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[post_content] => With glucagon-like peptide-1 receptor agonists (GLP-1 RAs) back and some basal insulins disappearing, pharmacists face a new wave of complexity in diabetes management.
Diabetes management has been significantly disrupted in recent years, from ongoing shortages of (GLP-1 RAs) to the discontinuation of several insulin formulations.
But with medicines like semaglutide (Ozempic) back on the market and the impending discontinuation of another long-acting basal insulin analogue – there are further complexities to navigate.
Here, Australian Pharmacist explores how the sector is tackling these issues.
Ozempic return leads to medicine double-ups
Medicine shortages of popular diabetes medicines have eased this year, including the official removal of Ozempic from the Therapeutic Goods Administration’s medicine shortages list in July.
But throughout the shortage period, it became common for patients to receive multiple prescriptions for whichever medicine was available at the time, said Kirrily Chambers MPS, Advanced Practice Pharmacist and credentialled diabetes educator during the National Medicines Symposium 2025, held last week.
For example, when Ozempic was out of stock, Ms Chambers said patients were often issued a prescription for sitagliptin (Januvia) in addition to their usual semaglutide.
‘When there have been issues with not being able to get [the medicine], people will often pick up both scripts when it comes back on the market,’ she said.
‘A patient might collect a 6-month prescription for Januvia. Then, when they present to the pharmacy, the pharmacist says, “Mrs Jones, your Ozempic is back – would you like one?” The patient says, “Yes, please,” forgetting the GP or specialist had advised using Januvia only while Ozempic was unavailable.’
If pharmacists encounter this situation, they should contact the GP or specialist to confirm the prescribing was intended.
‘We're now ringing to say, “Hey, did you really mean to put this person on multiple things? Because 6 months ago, they weren't on all these medications”,’ she said. ‘This is part of deprescribing to keep people safe, so that they're not bouncing into hospital.’
Regular Diabetes MedsChecks and medicines reconciliation, or a Home Medicines Review where appropriate, is critical to help the person living with diabetes understand the therapeutic approach. Any issues or duplications identified should then be communicated to the multidisciplinary team.
Discontinuations leave some patients without options
In the last few years, numerous diabetes medicines have faced discontinuation, including several insulin formulations and the GLP-1 RA liraglutide(Saxenda). There have also been device discontinuations, which can make diabetes care more difficult for older patients, said Associate Professor Margaret McGill AM, nurse manager and associate director at Royal Prince Alfred Hospital’s Diabetes Centre.
‘We know that people are living longer … and that age is the biggest predictor of type 2 diabetes,’ she said. ‘So we now see many referrals of people in their 80s and 90s – and some of these people need to go on insulin.’
Often, older patients don’t have the dexterity to navigate some of the newer devices, including putting a cartridge into a reusable pen.
‘When we lose the simple devices … it’s really impactful,’ A/Prof McGill told Symposium delegates.
Distinguished Professor David Simmons, the Chief Medical Officer, Diabetes Australia, has tried to ensure there are replacements for some of these devices.
‘Protaphane [is] one that we're trying to do, and it's quite challenging,’ he said.
‘If you're working with people [who have], for example, gestational diabetes, and they only have a limited number of weeks to actually understand what they're doing, some of the quicker learning devices are superior to learning how to put a cartridge into a pen.’
But the device discontinuation causing the most concern, however, is insulin detemir (Levemir) – which is set to be discontinued by December 2026.
Some patients who can tolerate a once daily dose of insulin could go on glargine, Prof Simmons said. However, the individual risks must be calculated for each patient.
‘For those who need Levemir twice daily so it can cover them during the day and night, there's a big risk when we go to once a day,’ he said.
‘During the day, they will be at risk of hypos – perhaps when they're driving if they haven't got a sensor on, or if the sensor is not working. If they then reduce their dose and their glucose goes up, they're going to be more hyperglycaemic at night – which will directly lead to long-term complications.’
While Diabetes Australia is looking into management strategies, the only current solution for these patients is an insulin pump.
‘There’s nothing else that's going to replace it for those individuals, and they may not be able to afford a pump,’ Prof Simmons said. ‘So we're certainly concerned about that. And GPs and pharmacists need to be very much aware that this is what's coming.’
Finding the right therapeutic approach
When considering new medicines for patients that are appropriate for diabetes, they must be selected for a person through a complex algorithm, said Dr Gary Deed, Chair of the Diabetes Specific Interest group at the Royal Australian College of General Practitioners.
‘[You] have to think, “do [they] have high blood pressure, lipid problems, kidney disease, metabolic-associated fatty liver disease? And how then, do I adapt that framework to the choices of medications and then negotiate with [the patient]?’ he said.
‘[You need a] well-trained, systematic approach and a very clear perspective of what that person is, not just physically, but also emotionally, and how they live.’
Renza Scibilia, a diabetes advocate who has lived with type 1 diabetes for 27 years, said that there’s a broad spectrum of people living with diabetes, and their understanding of the diabetes landscape may vary, including:
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[post_content] => Questions about spacers are abundant in community pharmacy. AP answers some of the trickiest ones pharmacists face.
Aren’t spacers just for kids?’ This is a common misconception pharmacists hear. People of all ages should use a spacer whenever they use a pressurised metered dose inhaler (pMDI).1 Spacers slow down aerosol spray, improve lung delivery and reduce oropharyngeal adverse effects like irritation, hoarseness or oral thrush from inhaled corticosteroids (ICS).1,2
They’re also useful for anyone who struggles with coordination or breath timing. When used correctly with a spacer, a pMDI delivers medicine as effectively
as a nebuliser, and is often more efficient and convenient.2
Which spacers are better?
Spacers can be made of plastic or cardboard. Collapsible spacers are more compact for the patient to carry. Cardboard spacers fold flat for easy storage. Some spacers have additional features e.g. anti-static spacers improve delivery of active ingredient by preventing medicine from sticking to the walls.4
Some spacers have an inhalation indicator that moves when the patient inhales and whistles if they inhale too fast.4 Spacers with one-way valves stop exhalation into the chamber, helping keep the medicine inside and making delivery more effective.4
Anti-bacterial spacers are embedded with materials e.g. silver ion to inhibit bacteria growth. Choice of spacer depends on age, treatment, budget, dexterity and lifestyle. It should suit the patient, be easy to put together and be compatible with their inhaler.2,3 The Spacers for pMDIs Chart helps identify spacer options. Visit www.nationalasthma.org.au/living-with-asthma/resources/health-professionals/charts
Do all inhalers fit into a spacer?
Not always. Some spacers have a rigid or fixed connection end. Those pMDIs with circular mouthpieces may require spacers with a flexible rubber/silicone opening that can form a seal around the mouthpiece. If in doubt, test the fit in the pharmacy and demonstrate with the patient’s own device.
Which devices don’t need spacers?
Breath-actuated inhalers, such as Accuhaler, Autohaler, Breezhaler, Ellipta, Respimat, Spiromax, and Turbuhaler are not spacer-compatible.5
Who needs to use a mask with a spacer?
A tightly fitting face mask is used for anyone who may find it harder to take a breath in through their mouth or cannot seal their lips tightly around the mouthpiece of an inhaler or spacer.2
What’s the big takeaway?
Spacers aren’t just for kids. For adults, they support technique and mean better medicine delivery with fewer adverse effects. Pharmacists play a key role in helping patients, especially adults, understand why using a spacer with pMDI is recommended.
References
- Lung Foundation Australia. Spacer and puffer inhaler device technique fact sheet. 2025. At: https://lungfoundation.com.au/support-resources/resource-hub/spacer-and-puffer-inhaler-device-technique-fact-sheet/
- National Asthma Council Australia. Spacer use and care fact sheet. 2025. At: www.nationalasthma.org.au/living-with-asthma/resources/patients-carers/factsheets/spacer-use-and-care
- Respiratory Therapeutic Guidelines. Inhalational drug delivery devices Melbourne: Therapeutic Guidelines; 2020 (amended 2025). At: https://app.tg.org.au/viewTopic?etgAccess=true&guidelinePage=Respiratory&topicfile=inhalational-drug-delivery-devices&guidelinename=Respiratory&sectionId=toc_d1e208#toc_d1e208
- National Asthma Council Australia. AeroChamber Plus* Flow-Vu* Spacers for pMDIs Information Paper. 2025. At: www.nationalasthma.org.au/living-with-asthma/resources/health-professionals/information-paper/aerochamber-plus-flow-vu-spacers-pmdi
- Asthma Australia. Devices and Techniques. 2025. At: www.asthma.org.au/devices-techniques/puffer-and-spacer/
[post_title] => Why all patients should be using a spacer
[post_excerpt] => Questions about spacers are abundant in community pharmacy. AP answers some of the trickiest ones pharmacists face.
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[post_content] => PSA presented its 2025 Queensland Excellence Awards in Brisbane over the weekend, recognising five outstanding pharmacists for their commitment to excellence in pharmacy practice.
PSA Queensland President Hannah Knowles MPS acknowledged the outstanding achievements of this year’s award winners and nominees, as well as the continued dedication of pharmacists practising throughout the state.
‘The amazing work pharmacists do in communities across Queensland every day is inspiring and it’s a great privilege to recognise them for what they do to advance the profession,’ she said.
‘On behalf of the PSA, I congratulate the outstanding pharmacists presented with awards and thank them for their commitment to bettering the health of Queenslanders.’
2025 PSA Queensland Pharmacist of the Year – Peter Fairgray MPS
As the Queensland lead for Men’s Health Downunder, pharmacy owner Mr Fairgray supports men in their recovery from prostate surgery, and assists those experiencing Peyronie’s disease, erectile dysfunction, or other conditions affecting the male anatomy.
As one of the first prescribing pharmacists, Mr Fairgray is passionate about safeguarding the public’s health and wellbeing. He is also a committed advocate for the profession, freely giving his time to train and energise fellow pharmacists.
Queensland Early Career Pharmacist of the Year – Gift Sailim MPS
Based in Far North Queensland, Ms Sailim is an accredited full-scope practitioner and forward-thinking innovator in compounding. She is a compassionate, community-focused pharmacist who elevates the profession.
Ms Phillips’ postgraduate research is focused on developing medicines for gestational diabetes, demonstrating her advocacy for safe, effective and equitable medicines use. As an accredited pharmacist, Ms Phillips also regularly liaises with rural and remote communities, improving care by providing medication reviews and collaborating with local clinicians.
Queensland Intern of the Year – Kaden Collier MPS
As a pharmacy intern, Mr Collier has shown exemplary commitment to patient care and medicines safety. Reducing jargon at every opportunity, he keeps medicines education accessible and relevant. Mr Collier strives to understand what’s important to patients and provides patient-centred care that aligns with their goals. When counselling patients, he uses educational resources, demonstrating evidence-based practice by explaining the rationale behind pharmacological and non-pharmacological forms of therapy.
Queensland Lifetime Achievement Award 2025 – Dr Danielle Stowasser MPS
Dr Stowasser has continuously advanced hospital pharmacy through innovation, leadership and tireless commitment. From pioneering safer transitions of care, to shaping national medicines safety and quality use of medicines initiatives, her impact extends across Australia. Dr Stowasser’s devotion, persistence, and vision exemplify the highest standards of the profession. Over her extensive career, Dr Stowasser has contributed to all six action items for change identified in PSA’s Pharmacists in 2030.
Professor James Dare Pharmacy Graduate of the Year – Tahlia O’Hara
Ms O’Hara, pharmacy student at Griffith University, is a passionate advocate for health equity. As a culturally grounded leader, she demonstrates the highest standards of professionalism and ethical conduct. Ms O’Hara is a proud Gumbaynggirr woman whose journey through pharmacy is shaped by her connection to community, culture and care. Her commitment to improving health outcomes for rural and Aboriginal and Torres Strait Islander people is evident in every aspect of her academic, professional and personal life.
[post_title] => Five pharmacists celebrated for excellence in practice
[post_excerpt] => PSA presented its 2025 Queensland Excellence Awards in Brisbane last weekend, recognising pharmacists for excellence in pharmacy practice.
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[post_content] => AI is rapidly transforming healthcare practice, but how will it challenge pharmacists’ identities – which are closely tied to knowledge, intelligence and decision-making expertise?
As AI continues to transform the labour market, the education of pharmacists needs to change, said Dr Louise Schaper, an internationally renowned digital health leader and Fellow of both the International Academy of Health Sciences Informatics and the Australasian Institute of Digital Health.
‘I think many pharmacists believe they just have to learn how to use a new tool and work out how AI is involved in the standard workflow,’ she said. ‘But AI is not just about replacing tasks – it’s about redefining human roles. We need to move away from the focus of rote knowledge towards teaching pharmacists to be wise interpreters of AI who have the human skills to interact with patients and customers.’
Redefining value
Like doctors, pharmacists have traditionally defined their value through deep knowledge and precision, Dr Schaper said. ‘Their sense of identity is closely tied to being an authority on medications.’
[caption id="attachment_30763" align="aligncenter" width="600"]
Dr Louise Schaper at PSA25[/caption]
Pharmacists also feel responsible for supporting population health, especially through vaccination programs, harm minimisation services and medicines adherence support.
‘They feel quiet pride in being the unsung hero of the health system, working behind the scenes to prevent medication errors, counsel patients and collaborate with prescribers.’
But with OpenAI aiming for 1 billion users by year’s end, and ChatGPT generating information at speeds far beyond human capacity, these traditional values are under pressure.
‘Pharmacists don’t just practice the profession, they embody it,’ Dr Schaper said. ‘That’s why this disruption feels so personal.’
Building relationships and trust
While AI can process vast amounts of data, Dr Schaper stressed that it cannot deliver what patients most value: human empathy.
‘The opportunity for a pharmacist to be seen as more of a health partner is ripe. Skills such as empathy, ethical reasoning and nuanced clinical judgement will all become increasingly important,’ she said.
‘AI can crunch data, but it's artificial and synthetic. It can't build real touch, real trust, empathy or judgement. A machine can’t tell if it is dealing with a struggling single [parent], or an elderly person on a walker.’
‘The opportunity for a pharmacist to be seen as more of a health partner is ripe. Skills such as empathy, ethical reasoning and nuanced clinical judgement will all become increasingly important.'
Dr Louise Schaper
This, she argued, is where pharmacists must lean in. ‘Pharmacists need to focus on building relationships. Not only do they have years of knowledge and experience, but they can understand patients as human beings.’
For Dr Schaper, this human connection is irreplaceable. ‘AI may allow patients to get information, but they want to bring it to someone with years of knowledge and experience, who understands what they might be going through and who will help them navigate the information.’
Seasoned pharmacists also have an opportunity to guide early-career colleagues in developing critical relational skills, ensuring the profession remains indispensable in an AI-driven healthcare system, she added.
The march of AI
Dr Schaper’s research highlights how major players such as Amazon are disrupting pharmacy. A recent study published in JAMA showed that Amazon’s RxPass has improved medicines adherence and lowered costs. The program lists about 60 generic medicines available to Prime members for a $5 monthly fee. The tech giant is also testing a chatbot and mobile app called Health AI that can answer health and wellness questions, provide common care options and suggest products.
Dr Schaper said Amazon has already registered Amazon Pharmacy in Australia – ‘they did that years ago’.
Meanwhile tools such as ChatGPT are giving patients new ways to ‘Doctor Google’ medicines, while technology companies are developing Agentic AI – systems capable of autonomous action and decision-making with minimal human input. In the future, these tools could undertake treatment planning, remote monitoring, documentation checks and supply chain optimisation, Dr Schaper said.
Despite this, the keynote speaker at PSA25 in August believes pharmacists should stop worrying about being replaced and instead view AI as a co-pilot. She suggested starting to use AI through tools such as ChatGPT to become familiar with what it can do, and transition to using it to reduce the burden of administrative tasks so more time can be spent on customer and business development.
But, she cautioned: ‘This isn’t just about learning a new piece of kit. Pharmacists need to work out their own identity in that process and make it happen, supported by the PSA and education that delivers real-world experience.’
This moment is a reminder of what makes healthcare unique: connection and relationships, Dr Schaper said. ‘Pharmacy, too, has that added entrepreneurial spirit, with many pharmacists running small businesses and innovating to meet community needs. That mix of expertise is exactly what will help the profession adapt and thrive.’
Her message to pharmacists is clear: think about these changes now and make sure you’re ready to embrace them.
[post_title] => Redefining identity in the age of AI
[post_excerpt] => AI is transforming healthcare, but how will it challenge pharmacists’ identities, which are closely tied to intelligence and decision-making?
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[post_content] => The Australian Technical Advisory Group on Immunisation (ATAGI) 2025 statement paints a mixed picture.
While Australia has made important gains with new vaccines and national immunisation reforms, rising cases of pertussis, measles and mpox reveal how fragile protection can be when coverage falters.
Australian Pharmacist explores where progress has been made and where urgent focus is required.
1. Vaccination rates are declining across the board
An ongoing decline in vaccination rates has been identified among all children, adolescents and adults. The steepest and most troubling drop is in childhood vaccination rates at 12 months of age – reducing 3.2 percentage points since 2020. Coverage for children aged 24 months has also dipped below 90% for the first time since 2016. Coverage at 60 months is the highest milestone (92.7%) – indicating that catch-up vaccination is occurring.
Adolescent human papillomavirus (HPV) vaccination rates are also on a downward trend, sitting well below the 90% target at 81.1% in females and 77.9% in males for at least one dose of the vaccine at 15 years of age. Concerningly, the rates are even lower among Aboriginal and Torres Strait Islander people, sitting at 76.7% in females and 69.2% in males.
Uptake of COVID-19 vaccines fell sharply in 2024 across all adult age groups, with only a fraction (2.3%) of younger adults aged 18 to <50 receiving at least one dose of the vaccine. Among those most vulnerable to severe complications, patients aged 75 and older, the vaccination rate dropped from 52.3% to 36.5%.
ATAGI will track declining coverage for selected vaccines to inform additional control strategies, and monitor the effects of schedule changes on coverage and disease – such as the shift to a 1-dose HPV schedule in 2023.
2. Australia’s RSV vaccination campaign is world leading
In 2024, Australia became the first country to put a combined maternal and infant respiratory syncytial virus (RSV) immunisation program in place. Pregnant women were given free access to Abrysvo under the National Immunisation Program (NIP)
from 28 weeks gestation ahead of the 2025 RSV season. Monoclonal antibody nirsevimab is funded for infants under various state and territory arrangements to ensure protection for at-risk infants and/or those whose mother did not receive the vaccine during pregnancy.
These arrangements include:
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[post_content] => With glucagon-like peptide-1 receptor agonists (GLP-1 RAs) back and some basal insulins disappearing, pharmacists face a new wave of complexity in diabetes management.
Diabetes management has been significantly disrupted in recent years, from ongoing shortages of (GLP-1 RAs) to the discontinuation of several insulin formulations.
But with medicines like semaglutide (Ozempic) back on the market and the impending discontinuation of another long-acting basal insulin analogue – there are further complexities to navigate.
Here, Australian Pharmacist explores how the sector is tackling these issues.
Ozempic return leads to medicine double-ups
Medicine shortages of popular diabetes medicines have eased this year, including the official removal of Ozempic from the Therapeutic Goods Administration’s medicine shortages list in July.
But throughout the shortage period, it became common for patients to receive multiple prescriptions for whichever medicine was available at the time, said Kirrily Chambers MPS, Advanced Practice Pharmacist and credentialled diabetes educator during the National Medicines Symposium 2025, held last week.
For example, when Ozempic was out of stock, Ms Chambers said patients were often issued a prescription for sitagliptin (Januvia) in addition to their usual semaglutide.
‘When there have been issues with not being able to get [the medicine], people will often pick up both scripts when it comes back on the market,’ she said.
‘A patient might collect a 6-month prescription for Januvia. Then, when they present to the pharmacy, the pharmacist says, “Mrs Jones, your Ozempic is back – would you like one?” The patient says, “Yes, please,” forgetting the GP or specialist had advised using Januvia only while Ozempic was unavailable.’
If pharmacists encounter this situation, they should contact the GP or specialist to confirm the prescribing was intended.
‘We're now ringing to say, “Hey, did you really mean to put this person on multiple things? Because 6 months ago, they weren't on all these medications”,’ she said. ‘This is part of deprescribing to keep people safe, so that they're not bouncing into hospital.’
Regular Diabetes MedsChecks and medicines reconciliation, or a Home Medicines Review where appropriate, is critical to help the person living with diabetes understand the therapeutic approach. Any issues or duplications identified should then be communicated to the multidisciplinary team.
Discontinuations leave some patients without options
In the last few years, numerous diabetes medicines have faced discontinuation, including several insulin formulations and the GLP-1 RA liraglutide(Saxenda). There have also been device discontinuations, which can make diabetes care more difficult for older patients, said Associate Professor Margaret McGill AM, nurse manager and associate director at Royal Prince Alfred Hospital’s Diabetes Centre.
‘We know that people are living longer … and that age is the biggest predictor of type 2 diabetes,’ she said. ‘So we now see many referrals of people in their 80s and 90s – and some of these people need to go on insulin.’
Often, older patients don’t have the dexterity to navigate some of the newer devices, including putting a cartridge into a reusable pen.
‘When we lose the simple devices … it’s really impactful,’ A/Prof McGill told Symposium delegates.
Distinguished Professor David Simmons, the Chief Medical Officer, Diabetes Australia, has tried to ensure there are replacements for some of these devices.
‘Protaphane [is] one that we're trying to do, and it's quite challenging,’ he said.
‘If you're working with people [who have], for example, gestational diabetes, and they only have a limited number of weeks to actually understand what they're doing, some of the quicker learning devices are superior to learning how to put a cartridge into a pen.’
But the device discontinuation causing the most concern, however, is insulin detemir (Levemir) – which is set to be discontinued by December 2026.
Some patients who can tolerate a once daily dose of insulin could go on glargine, Prof Simmons said. However, the individual risks must be calculated for each patient.
‘For those who need Levemir twice daily so it can cover them during the day and night, there's a big risk when we go to once a day,’ he said.
‘During the day, they will be at risk of hypos – perhaps when they're driving if they haven't got a sensor on, or if the sensor is not working. If they then reduce their dose and their glucose goes up, they're going to be more hyperglycaemic at night – which will directly lead to long-term complications.’
While Diabetes Australia is looking into management strategies, the only current solution for these patients is an insulin pump.
‘There’s nothing else that's going to replace it for those individuals, and they may not be able to afford a pump,’ Prof Simmons said. ‘So we're certainly concerned about that. And GPs and pharmacists need to be very much aware that this is what's coming.’
Finding the right therapeutic approach
When considering new medicines for patients that are appropriate for diabetes, they must be selected for a person through a complex algorithm, said Dr Gary Deed, Chair of the Diabetes Specific Interest group at the Royal Australian College of General Practitioners.
‘[You] have to think, “do [they] have high blood pressure, lipid problems, kidney disease, metabolic-associated fatty liver disease? And how then, do I adapt that framework to the choices of medications and then negotiate with [the patient]?’ he said.
‘[You need a] well-trained, systematic approach and a very clear perspective of what that person is, not just physically, but also emotionally, and how they live.’
Renza Scibilia, a diabetes advocate who has lived with type 1 diabetes for 27 years, said that there’s a broad spectrum of people living with diabetes, and their understanding of the diabetes landscape may vary, including:
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[post_content] => Questions about spacers are abundant in community pharmacy. AP answers some of the trickiest ones pharmacists face.
Aren’t spacers just for kids?’ This is a common misconception pharmacists hear. People of all ages should use a spacer whenever they use a pressurised metered dose inhaler (pMDI).1 Spacers slow down aerosol spray, improve lung delivery and reduce oropharyngeal adverse effects like irritation, hoarseness or oral thrush from inhaled corticosteroids (ICS).1,2
They’re also useful for anyone who struggles with coordination or breath timing. When used correctly with a spacer, a pMDI delivers medicine as effectively
as a nebuliser, and is often more efficient and convenient.2
Which spacers are better?
Spacers can be made of plastic or cardboard. Collapsible spacers are more compact for the patient to carry. Cardboard spacers fold flat for easy storage. Some spacers have additional features e.g. anti-static spacers improve delivery of active ingredient by preventing medicine from sticking to the walls.4
Some spacers have an inhalation indicator that moves when the patient inhales and whistles if they inhale too fast.4 Spacers with one-way valves stop exhalation into the chamber, helping keep the medicine inside and making delivery more effective.4
Anti-bacterial spacers are embedded with materials e.g. silver ion to inhibit bacteria growth. Choice of spacer depends on age, treatment, budget, dexterity and lifestyle. It should suit the patient, be easy to put together and be compatible with their inhaler.2,3 The Spacers for pMDIs Chart helps identify spacer options. Visit www.nationalasthma.org.au/living-with-asthma/resources/health-professionals/charts
Do all inhalers fit into a spacer?
Not always. Some spacers have a rigid or fixed connection end. Those pMDIs with circular mouthpieces may require spacers with a flexible rubber/silicone opening that can form a seal around the mouthpiece. If in doubt, test the fit in the pharmacy and demonstrate with the patient’s own device.
Which devices don’t need spacers?
Breath-actuated inhalers, such as Accuhaler, Autohaler, Breezhaler, Ellipta, Respimat, Spiromax, and Turbuhaler are not spacer-compatible.5
Who needs to use a mask with a spacer?
A tightly fitting face mask is used for anyone who may find it harder to take a breath in through their mouth or cannot seal their lips tightly around the mouthpiece of an inhaler or spacer.2
What’s the big takeaway?
Spacers aren’t just for kids. For adults, they support technique and mean better medicine delivery with fewer adverse effects. Pharmacists play a key role in helping patients, especially adults, understand why using a spacer with pMDI is recommended.
References
- Lung Foundation Australia. Spacer and puffer inhaler device technique fact sheet. 2025. At: https://lungfoundation.com.au/support-resources/resource-hub/spacer-and-puffer-inhaler-device-technique-fact-sheet/
- National Asthma Council Australia. Spacer use and care fact sheet. 2025. At: www.nationalasthma.org.au/living-with-asthma/resources/patients-carers/factsheets/spacer-use-and-care
- Respiratory Therapeutic Guidelines. Inhalational drug delivery devices Melbourne: Therapeutic Guidelines; 2020 (amended 2025). At: https://app.tg.org.au/viewTopic?etgAccess=true&guidelinePage=Respiratory&topicfile=inhalational-drug-delivery-devices&guidelinename=Respiratory&sectionId=toc_d1e208#toc_d1e208
- National Asthma Council Australia. AeroChamber Plus* Flow-Vu* Spacers for pMDIs Information Paper. 2025. At: www.nationalasthma.org.au/living-with-asthma/resources/health-professionals/information-paper/aerochamber-plus-flow-vu-spacers-pmdi
- Asthma Australia. Devices and Techniques. 2025. At: www.asthma.org.au/devices-techniques/puffer-and-spacer/
[post_title] => Why all patients should be using a spacer
[post_excerpt] => Questions about spacers are abundant in community pharmacy. AP answers some of the trickiest ones pharmacists face.
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[post_content] => PSA presented its 2025 Queensland Excellence Awards in Brisbane over the weekend, recognising five outstanding pharmacists for their commitment to excellence in pharmacy practice.
PSA Queensland President Hannah Knowles MPS acknowledged the outstanding achievements of this year’s award winners and nominees, as well as the continued dedication of pharmacists practising throughout the state.
‘The amazing work pharmacists do in communities across Queensland every day is inspiring and it’s a great privilege to recognise them for what they do to advance the profession,’ she said.
‘On behalf of the PSA, I congratulate the outstanding pharmacists presented with awards and thank them for their commitment to bettering the health of Queenslanders.’
2025 PSA Queensland Pharmacist of the Year – Peter Fairgray MPS
As the Queensland lead for Men’s Health Downunder, pharmacy owner Mr Fairgray supports men in their recovery from prostate surgery, and assists those experiencing Peyronie’s disease, erectile dysfunction, or other conditions affecting the male anatomy.
As one of the first prescribing pharmacists, Mr Fairgray is passionate about safeguarding the public’s health and wellbeing. He is also a committed advocate for the profession, freely giving his time to train and energise fellow pharmacists.
Queensland Early Career Pharmacist of the Year – Gift Sailim MPS
Based in Far North Queensland, Ms Sailim is an accredited full-scope practitioner and forward-thinking innovator in compounding. She is a compassionate, community-focused pharmacist who elevates the profession.
Ms Phillips’ postgraduate research is focused on developing medicines for gestational diabetes, demonstrating her advocacy for safe, effective and equitable medicines use. As an accredited pharmacist, Ms Phillips also regularly liaises with rural and remote communities, improving care by providing medication reviews and collaborating with local clinicians.
Queensland Intern of the Year – Kaden Collier MPS
As a pharmacy intern, Mr Collier has shown exemplary commitment to patient care and medicines safety. Reducing jargon at every opportunity, he keeps medicines education accessible and relevant. Mr Collier strives to understand what’s important to patients and provides patient-centred care that aligns with their goals. When counselling patients, he uses educational resources, demonstrating evidence-based practice by explaining the rationale behind pharmacological and non-pharmacological forms of therapy.
Queensland Lifetime Achievement Award 2025 – Dr Danielle Stowasser MPS
Dr Stowasser has continuously advanced hospital pharmacy through innovation, leadership and tireless commitment. From pioneering safer transitions of care, to shaping national medicines safety and quality use of medicines initiatives, her impact extends across Australia. Dr Stowasser’s devotion, persistence, and vision exemplify the highest standards of the profession. Over her extensive career, Dr Stowasser has contributed to all six action items for change identified in PSA’s Pharmacists in 2030.
Professor James Dare Pharmacy Graduate of the Year – Tahlia O’Hara
Ms O’Hara, pharmacy student at Griffith University, is a passionate advocate for health equity. As a culturally grounded leader, she demonstrates the highest standards of professionalism and ethical conduct. Ms O’Hara is a proud Gumbaynggirr woman whose journey through pharmacy is shaped by her connection to community, culture and care. Her commitment to improving health outcomes for rural and Aboriginal and Torres Strait Islander people is evident in every aspect of her academic, professional and personal life.
[post_title] => Five pharmacists celebrated for excellence in practice
[post_excerpt] => PSA presented its 2025 Queensland Excellence Awards in Brisbane last weekend, recognising pharmacists for excellence in pharmacy practice.
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[post_content] => AI is rapidly transforming healthcare practice, but how will it challenge pharmacists’ identities – which are closely tied to knowledge, intelligence and decision-making expertise?
As AI continues to transform the labour market, the education of pharmacists needs to change, said Dr Louise Schaper, an internationally renowned digital health leader and Fellow of both the International Academy of Health Sciences Informatics and the Australasian Institute of Digital Health.
‘I think many pharmacists believe they just have to learn how to use a new tool and work out how AI is involved in the standard workflow,’ she said. ‘But AI is not just about replacing tasks – it’s about redefining human roles. We need to move away from the focus of rote knowledge towards teaching pharmacists to be wise interpreters of AI who have the human skills to interact with patients and customers.’
Redefining value
Like doctors, pharmacists have traditionally defined their value through deep knowledge and precision, Dr Schaper said. ‘Their sense of identity is closely tied to being an authority on medications.’
[caption id="attachment_30763" align="aligncenter" width="600"] Dr Louise Schaper at PSA25[/caption]
Pharmacists also feel responsible for supporting population health, especially through vaccination programs, harm minimisation services and medicines adherence support.
‘They feel quiet pride in being the unsung hero of the health system, working behind the scenes to prevent medication errors, counsel patients and collaborate with prescribers.’
But with OpenAI aiming for 1 billion users by year’s end, and ChatGPT generating information at speeds far beyond human capacity, these traditional values are under pressure.
‘Pharmacists don’t just practice the profession, they embody it,’ Dr Schaper said. ‘That’s why this disruption feels so personal.’
Building relationships and trust
While AI can process vast amounts of data, Dr Schaper stressed that it cannot deliver what patients most value: human empathy.
‘The opportunity for a pharmacist to be seen as more of a health partner is ripe. Skills such as empathy, ethical reasoning and nuanced clinical judgement will all become increasingly important,’ she said.
‘AI can crunch data, but it's artificial and synthetic. It can't build real touch, real trust, empathy or judgement. A machine can’t tell if it is dealing with a struggling single [parent], or an elderly person on a walker.’
‘The opportunity for a pharmacist to be seen as more of a health partner is ripe. Skills such as empathy, ethical reasoning and nuanced clinical judgement will all become increasingly important.'
Dr Louise Schaper
This, she argued, is where pharmacists must lean in. ‘Pharmacists need to focus on building relationships. Not only do they have years of knowledge and experience, but they can understand patients as human beings.’
For Dr Schaper, this human connection is irreplaceable. ‘AI may allow patients to get information, but they want to bring it to someone with years of knowledge and experience, who understands what they might be going through and who will help them navigate the information.’
Seasoned pharmacists also have an opportunity to guide early-career colleagues in developing critical relational skills, ensuring the profession remains indispensable in an AI-driven healthcare system, she added.
The march of AI
Dr Schaper’s research highlights how major players such as Amazon are disrupting pharmacy. A recent study published in JAMA showed that Amazon’s RxPass has improved medicines adherence and lowered costs. The program lists about 60 generic medicines available to Prime members for a $5 monthly fee. The tech giant is also testing a chatbot and mobile app called Health AI that can answer health and wellness questions, provide common care options and suggest products.
Dr Schaper said Amazon has already registered Amazon Pharmacy in Australia – ‘they did that years ago’.
Meanwhile tools such as ChatGPT are giving patients new ways to ‘Doctor Google’ medicines, while technology companies are developing Agentic AI – systems capable of autonomous action and decision-making with minimal human input. In the future, these tools could undertake treatment planning, remote monitoring, documentation checks and supply chain optimisation, Dr Schaper said.
Despite this, the keynote speaker at PSA25 in August believes pharmacists should stop worrying about being replaced and instead view AI as a co-pilot. She suggested starting to use AI through tools such as ChatGPT to become familiar with what it can do, and transition to using it to reduce the burden of administrative tasks so more time can be spent on customer and business development.
But, she cautioned: ‘This isn’t just about learning a new piece of kit. Pharmacists need to work out their own identity in that process and make it happen, supported by the PSA and education that delivers real-world experience.’
This moment is a reminder of what makes healthcare unique: connection and relationships, Dr Schaper said. ‘Pharmacy, too, has that added entrepreneurial spirit, with many pharmacists running small businesses and innovating to meet community needs. That mix of expertise is exactly what will help the profession adapt and thrive.’
Her message to pharmacists is clear: think about these changes now and make sure you’re ready to embrace them.
[post_title] => Redefining identity in the age of AI
[post_excerpt] => AI is transforming healthcare, but how will it challenge pharmacists’ identities, which are closely tied to intelligence and decision-making?
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[post_content] => The Australian Technical Advisory Group on Immunisation (ATAGI) 2025 statement paints a mixed picture.
While Australia has made important gains with new vaccines and national immunisation reforms, rising cases of pertussis, measles and mpox reveal how fragile protection can be when coverage falters.
Australian Pharmacist explores where progress has been made and where urgent focus is required.
1. Vaccination rates are declining across the board
An ongoing decline in vaccination rates has been identified among all children, adolescents and adults. The steepest and most troubling drop is in childhood vaccination rates at 12 months of age – reducing 3.2 percentage points since 2020. Coverage for children aged 24 months has also dipped below 90% for the first time since 2016. Coverage at 60 months is the highest milestone (92.7%) – indicating that catch-up vaccination is occurring.
Adolescent human papillomavirus (HPV) vaccination rates are also on a downward trend, sitting well below the 90% target at 81.1% in females and 77.9% in males for at least one dose of the vaccine at 15 years of age. Concerningly, the rates are even lower among Aboriginal and Torres Strait Islander people, sitting at 76.7% in females and 69.2% in males.
Uptake of COVID-19 vaccines fell sharply in 2024 across all adult age groups, with only a fraction (2.3%) of younger adults aged 18 to <50 receiving at least one dose of the vaccine. Among those most vulnerable to severe complications, patients aged 75 and older, the vaccination rate dropped from 52.3% to 36.5%.
ATAGI will track declining coverage for selected vaccines to inform additional control strategies, and monitor the effects of schedule changes on coverage and disease – such as the shift to a 1-dose HPV schedule in 2023.
2. Australia’s RSV vaccination campaign is world leading
In 2024, Australia became the first country to put a combined maternal and infant respiratory syncytial virus (RSV) immunisation program in place. Pregnant women were given free access to Abrysvo under the National Immunisation Program (NIP)
from 28 weeks gestation ahead of the 2025 RSV season. Monoclonal antibody nirsevimab is funded for infants under various state and territory arrangements to ensure protection for at-risk infants and/or those whose mother did not receive the vaccine during pregnancy.
These arrangements include:
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[post_content] => With glucagon-like peptide-1 receptor agonists (GLP-1 RAs) back and some basal insulins disappearing, pharmacists face a new wave of complexity in diabetes management.
Diabetes management has been significantly disrupted in recent years, from ongoing shortages of (GLP-1 RAs) to the discontinuation of several insulin formulations.
But with medicines like semaglutide (Ozempic) back on the market and the impending discontinuation of another long-acting basal insulin analogue – there are further complexities to navigate.
Here, Australian Pharmacist explores how the sector is tackling these issues.
Ozempic return leads to medicine double-ups
Medicine shortages of popular diabetes medicines have eased this year, including the official removal of Ozempic from the Therapeutic Goods Administration’s medicine shortages list in July.
But throughout the shortage period, it became common for patients to receive multiple prescriptions for whichever medicine was available at the time, said Kirrily Chambers MPS, Advanced Practice Pharmacist and credentialled diabetes educator during the National Medicines Symposium 2025, held last week.
For example, when Ozempic was out of stock, Ms Chambers said patients were often issued a prescription for sitagliptin (Januvia) in addition to their usual semaglutide.
‘When there have been issues with not being able to get [the medicine], people will often pick up both scripts when it comes back on the market,’ she said.
‘A patient might collect a 6-month prescription for Januvia. Then, when they present to the pharmacy, the pharmacist says, “Mrs Jones, your Ozempic is back – would you like one?” The patient says, “Yes, please,” forgetting the GP or specialist had advised using Januvia only while Ozempic was unavailable.’
If pharmacists encounter this situation, they should contact the GP or specialist to confirm the prescribing was intended.
‘We're now ringing to say, “Hey, did you really mean to put this person on multiple things? Because 6 months ago, they weren't on all these medications”,’ she said. ‘This is part of deprescribing to keep people safe, so that they're not bouncing into hospital.’
Regular Diabetes MedsChecks and medicines reconciliation, or a Home Medicines Review where appropriate, is critical to help the person living with diabetes understand the therapeutic approach. Any issues or duplications identified should then be communicated to the multidisciplinary team.
Discontinuations leave some patients without options
In the last few years, numerous diabetes medicines have faced discontinuation, including several insulin formulations and the GLP-1 RA liraglutide(Saxenda). There have also been device discontinuations, which can make diabetes care more difficult for older patients, said Associate Professor Margaret McGill AM, nurse manager and associate director at Royal Prince Alfred Hospital’s Diabetes Centre.
‘We know that people are living longer … and that age is the biggest predictor of type 2 diabetes,’ she said. ‘So we now see many referrals of people in their 80s and 90s – and some of these people need to go on insulin.’
Often, older patients don’t have the dexterity to navigate some of the newer devices, including putting a cartridge into a reusable pen.
‘When we lose the simple devices … it’s really impactful,’ A/Prof McGill told Symposium delegates.
Distinguished Professor David Simmons, the Chief Medical Officer, Diabetes Australia, has tried to ensure there are replacements for some of these devices.
‘Protaphane [is] one that we're trying to do, and it's quite challenging,’ he said.
‘If you're working with people [who have], for example, gestational diabetes, and they only have a limited number of weeks to actually understand what they're doing, some of the quicker learning devices are superior to learning how to put a cartridge into a pen.’
But the device discontinuation causing the most concern, however, is insulin detemir (Levemir) – which is set to be discontinued by December 2026.
Some patients who can tolerate a once daily dose of insulin could go on glargine, Prof Simmons said. However, the individual risks must be calculated for each patient.
‘For those who need Levemir twice daily so it can cover them during the day and night, there's a big risk when we go to once a day,’ he said.
‘During the day, they will be at risk of hypos – perhaps when they're driving if they haven't got a sensor on, or if the sensor is not working. If they then reduce their dose and their glucose goes up, they're going to be more hyperglycaemic at night – which will directly lead to long-term complications.’
While Diabetes Australia is looking into management strategies, the only current solution for these patients is an insulin pump.
‘There’s nothing else that's going to replace it for those individuals, and they may not be able to afford a pump,’ Prof Simmons said. ‘So we're certainly concerned about that. And GPs and pharmacists need to be very much aware that this is what's coming.’
Finding the right therapeutic approach
When considering new medicines for patients that are appropriate for diabetes, they must be selected for a person through a complex algorithm, said Dr Gary Deed, Chair of the Diabetes Specific Interest group at the Royal Australian College of General Practitioners.
‘[You] have to think, “do [they] have high blood pressure, lipid problems, kidney disease, metabolic-associated fatty liver disease? And how then, do I adapt that framework to the choices of medications and then negotiate with [the patient]?’ he said.
‘[You need a] well-trained, systematic approach and a very clear perspective of what that person is, not just physically, but also emotionally, and how they live.’
Renza Scibilia, a diabetes advocate who has lived with type 1 diabetes for 27 years, said that there’s a broad spectrum of people living with diabetes, and their understanding of the diabetes landscape may vary, including:
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[post_content] => Questions about spacers are abundant in community pharmacy. AP answers some of the trickiest ones pharmacists face.
Aren’t spacers just for kids?’ This is a common misconception pharmacists hear. People of all ages should use a spacer whenever they use a pressurised metered dose inhaler (pMDI).1 Spacers slow down aerosol spray, improve lung delivery and reduce oropharyngeal adverse effects like irritation, hoarseness or oral thrush from inhaled corticosteroids (ICS).1,2
They’re also useful for anyone who struggles with coordination or breath timing. When used correctly with a spacer, a pMDI delivers medicine as effectively
as a nebuliser, and is often more efficient and convenient.2
Which spacers are better?
Spacers can be made of plastic or cardboard. Collapsible spacers are more compact for the patient to carry. Cardboard spacers fold flat for easy storage. Some spacers have additional features e.g. anti-static spacers improve delivery of active ingredient by preventing medicine from sticking to the walls.4
Some spacers have an inhalation indicator that moves when the patient inhales and whistles if they inhale too fast.4 Spacers with one-way valves stop exhalation into the chamber, helping keep the medicine inside and making delivery more effective.4
Anti-bacterial spacers are embedded with materials e.g. silver ion to inhibit bacteria growth. Choice of spacer depends on age, treatment, budget, dexterity and lifestyle. It should suit the patient, be easy to put together and be compatible with their inhaler.2,3 The Spacers for pMDIs Chart helps identify spacer options. Visit www.nationalasthma.org.au/living-with-asthma/resources/health-professionals/charts
Do all inhalers fit into a spacer?
Not always. Some spacers have a rigid or fixed connection end. Those pMDIs with circular mouthpieces may require spacers with a flexible rubber/silicone opening that can form a seal around the mouthpiece. If in doubt, test the fit in the pharmacy and demonstrate with the patient’s own device.
Which devices don’t need spacers?
Breath-actuated inhalers, such as Accuhaler, Autohaler, Breezhaler, Ellipta, Respimat, Spiromax, and Turbuhaler are not spacer-compatible.5
Who needs to use a mask with a spacer?
A tightly fitting face mask is used for anyone who may find it harder to take a breath in through their mouth or cannot seal their lips tightly around the mouthpiece of an inhaler or spacer.2
What’s the big takeaway?
Spacers aren’t just for kids. For adults, they support technique and mean better medicine delivery with fewer adverse effects. Pharmacists play a key role in helping patients, especially adults, understand why using a spacer with pMDI is recommended.
References
- Lung Foundation Australia. Spacer and puffer inhaler device technique fact sheet. 2025. At: https://lungfoundation.com.au/support-resources/resource-hub/spacer-and-puffer-inhaler-device-technique-fact-sheet/
- National Asthma Council Australia. Spacer use and care fact sheet. 2025. At: www.nationalasthma.org.au/living-with-asthma/resources/patients-carers/factsheets/spacer-use-and-care
- Respiratory Therapeutic Guidelines. Inhalational drug delivery devices Melbourne: Therapeutic Guidelines; 2020 (amended 2025). At: https://app.tg.org.au/viewTopic?etgAccess=true&guidelinePage=Respiratory&topicfile=inhalational-drug-delivery-devices&guidelinename=Respiratory&sectionId=toc_d1e208#toc_d1e208
- National Asthma Council Australia. AeroChamber Plus* Flow-Vu* Spacers for pMDIs Information Paper. 2025. At: www.nationalasthma.org.au/living-with-asthma/resources/health-professionals/information-paper/aerochamber-plus-flow-vu-spacers-pmdi
- Asthma Australia. Devices and Techniques. 2025. At: www.asthma.org.au/devices-techniques/puffer-and-spacer/
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[post_content] => PSA presented its 2025 Queensland Excellence Awards in Brisbane over the weekend, recognising five outstanding pharmacists for their commitment to excellence in pharmacy practice.
PSA Queensland President Hannah Knowles MPS acknowledged the outstanding achievements of this year’s award winners and nominees, as well as the continued dedication of pharmacists practising throughout the state.
‘The amazing work pharmacists do in communities across Queensland every day is inspiring and it’s a great privilege to recognise them for what they do to advance the profession,’ she said.
‘On behalf of the PSA, I congratulate the outstanding pharmacists presented with awards and thank them for their commitment to bettering the health of Queenslanders.’
2025 PSA Queensland Pharmacist of the Year – Peter Fairgray MPS
As the Queensland lead for Men’s Health Downunder, pharmacy owner Mr Fairgray supports men in their recovery from prostate surgery, and assists those experiencing Peyronie’s disease, erectile dysfunction, or other conditions affecting the male anatomy.
As one of the first prescribing pharmacists, Mr Fairgray is passionate about safeguarding the public’s health and wellbeing. He is also a committed advocate for the profession, freely giving his time to train and energise fellow pharmacists.
Queensland Early Career Pharmacist of the Year – Gift Sailim MPS
Based in Far North Queensland, Ms Sailim is an accredited full-scope practitioner and forward-thinking innovator in compounding. She is a compassionate, community-focused pharmacist who elevates the profession.
Ms Phillips’ postgraduate research is focused on developing medicines for gestational diabetes, demonstrating her advocacy for safe, effective and equitable medicines use. As an accredited pharmacist, Ms Phillips also regularly liaises with rural and remote communities, improving care by providing medication reviews and collaborating with local clinicians.
Queensland Intern of the Year – Kaden Collier MPS
As a pharmacy intern, Mr Collier has shown exemplary commitment to patient care and medicines safety. Reducing jargon at every opportunity, he keeps medicines education accessible and relevant. Mr Collier strives to understand what’s important to patients and provides patient-centred care that aligns with their goals. When counselling patients, he uses educational resources, demonstrating evidence-based practice by explaining the rationale behind pharmacological and non-pharmacological forms of therapy.
Queensland Lifetime Achievement Award 2025 – Dr Danielle Stowasser MPS
Dr Stowasser has continuously advanced hospital pharmacy through innovation, leadership and tireless commitment. From pioneering safer transitions of care, to shaping national medicines safety and quality use of medicines initiatives, her impact extends across Australia. Dr Stowasser’s devotion, persistence, and vision exemplify the highest standards of the profession. Over her extensive career, Dr Stowasser has contributed to all six action items for change identified in PSA’s Pharmacists in 2030.
Professor James Dare Pharmacy Graduate of the Year – Tahlia O’Hara
Ms O’Hara, pharmacy student at Griffith University, is a passionate advocate for health equity. As a culturally grounded leader, she demonstrates the highest standards of professionalism and ethical conduct. Ms O’Hara is a proud Gumbaynggirr woman whose journey through pharmacy is shaped by her connection to community, culture and care. Her commitment to improving health outcomes for rural and Aboriginal and Torres Strait Islander people is evident in every aspect of her academic, professional and personal life.
[post_title] => Five pharmacists celebrated for excellence in practice
[post_excerpt] => PSA presented its 2025 Queensland Excellence Awards in Brisbane last weekend, recognising pharmacists for excellence in pharmacy practice.
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[post_content] => AI is rapidly transforming healthcare practice, but how will it challenge pharmacists’ identities – which are closely tied to knowledge, intelligence and decision-making expertise?
As AI continues to transform the labour market, the education of pharmacists needs to change, said Dr Louise Schaper, an internationally renowned digital health leader and Fellow of both the International Academy of Health Sciences Informatics and the Australasian Institute of Digital Health.
‘I think many pharmacists believe they just have to learn how to use a new tool and work out how AI is involved in the standard workflow,’ she said. ‘But AI is not just about replacing tasks – it’s about redefining human roles. We need to move away from the focus of rote knowledge towards teaching pharmacists to be wise interpreters of AI who have the human skills to interact with patients and customers.’
Redefining value
Like doctors, pharmacists have traditionally defined their value through deep knowledge and precision, Dr Schaper said. ‘Their sense of identity is closely tied to being an authority on medications.’
[caption id="attachment_30763" align="aligncenter" width="600"] Dr Louise Schaper at PSA25[/caption]
Pharmacists also feel responsible for supporting population health, especially through vaccination programs, harm minimisation services and medicines adherence support.
‘They feel quiet pride in being the unsung hero of the health system, working behind the scenes to prevent medication errors, counsel patients and collaborate with prescribers.’
But with OpenAI aiming for 1 billion users by year’s end, and ChatGPT generating information at speeds far beyond human capacity, these traditional values are under pressure.
‘Pharmacists don’t just practice the profession, they embody it,’ Dr Schaper said. ‘That’s why this disruption feels so personal.’
Building relationships and trust
While AI can process vast amounts of data, Dr Schaper stressed that it cannot deliver what patients most value: human empathy.
‘The opportunity for a pharmacist to be seen as more of a health partner is ripe. Skills such as empathy, ethical reasoning and nuanced clinical judgement will all become increasingly important,’ she said.
‘AI can crunch data, but it's artificial and synthetic. It can't build real touch, real trust, empathy or judgement. A machine can’t tell if it is dealing with a struggling single [parent], or an elderly person on a walker.’
‘The opportunity for a pharmacist to be seen as more of a health partner is ripe. Skills such as empathy, ethical reasoning and nuanced clinical judgement will all become increasingly important.'
Dr Louise Schaper
This, she argued, is where pharmacists must lean in. ‘Pharmacists need to focus on building relationships. Not only do they have years of knowledge and experience, but they can understand patients as human beings.’
For Dr Schaper, this human connection is irreplaceable. ‘AI may allow patients to get information, but they want to bring it to someone with years of knowledge and experience, who understands what they might be going through and who will help them navigate the information.’
Seasoned pharmacists also have an opportunity to guide early-career colleagues in developing critical relational skills, ensuring the profession remains indispensable in an AI-driven healthcare system, she added.
The march of AI
Dr Schaper’s research highlights how major players such as Amazon are disrupting pharmacy. A recent study published in JAMA showed that Amazon’s RxPass has improved medicines adherence and lowered costs. The program lists about 60 generic medicines available to Prime members for a $5 monthly fee. The tech giant is also testing a chatbot and mobile app called Health AI that can answer health and wellness questions, provide common care options and suggest products.
Dr Schaper said Amazon has already registered Amazon Pharmacy in Australia – ‘they did that years ago’.
Meanwhile tools such as ChatGPT are giving patients new ways to ‘Doctor Google’ medicines, while technology companies are developing Agentic AI – systems capable of autonomous action and decision-making with minimal human input. In the future, these tools could undertake treatment planning, remote monitoring, documentation checks and supply chain optimisation, Dr Schaper said.
Despite this, the keynote speaker at PSA25 in August believes pharmacists should stop worrying about being replaced and instead view AI as a co-pilot. She suggested starting to use AI through tools such as ChatGPT to become familiar with what it can do, and transition to using it to reduce the burden of administrative tasks so more time can be spent on customer and business development.
But, she cautioned: ‘This isn’t just about learning a new piece of kit. Pharmacists need to work out their own identity in that process and make it happen, supported by the PSA and education that delivers real-world experience.’
This moment is a reminder of what makes healthcare unique: connection and relationships, Dr Schaper said. ‘Pharmacy, too, has that added entrepreneurial spirit, with many pharmacists running small businesses and innovating to meet community needs. That mix of expertise is exactly what will help the profession adapt and thrive.’
Her message to pharmacists is clear: think about these changes now and make sure you’re ready to embrace them.
[post_title] => Redefining identity in the age of AI
[post_excerpt] => AI is transforming healthcare, but how will it challenge pharmacists’ identities, which are closely tied to intelligence and decision-making?
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[post_content] => The Australian Technical Advisory Group on Immunisation (ATAGI) 2025 statement paints a mixed picture.
While Australia has made important gains with new vaccines and national immunisation reforms, rising cases of pertussis, measles and mpox reveal how fragile protection can be when coverage falters.
Australian Pharmacist explores where progress has been made and where urgent focus is required.
1. Vaccination rates are declining across the board
An ongoing decline in vaccination rates has been identified among all children, adolescents and adults. The steepest and most troubling drop is in childhood vaccination rates at 12 months of age – reducing 3.2 percentage points since 2020. Coverage for children aged 24 months has also dipped below 90% for the first time since 2016. Coverage at 60 months is the highest milestone (92.7%) – indicating that catch-up vaccination is occurring.
Adolescent human papillomavirus (HPV) vaccination rates are also on a downward trend, sitting well below the 90% target at 81.1% in females and 77.9% in males for at least one dose of the vaccine at 15 years of age. Concerningly, the rates are even lower among Aboriginal and Torres Strait Islander people, sitting at 76.7% in females and 69.2% in males.
Uptake of COVID-19 vaccines fell sharply in 2024 across all adult age groups, with only a fraction (2.3%) of younger adults aged 18 to <50 receiving at least one dose of the vaccine. Among those most vulnerable to severe complications, patients aged 75 and older, the vaccination rate dropped from 52.3% to 36.5%.
ATAGI will track declining coverage for selected vaccines to inform additional control strategies, and monitor the effects of schedule changes on coverage and disease – such as the shift to a 1-dose HPV schedule in 2023.
2. Australia’s RSV vaccination campaign is world leading
In 2024, Australia became the first country to put a combined maternal and infant respiratory syncytial virus (RSV) immunisation program in place. Pregnant women were given free access to Abrysvo under the National Immunisation Program (NIP)
from 28 weeks gestation ahead of the 2025 RSV season. Monoclonal antibody nirsevimab is funded for infants under various state and territory arrangements to ensure protection for at-risk infants and/or those whose mother did not receive the vaccine during pregnancy.
These arrangements include:
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[post_content] => With glucagon-like peptide-1 receptor agonists (GLP-1 RAs) back and some basal insulins disappearing, pharmacists face a new wave of complexity in diabetes management.
Diabetes management has been significantly disrupted in recent years, from ongoing shortages of (GLP-1 RAs) to the discontinuation of several insulin formulations.
But with medicines like semaglutide (Ozempic) back on the market and the impending discontinuation of another long-acting basal insulin analogue – there are further complexities to navigate.
Here, Australian Pharmacist explores how the sector is tackling these issues.
Ozempic return leads to medicine double-ups
Medicine shortages of popular diabetes medicines have eased this year, including the official removal of Ozempic from the Therapeutic Goods Administration’s medicine shortages list in July.
But throughout the shortage period, it became common for patients to receive multiple prescriptions for whichever medicine was available at the time, said Kirrily Chambers MPS, Advanced Practice Pharmacist and credentialled diabetes educator during the National Medicines Symposium 2025, held last week.
For example, when Ozempic was out of stock, Ms Chambers said patients were often issued a prescription for sitagliptin (Januvia) in addition to their usual semaglutide.
‘When there have been issues with not being able to get [the medicine], people will often pick up both scripts when it comes back on the market,’ she said.
‘A patient might collect a 6-month prescription for Januvia. Then, when they present to the pharmacy, the pharmacist says, “Mrs Jones, your Ozempic is back – would you like one?” The patient says, “Yes, please,” forgetting the GP or specialist had advised using Januvia only while Ozempic was unavailable.’
If pharmacists encounter this situation, they should contact the GP or specialist to confirm the prescribing was intended.
‘We're now ringing to say, “Hey, did you really mean to put this person on multiple things? Because 6 months ago, they weren't on all these medications”,’ she said. ‘This is part of deprescribing to keep people safe, so that they're not bouncing into hospital.’
Regular Diabetes MedsChecks and medicines reconciliation, or a Home Medicines Review where appropriate, is critical to help the person living with diabetes understand the therapeutic approach. Any issues or duplications identified should then be communicated to the multidisciplinary team.
Discontinuations leave some patients without options
In the last few years, numerous diabetes medicines have faced discontinuation, including several insulin formulations and the GLP-1 RA liraglutide(Saxenda). There have also been device discontinuations, which can make diabetes care more difficult for older patients, said Associate Professor Margaret McGill AM, nurse manager and associate director at Royal Prince Alfred Hospital’s Diabetes Centre.
‘We know that people are living longer … and that age is the biggest predictor of type 2 diabetes,’ she said. ‘So we now see many referrals of people in their 80s and 90s – and some of these people need to go on insulin.’
Often, older patients don’t have the dexterity to navigate some of the newer devices, including putting a cartridge into a reusable pen.
‘When we lose the simple devices … it’s really impactful,’ A/Prof McGill told Symposium delegates.
Distinguished Professor David Simmons, the Chief Medical Officer, Diabetes Australia, has tried to ensure there are replacements for some of these devices.
‘Protaphane [is] one that we're trying to do, and it's quite challenging,’ he said.
‘If you're working with people [who have], for example, gestational diabetes, and they only have a limited number of weeks to actually understand what they're doing, some of the quicker learning devices are superior to learning how to put a cartridge into a pen.’
But the device discontinuation causing the most concern, however, is insulin detemir (Levemir) – which is set to be discontinued by December 2026.
Some patients who can tolerate a once daily dose of insulin could go on glargine, Prof Simmons said. However, the individual risks must be calculated for each patient.
‘For those who need Levemir twice daily so it can cover them during the day and night, there's a big risk when we go to once a day,’ he said.
‘During the day, they will be at risk of hypos – perhaps when they're driving if they haven't got a sensor on, or if the sensor is not working. If they then reduce their dose and their glucose goes up, they're going to be more hyperglycaemic at night – which will directly lead to long-term complications.’
While Diabetes Australia is looking into management strategies, the only current solution for these patients is an insulin pump.
‘There’s nothing else that's going to replace it for those individuals, and they may not be able to afford a pump,’ Prof Simmons said. ‘So we're certainly concerned about that. And GPs and pharmacists need to be very much aware that this is what's coming.’
Finding the right therapeutic approach
When considering new medicines for patients that are appropriate for diabetes, they must be selected for a person through a complex algorithm, said Dr Gary Deed, Chair of the Diabetes Specific Interest group at the Royal Australian College of General Practitioners.
‘[You] have to think, “do [they] have high blood pressure, lipid problems, kidney disease, metabolic-associated fatty liver disease? And how then, do I adapt that framework to the choices of medications and then negotiate with [the patient]?’ he said.
‘[You need a] well-trained, systematic approach and a very clear perspective of what that person is, not just physically, but also emotionally, and how they live.’
Renza Scibilia, a diabetes advocate who has lived with type 1 diabetes for 27 years, said that there’s a broad spectrum of people living with diabetes, and their understanding of the diabetes landscape may vary, including:
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[post_content] => Questions about spacers are abundant in community pharmacy. AP answers some of the trickiest ones pharmacists face.
Aren’t spacers just for kids?’ This is a common misconception pharmacists hear. People of all ages should use a spacer whenever they use a pressurised metered dose inhaler (pMDI).1 Spacers slow down aerosol spray, improve lung delivery and reduce oropharyngeal adverse effects like irritation, hoarseness or oral thrush from inhaled corticosteroids (ICS).1,2
They’re also useful for anyone who struggles with coordination or breath timing. When used correctly with a spacer, a pMDI delivers medicine as effectively
as a nebuliser, and is often more efficient and convenient.2
Which spacers are better?
Spacers can be made of plastic or cardboard. Collapsible spacers are more compact for the patient to carry. Cardboard spacers fold flat for easy storage. Some spacers have additional features e.g. anti-static spacers improve delivery of active ingredient by preventing medicine from sticking to the walls.4
Some spacers have an inhalation indicator that moves when the patient inhales and whistles if they inhale too fast.4 Spacers with one-way valves stop exhalation into the chamber, helping keep the medicine inside and making delivery more effective.4
Anti-bacterial spacers are embedded with materials e.g. silver ion to inhibit bacteria growth. Choice of spacer depends on age, treatment, budget, dexterity and lifestyle. It should suit the patient, be easy to put together and be compatible with their inhaler.2,3 The Spacers for pMDIs Chart helps identify spacer options. Visit www.nationalasthma.org.au/living-with-asthma/resources/health-professionals/charts
Do all inhalers fit into a spacer?
Not always. Some spacers have a rigid or fixed connection end. Those pMDIs with circular mouthpieces may require spacers with a flexible rubber/silicone opening that can form a seal around the mouthpiece. If in doubt, test the fit in the pharmacy and demonstrate with the patient’s own device.
Which devices don’t need spacers?
Breath-actuated inhalers, such as Accuhaler, Autohaler, Breezhaler, Ellipta, Respimat, Spiromax, and Turbuhaler are not spacer-compatible.5
Who needs to use a mask with a spacer?
A tightly fitting face mask is used for anyone who may find it harder to take a breath in through their mouth or cannot seal their lips tightly around the mouthpiece of an inhaler or spacer.2
What’s the big takeaway?
Spacers aren’t just for kids. For adults, they support technique and mean better medicine delivery with fewer adverse effects. Pharmacists play a key role in helping patients, especially adults, understand why using a spacer with pMDI is recommended.
References
- Lung Foundation Australia. Spacer and puffer inhaler device technique fact sheet. 2025. At: https://lungfoundation.com.au/support-resources/resource-hub/spacer-and-puffer-inhaler-device-technique-fact-sheet/
- National Asthma Council Australia. Spacer use and care fact sheet. 2025. At: www.nationalasthma.org.au/living-with-asthma/resources/patients-carers/factsheets/spacer-use-and-care
- Respiratory Therapeutic Guidelines. Inhalational drug delivery devices Melbourne: Therapeutic Guidelines; 2020 (amended 2025). At: https://app.tg.org.au/viewTopic?etgAccess=true&guidelinePage=Respiratory&topicfile=inhalational-drug-delivery-devices&guidelinename=Respiratory&sectionId=toc_d1e208#toc_d1e208
- National Asthma Council Australia. AeroChamber Plus* Flow-Vu* Spacers for pMDIs Information Paper. 2025. At: www.nationalasthma.org.au/living-with-asthma/resources/health-professionals/information-paper/aerochamber-plus-flow-vu-spacers-pmdi
- Asthma Australia. Devices and Techniques. 2025. At: www.asthma.org.au/devices-techniques/puffer-and-spacer/
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[post_content] => PSA presented its 2025 Queensland Excellence Awards in Brisbane over the weekend, recognising five outstanding pharmacists for their commitment to excellence in pharmacy practice.
PSA Queensland President Hannah Knowles MPS acknowledged the outstanding achievements of this year’s award winners and nominees, as well as the continued dedication of pharmacists practising throughout the state.
‘The amazing work pharmacists do in communities across Queensland every day is inspiring and it’s a great privilege to recognise them for what they do to advance the profession,’ she said.
‘On behalf of the PSA, I congratulate the outstanding pharmacists presented with awards and thank them for their commitment to bettering the health of Queenslanders.’
2025 PSA Queensland Pharmacist of the Year – Peter Fairgray MPS
As the Queensland lead for Men’s Health Downunder, pharmacy owner Mr Fairgray supports men in their recovery from prostate surgery, and assists those experiencing Peyronie’s disease, erectile dysfunction, or other conditions affecting the male anatomy.
As one of the first prescribing pharmacists, Mr Fairgray is passionate about safeguarding the public’s health and wellbeing. He is also a committed advocate for the profession, freely giving his time to train and energise fellow pharmacists.
Queensland Early Career Pharmacist of the Year – Gift Sailim MPS
Based in Far North Queensland, Ms Sailim is an accredited full-scope practitioner and forward-thinking innovator in compounding. She is a compassionate, community-focused pharmacist who elevates the profession.
Ms Phillips’ postgraduate research is focused on developing medicines for gestational diabetes, demonstrating her advocacy for safe, effective and equitable medicines use. As an accredited pharmacist, Ms Phillips also regularly liaises with rural and remote communities, improving care by providing medication reviews and collaborating with local clinicians.
Queensland Intern of the Year – Kaden Collier MPS
As a pharmacy intern, Mr Collier has shown exemplary commitment to patient care and medicines safety. Reducing jargon at every opportunity, he keeps medicines education accessible and relevant. Mr Collier strives to understand what’s important to patients and provides patient-centred care that aligns with their goals. When counselling patients, he uses educational resources, demonstrating evidence-based practice by explaining the rationale behind pharmacological and non-pharmacological forms of therapy.
Queensland Lifetime Achievement Award 2025 – Dr Danielle Stowasser MPS
Dr Stowasser has continuously advanced hospital pharmacy through innovation, leadership and tireless commitment. From pioneering safer transitions of care, to shaping national medicines safety and quality use of medicines initiatives, her impact extends across Australia. Dr Stowasser’s devotion, persistence, and vision exemplify the highest standards of the profession. Over her extensive career, Dr Stowasser has contributed to all six action items for change identified in PSA’s Pharmacists in 2030.
Professor James Dare Pharmacy Graduate of the Year – Tahlia O’Hara
Ms O’Hara, pharmacy student at Griffith University, is a passionate advocate for health equity. As a culturally grounded leader, she demonstrates the highest standards of professionalism and ethical conduct. Ms O’Hara is a proud Gumbaynggirr woman whose journey through pharmacy is shaped by her connection to community, culture and care. Her commitment to improving health outcomes for rural and Aboriginal and Torres Strait Islander people is evident in every aspect of her academic, professional and personal life.
[post_title] => Five pharmacists celebrated for excellence in practice
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[post_content] => AI is rapidly transforming healthcare practice, but how will it challenge pharmacists’ identities – which are closely tied to knowledge, intelligence and decision-making expertise?
As AI continues to transform the labour market, the education of pharmacists needs to change, said Dr Louise Schaper, an internationally renowned digital health leader and Fellow of both the International Academy of Health Sciences Informatics and the Australasian Institute of Digital Health.
‘I think many pharmacists believe they just have to learn how to use a new tool and work out how AI is involved in the standard workflow,’ she said. ‘But AI is not just about replacing tasks – it’s about redefining human roles. We need to move away from the focus of rote knowledge towards teaching pharmacists to be wise interpreters of AI who have the human skills to interact with patients and customers.’
Redefining value
Like doctors, pharmacists have traditionally defined their value through deep knowledge and precision, Dr Schaper said. ‘Their sense of identity is closely tied to being an authority on medications.’
[caption id="attachment_30763" align="aligncenter" width="600"] Dr Louise Schaper at PSA25[/caption]
Pharmacists also feel responsible for supporting population health, especially through vaccination programs, harm minimisation services and medicines adherence support.
‘They feel quiet pride in being the unsung hero of the health system, working behind the scenes to prevent medication errors, counsel patients and collaborate with prescribers.’
But with OpenAI aiming for 1 billion users by year’s end, and ChatGPT generating information at speeds far beyond human capacity, these traditional values are under pressure.
‘Pharmacists don’t just practice the profession, they embody it,’ Dr Schaper said. ‘That’s why this disruption feels so personal.’
Building relationships and trust
While AI can process vast amounts of data, Dr Schaper stressed that it cannot deliver what patients most value: human empathy.
‘The opportunity for a pharmacist to be seen as more of a health partner is ripe. Skills such as empathy, ethical reasoning and nuanced clinical judgement will all become increasingly important,’ she said.
‘AI can crunch data, but it's artificial and synthetic. It can't build real touch, real trust, empathy or judgement. A machine can’t tell if it is dealing with a struggling single [parent], or an elderly person on a walker.’
‘The opportunity for a pharmacist to be seen as more of a health partner is ripe. Skills such as empathy, ethical reasoning and nuanced clinical judgement will all become increasingly important.'
Dr Louise Schaper
This, she argued, is where pharmacists must lean in. ‘Pharmacists need to focus on building relationships. Not only do they have years of knowledge and experience, but they can understand patients as human beings.’
For Dr Schaper, this human connection is irreplaceable. ‘AI may allow patients to get information, but they want to bring it to someone with years of knowledge and experience, who understands what they might be going through and who will help them navigate the information.’
Seasoned pharmacists also have an opportunity to guide early-career colleagues in developing critical relational skills, ensuring the profession remains indispensable in an AI-driven healthcare system, she added.
The march of AI
Dr Schaper’s research highlights how major players such as Amazon are disrupting pharmacy. A recent study published in JAMA showed that Amazon’s RxPass has improved medicines adherence and lowered costs. The program lists about 60 generic medicines available to Prime members for a $5 monthly fee. The tech giant is also testing a chatbot and mobile app called Health AI that can answer health and wellness questions, provide common care options and suggest products.
Dr Schaper said Amazon has already registered Amazon Pharmacy in Australia – ‘they did that years ago’.
Meanwhile tools such as ChatGPT are giving patients new ways to ‘Doctor Google’ medicines, while technology companies are developing Agentic AI – systems capable of autonomous action and decision-making with minimal human input. In the future, these tools could undertake treatment planning, remote monitoring, documentation checks and supply chain optimisation, Dr Schaper said.
Despite this, the keynote speaker at PSA25 in August believes pharmacists should stop worrying about being replaced and instead view AI as a co-pilot. She suggested starting to use AI through tools such as ChatGPT to become familiar with what it can do, and transition to using it to reduce the burden of administrative tasks so more time can be spent on customer and business development.
But, she cautioned: ‘This isn’t just about learning a new piece of kit. Pharmacists need to work out their own identity in that process and make it happen, supported by the PSA and education that delivers real-world experience.’
This moment is a reminder of what makes healthcare unique: connection and relationships, Dr Schaper said. ‘Pharmacy, too, has that added entrepreneurial spirit, with many pharmacists running small businesses and innovating to meet community needs. That mix of expertise is exactly what will help the profession adapt and thrive.’
Her message to pharmacists is clear: think about these changes now and make sure you’re ready to embrace them.
[post_title] => Redefining identity in the age of AI
[post_excerpt] => AI is transforming healthcare, but how will it challenge pharmacists’ identities, which are closely tied to intelligence and decision-making?
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[post_content] => The Australian Technical Advisory Group on Immunisation (ATAGI) 2025 statement paints a mixed picture.
While Australia has made important gains with new vaccines and national immunisation reforms, rising cases of pertussis, measles and mpox reveal how fragile protection can be when coverage falters.
Australian Pharmacist explores where progress has been made and where urgent focus is required.
1. Vaccination rates are declining across the board
An ongoing decline in vaccination rates has been identified among all children, adolescents and adults. The steepest and most troubling drop is in childhood vaccination rates at 12 months of age – reducing 3.2 percentage points since 2020. Coverage for children aged 24 months has also dipped below 90% for the first time since 2016. Coverage at 60 months is the highest milestone (92.7%) – indicating that catch-up vaccination is occurring.
Adolescent human papillomavirus (HPV) vaccination rates are also on a downward trend, sitting well below the 90% target at 81.1% in females and 77.9% in males for at least one dose of the vaccine at 15 years of age. Concerningly, the rates are even lower among Aboriginal and Torres Strait Islander people, sitting at 76.7% in females and 69.2% in males.
Uptake of COVID-19 vaccines fell sharply in 2024 across all adult age groups, with only a fraction (2.3%) of younger adults aged 18 to <50 receiving at least one dose of the vaccine. Among those most vulnerable to severe complications, patients aged 75 and older, the vaccination rate dropped from 52.3% to 36.5%.
ATAGI will track declining coverage for selected vaccines to inform additional control strategies, and monitor the effects of schedule changes on coverage and disease – such as the shift to a 1-dose HPV schedule in 2023.
2. Australia’s RSV vaccination campaign is world leading
In 2024, Australia became the first country to put a combined maternal and infant respiratory syncytial virus (RSV) immunisation program in place. Pregnant women were given free access to Abrysvo under the National Immunisation Program (NIP)
from 28 weeks gestation ahead of the 2025 RSV season. Monoclonal antibody nirsevimab is funded for infants under various state and territory arrangements to ensure protection for at-risk infants and/or those whose mother did not receive the vaccine during pregnancy.
These arrangements include:
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Australian Pharmacist is the official journal for Pharmaceutical Society of Australia Ltd.
