified immuniser to meet the requirements for administering that particular medication. You'd be hard pressed to justify why you did it if something went wrong,’ said Mr Wallace. The responsibility extends beyond simple administrative practices, and relates to professional accountability and emergency management responsibilities. Mr Wallace noted that while serious reactions are rare, pharmacists still need to be prepared for any situation at hand. ‘If you weren't qualified and a claim was made, your insurer and The Australian Health Practitioner Regulation Agency (Ahpra) would have many questions for you about your practice.’

      2. Can pharmacists co-administer vaccines?

      As Australia’s adult vaccination schedules get more complex, co-administration queries are becoming increasingly common. ‘Timing intervals and co-administration of vaccines is probably one of the more common clinical inquiries,’ Mr Wallace said. Questions to the advice line often relate to whether vaccines can be given together, which vaccines require spacing, and whether they should be administered in one arm or both. The National Centre for Immunisation Research and Surveillance guideline for vaccine co-administration and Australian Immunisation Handbook state that while most vaccines can generally be co-administered, separate injection sites should be used where possible,  ensuring a distance of 2.5 cm between. But Mr Wallace suggests pharmacists should also take additional care when reviewing Australian Immunisation Register (AIR) records and confirming patient histories to avoid inadvertent duplication Particularly for older Australians, co-administration will be increasingly normalised for  routine adult vaccinations (e.g. RSV, shingles, pneumoccocal, DTPa etc). 

      3. Can pharmacists vaccinate interstate?

      Interstate practice continues to create a point of tension for pharmacist immunisers as requirements differ significantly between jurisdictions.  There are discrepancies between patient age eligibility, refresher requirements and additional accreditation, meaning pharmacists cannot automatically assume their qualifications transfer across all states and territories. There are also differences between state and territory legislations which govern interstate pharmacists’ eligibility to administer vaccines, introducing barriers to interstate practice, according to the Immunisation Coalition. ‘Certain states, Tasmania, Victoria, and WA have slightly different training requirements … you need to ensure that you meet local state immunisation requirements prior to providing vaccinations,’ Mr Wallace said. He stresses the importance of ‘checking what the differences are, and referring to resources like the local state pharmacist vaccination guidelines before administering vaccines’. In some cases, pharmacists may need to complete an additional online module, although requirements vary. For example, the ACT has a Japanese encephalitis module that is required, and Victoria requires extra training to be able to provide certain travel vaccines. Complicating matters further, immunisation requirements and eligibility for state and territory programs may change.

      4. How do pharmacists maintain immunisation credentials?

      Is it a matter of once a pharmacist immuniser, always a pharmacist immuniser?  Not quite. According to Ahpra and state regulators, pharmacists must undertake annual immunisation-related CPD activities to maintain their currency. ‘Pharmacists must also maintain first aid every 3 years and CPR every 12 months,’ Mr Wallace said.  The PSA offers an online refresher training course which aligns with the current immunisation training. The training program consists of online modules to ensure a pharmacists’ accredited training remains up to date. ‘Some pharmacists did their vaccination courses a long time ago, with a much limited range of vaccines,’ he said. ‘There is also an Immunisation Practical Refresher Workshop that pharmacists can do if they've had a break in practice or want to refresh their technique.’ The online immunisation refresher course allows pharmacists to expand their training to cover all vaccines. Looking for any answers to your queries? Hit up the Pharmacist Advice Line here. [post_title] => Top 4 vaccine queries to the P2P Advice Line [post_excerpt] => With the expansion of pharmacy vaccination services across Australia, pharmacists are navigating an increasingly layered set of challenges.  [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => top-4-vaccine-queries-to-the-p2p-advice-line [to_ping] => [pinged] => [post_modified] => 2026-05-25 16:11:16 [post_modified_gmt] => 2026-05-25 06:11:16 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=32120 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Top 4 vaccine queries to the P2P Advice Line [title] => Top 4 vaccine queries to the P2P Advice Line [href] => https://www.australianpharmacist.com.au/top-4-vaccine-queries-to-the-p2p-advice-line/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 32124 [authorType] => )

      Top 4 vaccine queries to the P2P Advice Line

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                  [post_author] => 3387
                  [post_date] => 2026-05-20 13:03:36
                  [post_date_gmt] => 2026-05-20 03:03:36
                  [post_content] => Once a disease of the past, diphtheria is rapidly re-emerging across Australia. Here’s what pharmacists need to know.
      

      What is diphtheria?

      A potentially deadly and highly contagious  bacterial disease, diphtheria can infect the nose and throat, cause skin sores, and spread toxin through the body; in severe cases it can cause airway blockage, heart damage and nerve damage.  Respiratory diphtheria is the more deadly variant, and is typically spread through respiratory droplets, often when people cough and sneeze. Cutaneous diphtheria can spread through touching skin sores.

      What are the symptoms?

      Signs and symptoms of diphtheria include:
      • sore throat
      • fever 
      • swollen neck glands
      • weakness.
      Post-exposure to the bacteria, symptoms typically appear within 2–5 days. And within 2–3 days of illness onset, dead tissue can form a thick grey membrane in the respiratory tract, covering the nose, tonsils and throat, which can make breathing and swallowing difficult. In unvaccinated people who do not receive appropriate treatment, diphtheria is fatal in up to 30% of cases.

      How dangerous is the disease?

      Before vaccination, diphtheria was a leading cause of childhood death in Australia. Between 1926 and 1935, there were more than 4,000 diphtheria-related childhood deaths recorded. Once vaccination programs rolled out in the 1940s, cases of diphtheria significantly reduced.

      Was it once eradicated in Australia?

      Not entirely. While Australia has largely managed to control diphtheria through vaccination, surveillance data show cases continued to occur at low levels. Until recently, there have been no recorded respiratory childhood cases since 1992. Between 2011 and 2019, 38 cases of cutaneous diphtheria were reported in both children and adults, along with seven cases of respiratory diphtheria, all in adults. Two adults who were not vaccinated against the disease died from respiratory diphtheria in 2011 and 2018. But post-COVID-19, the disease made a resurgence – with the National Centre for Immunisation Research and Surveillance announcing in 2022 that ‘Diphtheria is back’.

      Why has there been a resurgence?

      Likely because vaccination coverage has declined since the COVID-19 pandemic. While Australia's vaccination rates are still considered high by global standards, recent national data show full immunisation coverage of 91.54% at 1 year, 89.57% at 2 years, and 93.17% at 5 years of age, which is well below the 95% target in older age groups.

      Can diphtheria be treated?

      While diphtheria can be treated with antibiotics, they may have little effect once the infection takes hold. Another treatment, diphtheria antitoxin (DAT), can neutralise the effects of the toxin, but it needs to be administered within 48 hours of infection.  And because diphtheria had been largely eradicated, low production of DAT has led to global shortages. Even when this treatment is administered, the Australian Centre for Disease Control has cautioned that up to 1 in 10 people with respiratory diphtheria will die.

      Who is most at risk?

      Children under 5 years of age are at particularly high risk of death. Other at-risk groups include:
      • those who are unvaccinated or not up to date with diphtheria boosters doses
      • travellers to outbreak areas or countries where diphtheria is more common such as Nigeria, Guinea, Niger, Mauritania, Algeria, Chad, Mali, and South Africa
      • immunocompromised people
      • Aboriginal and Torres Strait Islander people in affected communities.

      What are the risks of an outbreak here?

      Pretty high when coverage is low, health experts have warned. ‘There was an outbreak of diphtheria between 2022 and 2024 in North Queensland, and also in the Kimberley in 2025,’ said Northern Territory Chief Health Officer Paul Burgess. So far this year, more than 220 cases of diphtheria have been reported across Australia. While most cases have been recorded in the Northern Territory, the disease has spread to Western Australia, South Australia and Queensland. Internationally, the World Health Organization reported over 29,000 suspected diphtheria cases and 1,420 deaths in the African Region from the beginning of 2025 to 1 March 2026.

      How often are booster doses required?

      Routine diphtheria boosters are generally recommended every 10 years for adults to maintain immunity. For travellers to higher-risk settings, booster timing may be more frequent depending on exposure risk and destination.

      What can pharmacists do?

      When patients come in for routine vaccinations, pharmacists should check the Australian Immunisation Register, suggesting catch up vaccinations for children who are behind with routine immunisations, and booster doses for adults who require them. Pharmacists can also counsel patients on travel-related boosters, reminding adults that protection wanes. ‘There are new diphtheria guidelines produced by the Northern Territory government to cover this outbreak, and pharmacists need to be aware of the new guidelines,’ said Helen Stone, PSA SA & NT State and Territory Manager. ‘All frontline workers in the Northern Territory need to be protected. This includes ensuring that they've been vaccinated and reminding people to check their immunisation records. ‘As 69% of cases are actually cutaneous diphtheria, the message I would really like to get out is that in its early stages, the skin infection could be confused with other skin infections, e.g. a fungal skin infection. Pharmacists should be very cautious and ensure that they are referring to skin infections for further investigation, particularly in areas of the outbreak.’ [post_title] => Another vaccine-preventable disease makes a resurgence [post_excerpt] => Once a disease of the past, diphtheria is rapidly re-emerging across Australia. Here’s what pharmacists need to know. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => another-vaccine-preventable-disease-makes-a-resurgence [to_ping] => [pinged] => [post_modified] => 2026-05-20 15:15:03 [post_modified_gmt] => 2026-05-20 05:15:03 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=32111 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Another vaccine-preventable disease makes a resurgence [title] => Another vaccine-preventable disease makes a resurgence [href] => https://www.australianpharmacist.com.au/another-vaccine-preventable-disease-makes-a-resurgence/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 32112 [authorType] => )

      Another vaccine-preventable disease makes a resurgence

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          [post] => WP_Post Object
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                  [post_date] => 2026-05-18 12:59:24
                  [post_date_gmt] => 2026-05-18 02:59:24
                  [post_content] => AI is transforming pharmacy practice — but without the right safeguards, it can also put your registration at risk.
      
      AI is no longer an emerging consideration for pharmacists – it’s already embedded in practice.
      
      Using large language models (LLMs) such as ChatGPT to answer clinical questions and AI scribes like Heidi Health to capture consultation notes is becoming more commonplace. With agentic AI – systems that act autonomously on a patient’s behalf – now growing in popularity, the pace of AI adoption is only set to increase.
      
      But these opportunities come with obligations – and without a distinct regulatory framework. Here, PSA Digital Health Lead and Victorian state manager Jarrod McMaugh MPS outlines the sixAI traps pharmacists need to avoid.
      

      1. Entering identifiable patient information into AI platforms

      One of the most significant risks pharmacists face when using AI is entering patients’ health information into AI platforms. Regardless of the purpose or the pharmacist’s intent, it may constitute a breach of Australian privacy law.  ‘Let's say you were providing a Home Medicines Review (HMR) and you put the patient’s details into ChatGPT and asked, “What medicines is this person missing for their diagnosed conditions?” That would be a breach of privacy regulations,’ Mr McMaugh said. ‘Any information put into AI is stored. And therefore, where it is stored must adhere to the Australian privacy requirements.’ However, pharmacists who use LLMs to check for missed medicines or potential interactions can do so legitimately, provided no identifying information is included. And while taking out a patient's name and address is a good first step, this may not adequately deidentify them. ‘You could prompt an LLM by saying, “I have a person who is taking medicines, x, y, z, and they have these diagnoses. Can you identify any missed medicines or any interactions?”’ Mr McMaugh said. ‘As long as there's no way to identify the individual, and it's just down to what is clinically appropriate, it's not a breach of any privacy matters.’ 2. Assuming a business account equals compliance You may think that moving from a free AI account to a paid business subscription resolves any compliance concerns. But to be compliant, business or enterprise AI subscriptions must explicitly confirm that the platform meets Australian privacy regulations in the delivery of that service. 'You would need to be satisfied that the LLM, under contract, specifically states that it meets Australian privacy regulations,’ Mr McMaugh said. ‘It's similar to the agreement you have with your dispensing software [provider] or the clinical platform you use to record scope of practice work.’

      3. Using AI scribes without proper consent

      For pharmacists conducting clinical consultations, such as accredited and prescribing pharmacists, AI scribes can be incredibly useful for collecting and collating patient information. But deploying them without meeting the required consent obligations creates significant professional risk. ‘You must get consent from the person whose session is being recorded by the AI tool,’ Mr McMaugh said. ‘And you must have the ability to turn it off if somebody says, “I want the service, but I don't want the AI tool recording our discussion”.’ For pharmacists uncertain about what adequate consent looks like in practice, he suggests the following approach: 'I'm going to use an AI scribe in this session. It will record our conversation and take notes on our behalf. It will create a copy that I'll keep on record, and you have the right to access that record any time you request it. Are you comfortable with me proceeding?’ Pharmacists should also ensure that the AI tool is not in an active learning phase, with systems that continue to learn from patient interactions requiring an additional layer of consent. ‘For the vast majority of pharmacists, that shouldn't be a scenario they find themselves in – unless they're involved in clinical research about an intervention or research about the AI tool,’ he said. ‘For the vast majority of pharmacists, that shouldn't be a scenario they find themselves in – unless they're involved in clinical research about an intervention or research about the AI tool,’ he said. Pharmacists should confirm that AI dictation tools don't record voice snippets or retain details to improve the quality of their systems. Utilising AI models that are actively learning is generally not appropriate outside of a clinical trial with the accompanying level of consent seen in a trial setting.  Using an ‘active learning’ AI requires well documented consent for the person's health information to be used in this way, and is usually out of scope for most clinical settings.

      4. Failing to check transcription accuracy

      The second area of risk when using AI scribes is accuracy. While generally reliable, they can make mistakes; and the professional obligation to maintain accurate records rests with the pharmacist, not the AI tool. To prevent errors, pharmacists should still take notes while the AI scribe is working in the background, particularly around critical details such as dosing. 'If you were in a position in the future where something has gone wrong and you're in front of AHPRA or another regulator, and they say, “Why are your notes incorrect?”  just assuming that the digital scribe was doing its job is not sufficient for meeting your professional obligations,’ Mr McMaugh said. AI and handwritten notes should also be reviewed at the end of each session, while details of the consultation are still fresh. 'If you use an AI scribe during an HMR interview and you don't review the transcript until a week later, how are you going to correct the information that it got wrong?’ Mr McMaugh said. ‘From a workflow perspective, and to adhere to professional obligations, you need to make sure it's accurate.’

      5. Trusting AI output without checking the references

      AI platforms can produce clinical responses that are well structured, but are actually incorrect. These AI ‘hallucinations’, where LLMs return fabricated or inconsistent information, are commonplace. Another, more subtle risk is when LLMs draw on international sources rather than Australian-specific guidelines. ‘If you ask what the standard dose of a medication is, you might get a generally acceptable dose that's not applicable to specific Australian scenarios,’ Mr McMaugh said. Antibiotic selection is a clear example, with resistance patterns varying between countries, meaning recommendations based on international data may be inappropriate or inadequate for an Australian patient. 'You should therefore always ask LLMs for references so you can confirm the information is correct,’ he added. And don’t forget to check these references also, which aren’t immune to AI hallucinations. 6. Accepting an AI-generated booking as genuine patient consent Agentic AI is a system designed to act autonomously on a person's behalf, booking appointments, managing schedules and completing transactions. While these tools have the potential to streamline service appointments, such as vaccinations, pharmacists must be vigilant around digital bookings. When an AI agent books a consultation on a patient's behalf, it’s not possible to confirm at the point of booking whether the patient themselves made an informed, active decision to attend. ‘If booked online, pharmacists should double-check that a person has provided consent to have a particular service when they come in,’ Mr McMaugh said. 'This is a good way to confirm that consent has been provided by the [person] receiving the service – not the AI that is booking on their behalf.’ To close any gaps in the consent chain, he suggests:
      • confirming the service to be received i.e. ‘I will be administering an influenza vaccine for you today’
      • asking whether the patient booked the service themselves and whether they are comfortable proceeding.
      ‘It’s generally good practice to manage risk by confirming the service because an appointment also could have been booked by someone other than the patient receiving the service, such as a family member.’

      An evolving space

      While AI does not alter a pharmacist's professional obligations – it creates new contexts in which those obligations must be applied. According to Mr McMaugh, pharmacists should expect these considerations to continue evolving. ‘We might even get to a point in the future where AI is so effective at doing a certain task that if you don't use it, you may be less effective, and in turn, unethical,’ he said. ‘It’s very much a moving space.’ [post_title] => The 6 AI mistakes that could land pharmacists in hot water [post_excerpt] => AI is transforming pharmacy practice — but without the right safeguards, it can also put your registration at risk. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => the-6-ai-mistakes-that-could-land-pharmacists-in-hot-water [to_ping] => [pinged] => [post_modified] => 2026-05-18 16:52:09 [post_modified_gmt] => 2026-05-18 06:52:09 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=32107 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => The 6 AI mistakes that could land pharmacists in hot water [title] => The 6 AI mistakes that could land pharmacists in hot water [href] => https://www.australianpharmacist.com.au/the-6-ai-mistakes-that-could-land-pharmacists-in-hot-water/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 32108 [authorType] => )

      The 6 AI mistakes that could land pharmacists in hot water

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                  [post_date] => 2026-05-13 11:33:26
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                  [post_content] => A new transitions of care model is helping high-risk patients in rural and remote areas avoid medication misadventure and hospital readmission through virtual pharmacist-led care.
      
      After patients are discharged from the hospital, their transition back into the community can be high-risk, with significant potential for medicine-related harm. These risks are amplified significantly for rural communities due to sparse healthcare facilities, fragmented continuity of care and workforce shortages.  
      
      The TIC TOC program in Western NSW is tackling these issues via a virtual model designed to support patients who are struggling to access care during vulnerable post-discharge periods.
      
      The TIC TOC program will be further explored at the CPC26 conference later this month and is set to demonstrate how digital health and multidisciplinary collaboration can help bridge the gap between hospital and home. 
      
      Ahead of the program’s launch, AP spoke with Linda Krogh, the Virtual Transitions-of-Care Stewardship Pharmacist with the Western NSW Local Health District and a current PhD candidate with the University of Sydney.
      

      A virtual model of care

      ‘Transitions of care are deeply complex – even more so in remote settings due to factors such as distance, workforce, and community care,’ said Ms Krogh. The CPC26 presentation will outline how the model translates into practice, including identifying high-risk patients, virtual medication reconciliation, multidisciplinary communication, and rapid coordination of Home Medicines Reviews (HMRs). The Transitions of Care (ToC) Pharmacist role was introduced to provide virtual support across 19 towns, ensuring high-risk patients receive an optimal discharge and follow up, particularly when onsite pharmacy services are unavailable. The layout of the model means that the ‘TOCS pharmacist monitors the patient’s hospital admission and supports the onsite or virtual clinical pharmacist to ensure all required discharge activities are completed,’ Ms Krogh said. This includes reviewing electronic medical records to identify medicines that were commenced, ceased, changed, or continued during admission. ‘The role includes medication reconciliation, patient counselling, preparation of patient-friendly medication lists and direct communication with GPs and consultant pharmacists to facilitate timely post-discharge medication reviews,’ she said. Through virtual work, pharmacists can connect hospital teams, patients, carers, and primary care providers across geographically disconnected areas. 

      The risk in transitions

      The severely limited access to GP services and healthcare facilities delays crucial follow-up appointments and check-ins after discharge. In most rural communities, locum professionals make up a significant part of the primary care workforce, creating significant challenges in ensuring continuity of care. ‘Patients are often discharged from hospitals located a long distance from home, which can delay access to medicines and follow-up post-discharge,’ Ms Krogh said. Patients are identified as high risk for medicines misadventure and readmission based on criteria including  ‘use of high-risk medicines such as insulin, alongside a hospital readmission within the previous 6 months.’  ‘These factors can increase the risk of medication discrepancies, misunderstandings, and adverse events once the patient returns home,’ she added.

      Fast-tracking post-discharge HMRs

      A key feature of the program is its focus on ensuring HMRs occur when they are needed – not when they are possible. To ensure time-sensitive cases are addressed, the TOC pharmacist prepares a HMR referral for the patient’s GP before discharge. If the referral cannot be signed within a 48-hour window, the program activates the hospital-initiated HMR pathway, to avoid delays.  ‘The goal is for the post-discharge HMR to be completed within 10 days,’ Ms Krogh said. Patients can choose whether they prefer their HMR conducted face-to-face or virtually, allowing referrals to be matched to credentialed pharmacists based on patient preference and location. The TOCs pharmacist then books a GP appointment to ‘review the HMR recommendations and develop medication management plans, helping to close the loop on the patient's transition of care,’ she said. By clearly identifying patients as high-risk, reception staff are better able to triage appointment availability where demand exceeds capacity.

      Connecting hospital and community care

      A major strength of the TIC  TOC model is its ability to connect traditionally siloed parts of the healthcare system by facilitating communication between hospital clinicians, GPs, and community pharmacists – improving continuity of care throughout each patient’s journey.  ‘In rural towns where GP appointments are often booked out weeks in advance, this model ensures high-risk patients have their medications reviewed promptly by a pharmacist,’ Ms Krogh said. With post-discharge HMRs frequently identifying medication misunderstandings, the early identification of medication-related issues also allows GP appointments to focus more efficiently on clinical decision-making and care planning. The most common errors identified relate to patients’ misunderstanding of how to take their medicines following discharge, as well as short-term medicines that pose a point of confusion, such as tapered prednisolone regimens and analgesics. ‘In one case, a patient stopped taking an antihypertensive medication after overhearing nursing staff say it should be withheld during admission, not realising the change was only temporary,’ Ms Krogh said. ‘Another patient discharged with two antibiotics misunderstood the instructions and intended to take the medicines sequentially rather than concurrently.’ 

      Multidisciplinary action

      The TIC TOC model encapsulates a broader theme of multidisciplinary collaboration that will underpin CPC26.  With healthcare systems championing the importance of coordinated care, this program demonstrates how pharmacists can play a central role in ensuring patient safety during transitions of care, particularly for vulnerable rural populations where limited access to timely healthcare poses challenges. Further insights into the TIC TOC program and the virtual TOC's pharmacist role will be shared during the CPC26 conference session, held between 29 – 31 May 2026 at the RACV Royal Pines Resort, Gold Coast. Click here to register. [post_title] => Virtually easing transitions of care [post_excerpt] => A new transitions of care model is helping high-risk patients in rural and remote areas through virtual pharmacist-led care. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => virtually-easing-transitions-of-care [to_ping] => [pinged] => [post_modified] => 2026-05-13 14:51:23 [post_modified_gmt] => 2026-05-13 04:51:23 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.australianpharmacist.com.au/?p=32093 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [title_attribute] => Virtually easing transitions of care [title] => Virtually easing transitions of care [href] => https://www.australianpharmacist.com.au/virtually-easing-transitions-of-care/ [module_atts:td_module:private] => Array ( ) [td_review:protected] => Array ( ) [is_review:protected] => [post_thumb_id:protected] => 32094 [authorType] => )

      Virtually easing transitions of care

AUSTRALIAN PHARMACIST Australian Pharmacist

RB - 31 October 2000
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