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[post_content] => Pharmacist scope of practice is expanding at a rapid rate. With more services, training courses and learning opportunities on offer – it can be difficult to know which direction to choose.
Australian Pharmacist spoke with Bridget Totterman MPS – multi-pharmacy owner and PSA Board Director – about how she’s paving her own path to become a pharmacist prescriber.
Tell us about your journey to becoming a prescribing pharmacist.
It’s still ongoing! I’m currently enrolled in PSA’s Pharmacist Prescribing Scope of Practice Training Program – which is in-depth, and certainly challenging, but in a good way.
I chose the PSA course because it’s self-paced and the team is so supportive. I know PSA will continue to support me through the implementation of new services, and beyond.
The training has two arms – a prescribing and clinical practice training program.
The prescribing component involves theory-based learning focused on the prescribing cycle, including information gathering, clinical decision making, communicating decisions to patients and other healthcare professionals and reviewing those decisions.
Meanwhile, the clinical component focuses on differential diagnosis. While we learn about that at uni, the clinical training takes a more rigorous approach. It reminds us of the step-by-step process, practical implications and alternative explanations for each symptom.
Even if you’re 99% confident in a patient’s diagnosis, it’s great to challenge yourself and think about what else it could be. This helps to build confidence in the diagnosis and offer the appropriate treatment plan. It also highlights red flags for certain conditions and reiterates the need for referral in these cases – ensuring we are always working as part of a broader healthcare team in the best interests of the patient.
Are you offering expanded services in your pharmacies?
Some of our pharmacists have completed the training and are already practicing as prescribing pharmacists.
As of 1 July 2025, the Queensland pharmacy prescribing pilots became permanent for listed acute conditions and medication management services, such as therapeutic substitution and adaptation, and PBS Continued Dispensing Arrangements. So appropriately trained pharmacists can prescribe hormonal contraception and medicines for a raft of acute conditions, such as ear infections and skin conditions. They can also prescribe and administer travel vaccines and provide smoking cessation and weight management services.
If someone comes into the pharmacy with shingles, our trained pharmacists can now prescribe the right treatment for the patient. We all know time is of the essence when it comes to antivirals, and if patients have to wait to see their GP, they may miss the window where treatment is effective.
What impact has this had on patients and staff?
Patients have always found pharmacy convenient. Every day of the week, patients can walk in and speak to a trained healthcare professional – no appointment needed. With expanded scope and the ability to prescribe more medicines, we now have more tools in our belt to provide quality healthcare solutions to our patients in a timely manner.
It's also great for pharmacists’ professional satisfaction. We had a team meeting at one of my pharmacies last week, and the whole team was so excited to get behind the prescribing pharmacists so we can all help patients access the healthcare they need in a timely way.
Our amazing pharmacy assistants have also jumped on board and are of vital assistance in triaging patients and letting them know care is available. It lifts everyone's confidence and reminds us why we love this profession and why we chose pharmacy in the first place – to help patients.
What would you say to pharmacists apprehensive about prescribing?
Come to PSA25! Listen to the speakers on the scope of practice panels and talk to people offering these services from different states and territories.
Back in 2014, I was lucky enough to be one of the first pharmacists to participate in the Queensland Pharmacist Immunisation Pilot, allowing us to administer flu vaccines to patients.
At the time, I had pharmacists working for me who said, ‘I’ll never be able to vaccinate. I couldn't imagine putting a needle in someone’s arm’. But now they are smashing out vaccinations. While it’s normal to be hesitant, remember that PSA has a long history of supporting pharmacists every step of the way, wherever your scope of practice takes you.
You don't have to see the whole staircase, just take the first step. And if you’re comfortable, the next step. Who knows where it'll take you.
Which aspect of scope of practice expansion excites you the most?
Helping more people, more quickly. It’s disheartening when red tape gets in the way – like when a mum walks into the pharmacy at 10:00 pm on a Friday with a sick child, no access to a GP, and you’re limited in your ability to help.
Hopefully, scope of practice expansion will help to expand the workforce by attracting more pharmacists to our profession. And if we're all doing more, that should help to improve the healthcare access crisis we're experiencing at the moment.
What services are you keen to see pharmacists branch into?
Preventative care. I think we can have a huge impact on patients’ lives through weight management and smoking cessation. We chat to people all day, every day. While they may feel uncomfortable discussing their weight in other healthcare settings, speaking with the friendly pharmacist they've seen every week for the past 20 years might put them more at ease.
Where do you see scope of practice going nationally?
I'm hoping it will be a domino effect. I don't want to see resources wasted with people trying to reinvent the wheel. Other states and other jurisdictions should adopt guidelines and protocols that have been proven to work. We need consistency across the country, and while that may take time, we should aim to make the process as seamless as possible. Let's just take what works and roll it out.
What scope of practice sessions or panels are you excited to see at PSA25?
There's so many. I always look forward to hearing from Penny Shakespeare, Deputy Secretary for Health Resourcing at the Department of Health, Disability and Ageing – who's participating in the first Policy Panel on Friday morning (1 August).
Professor Bruce Warner, Honorary Professor of Pharmacy Policy and Practice at theUniversity of Nottingham in the UK, will also be sharing his experiences from an international perspective. I love hearing from people who are actually practicing at full scope.
Pharmacists enhancing Palliative Care across the Health Neighbourhood is another session I hope pharmacists will go along to. Now that PSA’s ASPIRE Palliative Care Foundation Training Program is freely available, pharmacists interested in that field make such a difference in people's lives.
Why is it important to connect with other pharmacists at industry events like PSA25?
To connect with others in our profession. Who knows, you might meet your next employer or someone you want to go into business with. You might even end up with a lifelong mentor or a mentee. It's all about connection, positivity and uplifting each other.
Learn more about expanding your scope of practice from Bridget Totterman and others at PSA25, held in Sydney from 1–3 August. Register here to attend.
[post_title] => Taking the first steps into pharmacist prescribing
[post_excerpt] => Any pharmacist can become a pharmacist prescriber, according to this expert. Here’s how to forge your own path.
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[post_content] => A practical workflow for cancelling tokens, updating profiles and preventing repeat-token errors at every dispense.
Electronic prescriptions are safe, secure and generally convenient for patients and
health practitioners.1 This convenience largely stems from the rapid transfer of
prescriptions and their digital tokens without the need for a physical paper
prescription.
This transfer is so fast there’s often no lag between a dispensing label being printed
and the patient receiving a new repeat token on their phone via SMS. So what
happens if that repeat is sent to the wrong number?
What happens if a pharmacy sends a token to the wrong phone number?
The wrong person will receive the token. While the design of tokens (no name,
limited information) limits the likelihood of a privacy breach, it provides the recipient
with unauthorised access to the prescription (and therefore unauthorised access to
the prescribed medicine).
What can cause the token to be associated with the wrong phone number?
A person’s phone numbers in dispensing software may be incorrect when:
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[post_content] => The Australian Health Practitioner Regulation Agency (AHPRA) has cracked down on medicinal cannabis, with new guidance to tighten up the rules and put practitioners ‘on notice’.
Poor prescribing practices have placed patients at significant harm, with AHPRA stepping in to remind prescribers and dispensers that medicinal cannabis should be treated as any other Controlled Drug (Schedule 8 medicine).
‘We don’t prescribe opioids to every patient who asks for them, and medicinal cannabis is no different,’ said Medical Board of Australia Chair, Dr Susan O’Dwyer. ‘Patient demand is no indicator of clinical need.’
AHPRA has already taken action against 57 medical practitioners, pharmacists and nurses over medicinal cannabis prescribing practices, with AHPRA CEO Justin Untersteiner confirming that the regulator is currently investigating 60 more.
Australian Pharmacist investigates the issue and pharmacists' obligations going forward.
Booming business, bad practice
Demand for medicinal cannabis has grown significantly in recent years. Australians spent approximately $402 million on medicinal cannabis in the first half of 2024, nearly matching the $448 million spent in all of 2023.
This surge in demand has led to a significant upswing in prescribing, with APHRA identifying eight practitioners who issued more than 10,000 scripts over a 6-month, and one who appears to have issued more than 17,000 scripts.
Nearly all medicinal cannabis products are unapproved Schedule 8 medicines, meaning prescribers must use the Special Access Scheme or Authorised Prescriber pathway to prescribe them.
But the development of closed loop arrangements, where medicinal cannabis is prescribed via telehealth appointments, has meant that the required level of scrutiny and investigation by prescribing doctors has perhaps not been conducted, said PSA National Vice President and Pharmacy Council of New South Wales Board Member Caroline Diamantis FPS.
[caption id="attachment_24130" align="alignright" width="267"]
Caroline Diamantis FPS[/caption]
‘Prescribers need to assess if there is a therapeutic need for the prescription and ensure they've developed appropriate management plans.’
AHPRA has said that poor professional standards have been applied, particularly around the volume of medicinal cannabis being prescribed and dispensed.
‘They are looking for stronger safeguards around prescribing, real-time prescription monitoring (RTPM) and S8 controls – prioritising therapeutic need over commercial convenience,’ Ms Diamantis said.
The other concern is around various business models that have been ‘conveniently’ created around the demand for medicinal cannabis.
‘AHPRA’s concern is that the prescriber and dispenser obligations for therapeutic suitability have been overlooked,’ she added.
Part and parcel of this new business model is the delivery service for medicinal cannabis adopted by some pharmacists.
‘The very real concern is there's minimal human contact,’ she said. ‘The patient does not have an opportunity to speak with the dispensing pharmacist about any concerns or questions.’
A real danger for patients
Medicinal cannabis comes in various dosage formulations with various levels of activity including gummies, tinctures or vaporisers.
Patients can sometimes walk away with several different dose forms without prescribers investigating their:
‘It’s illegal in NSW to dispense an S8 unregistered item on a fax or email. YOu either need a token or a real paper script.' CAROLINE DIAMANTIS FPSHowever, pharmacists should also be aware there may be gaps in these records. While all electronic prescriptions and computer-generated paper scripts with an eScript barcode will automatically be recorded in RTPM as unapproved therapeutic goods, human coding errors mean sometimes medicinal cannabis prescription or dispense events are not visible. Other reasons the script may not be visible include:
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[post_content] => Endometriosis, affecting approximately one in seven Australian women, remains under-recognised, under-funded and misunderstood.
Despite the profound impact endometriosis has on health and wellbeing, its diagnosis and management is complex – with an average of 6–8 years between the onset of symptoms and diagnosis.
‘This delay is where pharmacists have a crucial role in recognising the symptoms of endometriosis and referring women promptly for diagnosis and treatment,’ said Grace Wong, Medication Safety Pharmacist at The Royal Women's Hospital – who will be leading a session on Championing change for endometriosis care at PSA25 next month.
Why does endometriosis take so long to diagnose?
There are several interrelated factors at play. Historically, a definitive diagnosis of endometriosis required laparoscopic surgery with histopathological confirmation.
But the limited availability of trained gynaecologists to perform these procedures has created a bottleneck in timely diagnosis.
Additionally, the variable and often non-specific nature of endometriosis symptoms – such as chronic pelvic pain, fatigue, dysmenorrhea, cyclical hematuria, dysuria and gastrointestinal disturbances – can lead to misdiagnosis of other conditions such as irritable bowel syndrome.
Patients experiencing chronic pelvic or abdominal pain may present repeatedly for symptom relief, with opioids or high-dose non-steroidal anti-inflammatory drugs (NSAIDs) often supplied without further investigation into the underlying cause. This pattern not only delays appropriate diagnosis but also increases the risk of adverse effects and medicine overuse.
Societal stigmas surrounding menstruation can lead many to normalise menstrual pain, delaying medical attention.
‘Removing stigma and making women feel confident and comfortable to speak to their pharmacist for advice is something pharmacists and pharmacy support staff can continue to improve,’ Wong said.
When should endometriosis be suspected?
Endometriosis should be considered in anyone of reproductive age presenting with persistent pelvic pain – especially when it’s acyclical, unresponsive to first-line treatments, or associated with other gynaecological symptoms such as dyspareunia (painful intercourse) or dysmenorrhoea.
Atypical symptoms of endometriosis include:
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[post_content] => On 1 July 2025, new vaping standards came into force for all therapeutic vaping products for smoking cessation and nicotine dependence.
The Therapeutic Goods Administration's (TGA’s) strengthened standards, designed to reduce harm from vape use, are the culmination of the national vaping reforms, said PSA Project Manager Nikita Dalla Venezia, who worked closely on the PSA’s Professional practice guidelines for pharmacists: nicotine dependence support.
‘Because the changes were fairly substantial, my understanding is that they were staggered,’ she said. ‘This is just the next step of that comprehensive approach to mitigating risk for people who use therapeutic vapes.’
The principal purpose of the reforms is to minimise youth uptake of vaping – an objective that, according to the Cancer Council’s iterative Generation Vape study, appears to be succeeding.
‘In Wave 7 of the study, which came out after the reforms were introduced, over 50% of youths said they would decline a vape if offered one from a friend, which is a substantial increase from Wave 2 data (less than 40%) that was collected prior to the reforms,’ Ms Dalla Venezia said.
What key changes are introduced in the updated standards?
Changes to the packaging, labelling and design of vaping products have been introduced.
Vaping devices and accessories now need to appear as therapeutic products to reduce their appeal for recreational use among both adolescents and adults, Ms Dalla Venezia said.
‘The packaging needs to be plain, and the design has to be simple with very limited colours,’ she said.
New labelling, usage instructions and information leaflets are also required, along with name restrictions.
‘The permitted ingredients have changed, to now only include nicotine, propylene glycol glycerol, and water,’ she said. ‘And the only flavours allowed are mint, menthol or tobacco.’
Vaping devices and accessories must also meet stricter standards for:
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[post_content] => Pharmacist scope of practice is expanding at a rapid rate. With more services, training courses and learning opportunities on offer – it can be difficult to know which direction to choose.
Australian Pharmacist spoke with Bridget Totterman MPS – multi-pharmacy owner and PSA Board Director – about how she’s paving her own path to become a pharmacist prescriber.
Tell us about your journey to becoming a prescribing pharmacist.
It’s still ongoing! I’m currently enrolled in PSA’s Pharmacist Prescribing Scope of Practice Training Program – which is in-depth, and certainly challenging, but in a good way.
I chose the PSA course because it’s self-paced and the team is so supportive. I know PSA will continue to support me through the implementation of new services, and beyond.
The training has two arms – a prescribing and clinical practice training program.
The prescribing component involves theory-based learning focused on the prescribing cycle, including information gathering, clinical decision making, communicating decisions to patients and other healthcare professionals and reviewing those decisions.
Meanwhile, the clinical component focuses on differential diagnosis. While we learn about that at uni, the clinical training takes a more rigorous approach. It reminds us of the step-by-step process, practical implications and alternative explanations for each symptom.
Even if you’re 99% confident in a patient’s diagnosis, it’s great to challenge yourself and think about what else it could be. This helps to build confidence in the diagnosis and offer the appropriate treatment plan. It also highlights red flags for certain conditions and reiterates the need for referral in these cases – ensuring we are always working as part of a broader healthcare team in the best interests of the patient.
Are you offering expanded services in your pharmacies?
Some of our pharmacists have completed the training and are already practicing as prescribing pharmacists.
As of 1 July 2025, the Queensland pharmacy prescribing pilots became permanent for listed acute conditions and medication management services, such as therapeutic substitution and adaptation, and PBS Continued Dispensing Arrangements. So appropriately trained pharmacists can prescribe hormonal contraception and medicines for a raft of acute conditions, such as ear infections and skin conditions. They can also prescribe and administer travel vaccines and provide smoking cessation and weight management services.
If someone comes into the pharmacy with shingles, our trained pharmacists can now prescribe the right treatment for the patient. We all know time is of the essence when it comes to antivirals, and if patients have to wait to see their GP, they may miss the window where treatment is effective.
What impact has this had on patients and staff?
Patients have always found pharmacy convenient. Every day of the week, patients can walk in and speak to a trained healthcare professional – no appointment needed. With expanded scope and the ability to prescribe more medicines, we now have more tools in our belt to provide quality healthcare solutions to our patients in a timely manner.
It's also great for pharmacists’ professional satisfaction. We had a team meeting at one of my pharmacies last week, and the whole team was so excited to get behind the prescribing pharmacists so we can all help patients access the healthcare they need in a timely way.
Our amazing pharmacy assistants have also jumped on board and are of vital assistance in triaging patients and letting them know care is available. It lifts everyone's confidence and reminds us why we love this profession and why we chose pharmacy in the first place – to help patients.
What would you say to pharmacists apprehensive about prescribing?
Come to PSA25! Listen to the speakers on the scope of practice panels and talk to people offering these services from different states and territories.
Back in 2014, I was lucky enough to be one of the first pharmacists to participate in the Queensland Pharmacist Immunisation Pilot, allowing us to administer flu vaccines to patients.
At the time, I had pharmacists working for me who said, ‘I’ll never be able to vaccinate. I couldn't imagine putting a needle in someone’s arm’. But now they are smashing out vaccinations. While it’s normal to be hesitant, remember that PSA has a long history of supporting pharmacists every step of the way, wherever your scope of practice takes you.
You don't have to see the whole staircase, just take the first step. And if you’re comfortable, the next step. Who knows where it'll take you.
Which aspect of scope of practice expansion excites you the most?
Helping more people, more quickly. It’s disheartening when red tape gets in the way – like when a mum walks into the pharmacy at 10:00 pm on a Friday with a sick child, no access to a GP, and you’re limited in your ability to help.
Hopefully, scope of practice expansion will help to expand the workforce by attracting more pharmacists to our profession. And if we're all doing more, that should help to improve the healthcare access crisis we're experiencing at the moment.
What services are you keen to see pharmacists branch into?
Preventative care. I think we can have a huge impact on patients’ lives through weight management and smoking cessation. We chat to people all day, every day. While they may feel uncomfortable discussing their weight in other healthcare settings, speaking with the friendly pharmacist they've seen every week for the past 20 years might put them more at ease.
Where do you see scope of practice going nationally?
I'm hoping it will be a domino effect. I don't want to see resources wasted with people trying to reinvent the wheel. Other states and other jurisdictions should adopt guidelines and protocols that have been proven to work. We need consistency across the country, and while that may take time, we should aim to make the process as seamless as possible. Let's just take what works and roll it out.
What scope of practice sessions or panels are you excited to see at PSA25?
There's so many. I always look forward to hearing from Penny Shakespeare, Deputy Secretary for Health Resourcing at the Department of Health, Disability and Ageing – who's participating in the first Policy Panel on Friday morning (1 August).
Professor Bruce Warner, Honorary Professor of Pharmacy Policy and Practice at theUniversity of Nottingham in the UK, will also be sharing his experiences from an international perspective. I love hearing from people who are actually practicing at full scope.
Pharmacists enhancing Palliative Care across the Health Neighbourhood is another session I hope pharmacists will go along to. Now that PSA’s ASPIRE Palliative Care Foundation Training Program is freely available, pharmacists interested in that field make such a difference in people's lives.
Why is it important to connect with other pharmacists at industry events like PSA25?
To connect with others in our profession. Who knows, you might meet your next employer or someone you want to go into business with. You might even end up with a lifelong mentor or a mentee. It's all about connection, positivity and uplifting each other.
Learn more about expanding your scope of practice from Bridget Totterman and others at PSA25, held in Sydney from 1–3 August. Register here to attend.
[post_title] => Taking the first steps into pharmacist prescribing
[post_excerpt] => Any pharmacist can become a pharmacist prescriber, according to this expert. Here’s how to forge your own path.
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[post_content] => A practical workflow for cancelling tokens, updating profiles and preventing repeat-token errors at every dispense.
Electronic prescriptions are safe, secure and generally convenient for patients and
health practitioners.1 This convenience largely stems from the rapid transfer of
prescriptions and their digital tokens without the need for a physical paper
prescription.
This transfer is so fast there’s often no lag between a dispensing label being printed
and the patient receiving a new repeat token on their phone via SMS. So what
happens if that repeat is sent to the wrong number?
What happens if a pharmacy sends a token to the wrong phone number?
The wrong person will receive the token. While the design of tokens (no name,
limited information) limits the likelihood of a privacy breach, it provides the recipient
with unauthorised access to the prescription (and therefore unauthorised access to
the prescribed medicine).
What can cause the token to be associated with the wrong phone number?
A person’s phone numbers in dispensing software may be incorrect when:
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[post_content] => The Australian Health Practitioner Regulation Agency (AHPRA) has cracked down on medicinal cannabis, with new guidance to tighten up the rules and put practitioners ‘on notice’.
Poor prescribing practices have placed patients at significant harm, with AHPRA stepping in to remind prescribers and dispensers that medicinal cannabis should be treated as any other Controlled Drug (Schedule 8 medicine).
‘We don’t prescribe opioids to every patient who asks for them, and medicinal cannabis is no different,’ said Medical Board of Australia Chair, Dr Susan O’Dwyer. ‘Patient demand is no indicator of clinical need.’
AHPRA has already taken action against 57 medical practitioners, pharmacists and nurses over medicinal cannabis prescribing practices, with AHPRA CEO Justin Untersteiner confirming that the regulator is currently investigating 60 more.
Australian Pharmacist investigates the issue and pharmacists' obligations going forward.
Booming business, bad practice
Demand for medicinal cannabis has grown significantly in recent years. Australians spent approximately $402 million on medicinal cannabis in the first half of 2024, nearly matching the $448 million spent in all of 2023.
This surge in demand has led to a significant upswing in prescribing, with APHRA identifying eight practitioners who issued more than 10,000 scripts over a 6-month, and one who appears to have issued more than 17,000 scripts.
Nearly all medicinal cannabis products are unapproved Schedule 8 medicines, meaning prescribers must use the Special Access Scheme or Authorised Prescriber pathway to prescribe them.
But the development of closed loop arrangements, where medicinal cannabis is prescribed via telehealth appointments, has meant that the required level of scrutiny and investigation by prescribing doctors has perhaps not been conducted, said PSA National Vice President and Pharmacy Council of New South Wales Board Member Caroline Diamantis FPS.
[caption id="attachment_24130" align="alignright" width="267"] Caroline Diamantis FPS[/caption]
‘Prescribers need to assess if there is a therapeutic need for the prescription and ensure they've developed appropriate management plans.’
AHPRA has said that poor professional standards have been applied, particularly around the volume of medicinal cannabis being prescribed and dispensed.
‘They are looking for stronger safeguards around prescribing, real-time prescription monitoring (RTPM) and S8 controls – prioritising therapeutic need over commercial convenience,’ Ms Diamantis said.
The other concern is around various business models that have been ‘conveniently’ created around the demand for medicinal cannabis.
‘AHPRA’s concern is that the prescriber and dispenser obligations for therapeutic suitability have been overlooked,’ she added.
Part and parcel of this new business model is the delivery service for medicinal cannabis adopted by some pharmacists.
‘The very real concern is there's minimal human contact,’ she said. ‘The patient does not have an opportunity to speak with the dispensing pharmacist about any concerns or questions.’
A real danger for patients
Medicinal cannabis comes in various dosage formulations with various levels of activity including gummies, tinctures or vaporisers.
Patients can sometimes walk away with several different dose forms without prescribers investigating their:
‘It’s illegal in NSW to dispense an S8 unregistered item on a fax or email. YOu either need a token or a real paper script.' CAROLINE DIAMANTIS FPSHowever, pharmacists should also be aware there may be gaps in these records. While all electronic prescriptions and computer-generated paper scripts with an eScript barcode will automatically be recorded in RTPM as unapproved therapeutic goods, human coding errors mean sometimes medicinal cannabis prescription or dispense events are not visible. Other reasons the script may not be visible include:
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[post_content] => Endometriosis, affecting approximately one in seven Australian women, remains under-recognised, under-funded and misunderstood.
Despite the profound impact endometriosis has on health and wellbeing, its diagnosis and management is complex – with an average of 6–8 years between the onset of symptoms and diagnosis.
‘This delay is where pharmacists have a crucial role in recognising the symptoms of endometriosis and referring women promptly for diagnosis and treatment,’ said Grace Wong, Medication Safety Pharmacist at The Royal Women's Hospital – who will be leading a session on Championing change for endometriosis care at PSA25 next month.
Why does endometriosis take so long to diagnose?
There are several interrelated factors at play. Historically, a definitive diagnosis of endometriosis required laparoscopic surgery with histopathological confirmation.
But the limited availability of trained gynaecologists to perform these procedures has created a bottleneck in timely diagnosis.
Additionally, the variable and often non-specific nature of endometriosis symptoms – such as chronic pelvic pain, fatigue, dysmenorrhea, cyclical hematuria, dysuria and gastrointestinal disturbances – can lead to misdiagnosis of other conditions such as irritable bowel syndrome.
Patients experiencing chronic pelvic or abdominal pain may present repeatedly for symptom relief, with opioids or high-dose non-steroidal anti-inflammatory drugs (NSAIDs) often supplied without further investigation into the underlying cause. This pattern not only delays appropriate diagnosis but also increases the risk of adverse effects and medicine overuse.
Societal stigmas surrounding menstruation can lead many to normalise menstrual pain, delaying medical attention.
‘Removing stigma and making women feel confident and comfortable to speak to their pharmacist for advice is something pharmacists and pharmacy support staff can continue to improve,’ Wong said.
When should endometriosis be suspected?
Endometriosis should be considered in anyone of reproductive age presenting with persistent pelvic pain – especially when it’s acyclical, unresponsive to first-line treatments, or associated with other gynaecological symptoms such as dyspareunia (painful intercourse) or dysmenorrhoea.
Atypical symptoms of endometriosis include:
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[post_date] => 2025-07-07 12:34:12
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[post_content] => On 1 July 2025, new vaping standards came into force for all therapeutic vaping products for smoking cessation and nicotine dependence.
The Therapeutic Goods Administration's (TGA’s) strengthened standards, designed to reduce harm from vape use, are the culmination of the national vaping reforms, said PSA Project Manager Nikita Dalla Venezia, who worked closely on the PSA’s Professional practice guidelines for pharmacists: nicotine dependence support.
‘Because the changes were fairly substantial, my understanding is that they were staggered,’ she said. ‘This is just the next step of that comprehensive approach to mitigating risk for people who use therapeutic vapes.’
The principal purpose of the reforms is to minimise youth uptake of vaping – an objective that, according to the Cancer Council’s iterative Generation Vape study, appears to be succeeding.
‘In Wave 7 of the study, which came out after the reforms were introduced, over 50% of youths said they would decline a vape if offered one from a friend, which is a substantial increase from Wave 2 data (less than 40%) that was collected prior to the reforms,’ Ms Dalla Venezia said.
What key changes are introduced in the updated standards?
Changes to the packaging, labelling and design of vaping products have been introduced.
Vaping devices and accessories now need to appear as therapeutic products to reduce their appeal for recreational use among both adolescents and adults, Ms Dalla Venezia said.
‘The packaging needs to be plain, and the design has to be simple with very limited colours,’ she said.
New labelling, usage instructions and information leaflets are also required, along with name restrictions.
‘The permitted ingredients have changed, to now only include nicotine, propylene glycol glycerol, and water,’ she said. ‘And the only flavours allowed are mint, menthol or tobacco.’
Vaping devices and accessories must also meet stricter standards for:
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[post_content] => Pharmacist scope of practice is expanding at a rapid rate. With more services, training courses and learning opportunities on offer – it can be difficult to know which direction to choose.
Australian Pharmacist spoke with Bridget Totterman MPS – multi-pharmacy owner and PSA Board Director – about how she’s paving her own path to become a pharmacist prescriber.
Tell us about your journey to becoming a prescribing pharmacist.
It’s still ongoing! I’m currently enrolled in PSA’s Pharmacist Prescribing Scope of Practice Training Program – which is in-depth, and certainly challenging, but in a good way.
I chose the PSA course because it’s self-paced and the team is so supportive. I know PSA will continue to support me through the implementation of new services, and beyond.
The training has two arms – a prescribing and clinical practice training program.
The prescribing component involves theory-based learning focused on the prescribing cycle, including information gathering, clinical decision making, communicating decisions to patients and other healthcare professionals and reviewing those decisions.
Meanwhile, the clinical component focuses on differential diagnosis. While we learn about that at uni, the clinical training takes a more rigorous approach. It reminds us of the step-by-step process, practical implications and alternative explanations for each symptom.
Even if you’re 99% confident in a patient’s diagnosis, it’s great to challenge yourself and think about what else it could be. This helps to build confidence in the diagnosis and offer the appropriate treatment plan. It also highlights red flags for certain conditions and reiterates the need for referral in these cases – ensuring we are always working as part of a broader healthcare team in the best interests of the patient.
Are you offering expanded services in your pharmacies?
Some of our pharmacists have completed the training and are already practicing as prescribing pharmacists.
As of 1 July 2025, the Queensland pharmacy prescribing pilots became permanent for listed acute conditions and medication management services, such as therapeutic substitution and adaptation, and PBS Continued Dispensing Arrangements. So appropriately trained pharmacists can prescribe hormonal contraception and medicines for a raft of acute conditions, such as ear infections and skin conditions. They can also prescribe and administer travel vaccines and provide smoking cessation and weight management services.
If someone comes into the pharmacy with shingles, our trained pharmacists can now prescribe the right treatment for the patient. We all know time is of the essence when it comes to antivirals, and if patients have to wait to see their GP, they may miss the window where treatment is effective.
What impact has this had on patients and staff?
Patients have always found pharmacy convenient. Every day of the week, patients can walk in and speak to a trained healthcare professional – no appointment needed. With expanded scope and the ability to prescribe more medicines, we now have more tools in our belt to provide quality healthcare solutions to our patients in a timely manner.
It's also great for pharmacists’ professional satisfaction. We had a team meeting at one of my pharmacies last week, and the whole team was so excited to get behind the prescribing pharmacists so we can all help patients access the healthcare they need in a timely way.
Our amazing pharmacy assistants have also jumped on board and are of vital assistance in triaging patients and letting them know care is available. It lifts everyone's confidence and reminds us why we love this profession and why we chose pharmacy in the first place – to help patients.
What would you say to pharmacists apprehensive about prescribing?
Come to PSA25! Listen to the speakers on the scope of practice panels and talk to people offering these services from different states and territories.
Back in 2014, I was lucky enough to be one of the first pharmacists to participate in the Queensland Pharmacist Immunisation Pilot, allowing us to administer flu vaccines to patients.
At the time, I had pharmacists working for me who said, ‘I’ll never be able to vaccinate. I couldn't imagine putting a needle in someone’s arm’. But now they are smashing out vaccinations. While it’s normal to be hesitant, remember that PSA has a long history of supporting pharmacists every step of the way, wherever your scope of practice takes you.
You don't have to see the whole staircase, just take the first step. And if you’re comfortable, the next step. Who knows where it'll take you.
Which aspect of scope of practice expansion excites you the most?
Helping more people, more quickly. It’s disheartening when red tape gets in the way – like when a mum walks into the pharmacy at 10:00 pm on a Friday with a sick child, no access to a GP, and you’re limited in your ability to help.
Hopefully, scope of practice expansion will help to expand the workforce by attracting more pharmacists to our profession. And if we're all doing more, that should help to improve the healthcare access crisis we're experiencing at the moment.
What services are you keen to see pharmacists branch into?
Preventative care. I think we can have a huge impact on patients’ lives through weight management and smoking cessation. We chat to people all day, every day. While they may feel uncomfortable discussing their weight in other healthcare settings, speaking with the friendly pharmacist they've seen every week for the past 20 years might put them more at ease.
Where do you see scope of practice going nationally?
I'm hoping it will be a domino effect. I don't want to see resources wasted with people trying to reinvent the wheel. Other states and other jurisdictions should adopt guidelines and protocols that have been proven to work. We need consistency across the country, and while that may take time, we should aim to make the process as seamless as possible. Let's just take what works and roll it out.
What scope of practice sessions or panels are you excited to see at PSA25?
There's so many. I always look forward to hearing from Penny Shakespeare, Deputy Secretary for Health Resourcing at the Department of Health, Disability and Ageing – who's participating in the first Policy Panel on Friday morning (1 August).
Professor Bruce Warner, Honorary Professor of Pharmacy Policy and Practice at theUniversity of Nottingham in the UK, will also be sharing his experiences from an international perspective. I love hearing from people who are actually practicing at full scope.
Pharmacists enhancing Palliative Care across the Health Neighbourhood is another session I hope pharmacists will go along to. Now that PSA’s ASPIRE Palliative Care Foundation Training Program is freely available, pharmacists interested in that field make such a difference in people's lives.
Why is it important to connect with other pharmacists at industry events like PSA25?
To connect with others in our profession. Who knows, you might meet your next employer or someone you want to go into business with. You might even end up with a lifelong mentor or a mentee. It's all about connection, positivity and uplifting each other.
Learn more about expanding your scope of practice from Bridget Totterman and others at PSA25, held in Sydney from 1–3 August. Register here to attend.
[post_title] => Taking the first steps into pharmacist prescribing
[post_excerpt] => Any pharmacist can become a pharmacist prescriber, according to this expert. Here’s how to forge your own path.
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[post_content] => A practical workflow for cancelling tokens, updating profiles and preventing repeat-token errors at every dispense.
Electronic prescriptions are safe, secure and generally convenient for patients and
health practitioners.1 This convenience largely stems from the rapid transfer of
prescriptions and their digital tokens without the need for a physical paper
prescription.
This transfer is so fast there’s often no lag between a dispensing label being printed
and the patient receiving a new repeat token on their phone via SMS. So what
happens if that repeat is sent to the wrong number?
What happens if a pharmacy sends a token to the wrong phone number?
The wrong person will receive the token. While the design of tokens (no name,
limited information) limits the likelihood of a privacy breach, it provides the recipient
with unauthorised access to the prescription (and therefore unauthorised access to
the prescribed medicine).
What can cause the token to be associated with the wrong phone number?
A person’s phone numbers in dispensing software may be incorrect when:
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[post_date] => 2025-07-14 09:04:41
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[post_content] => The Australian Health Practitioner Regulation Agency (AHPRA) has cracked down on medicinal cannabis, with new guidance to tighten up the rules and put practitioners ‘on notice’.
Poor prescribing practices have placed patients at significant harm, with AHPRA stepping in to remind prescribers and dispensers that medicinal cannabis should be treated as any other Controlled Drug (Schedule 8 medicine).
‘We don’t prescribe opioids to every patient who asks for them, and medicinal cannabis is no different,’ said Medical Board of Australia Chair, Dr Susan O’Dwyer. ‘Patient demand is no indicator of clinical need.’
AHPRA has already taken action against 57 medical practitioners, pharmacists and nurses over medicinal cannabis prescribing practices, with AHPRA CEO Justin Untersteiner confirming that the regulator is currently investigating 60 more.
Australian Pharmacist investigates the issue and pharmacists' obligations going forward.
Booming business, bad practice
Demand for medicinal cannabis has grown significantly in recent years. Australians spent approximately $402 million on medicinal cannabis in the first half of 2024, nearly matching the $448 million spent in all of 2023.
This surge in demand has led to a significant upswing in prescribing, with APHRA identifying eight practitioners who issued more than 10,000 scripts over a 6-month, and one who appears to have issued more than 17,000 scripts.
Nearly all medicinal cannabis products are unapproved Schedule 8 medicines, meaning prescribers must use the Special Access Scheme or Authorised Prescriber pathway to prescribe them.
But the development of closed loop arrangements, where medicinal cannabis is prescribed via telehealth appointments, has meant that the required level of scrutiny and investigation by prescribing doctors has perhaps not been conducted, said PSA National Vice President and Pharmacy Council of New South Wales Board Member Caroline Diamantis FPS.
[caption id="attachment_24130" align="alignright" width="267"] Caroline Diamantis FPS[/caption]
‘Prescribers need to assess if there is a therapeutic need for the prescription and ensure they've developed appropriate management plans.’
AHPRA has said that poor professional standards have been applied, particularly around the volume of medicinal cannabis being prescribed and dispensed.
‘They are looking for stronger safeguards around prescribing, real-time prescription monitoring (RTPM) and S8 controls – prioritising therapeutic need over commercial convenience,’ Ms Diamantis said.
The other concern is around various business models that have been ‘conveniently’ created around the demand for medicinal cannabis.
‘AHPRA’s concern is that the prescriber and dispenser obligations for therapeutic suitability have been overlooked,’ she added.
Part and parcel of this new business model is the delivery service for medicinal cannabis adopted by some pharmacists.
‘The very real concern is there's minimal human contact,’ she said. ‘The patient does not have an opportunity to speak with the dispensing pharmacist about any concerns or questions.’
A real danger for patients
Medicinal cannabis comes in various dosage formulations with various levels of activity including gummies, tinctures or vaporisers.
Patients can sometimes walk away with several different dose forms without prescribers investigating their:
‘It’s illegal in NSW to dispense an S8 unregistered item on a fax or email. YOu either need a token or a real paper script.' CAROLINE DIAMANTIS FPSHowever, pharmacists should also be aware there may be gaps in these records. While all electronic prescriptions and computer-generated paper scripts with an eScript barcode will automatically be recorded in RTPM as unapproved therapeutic goods, human coding errors mean sometimes medicinal cannabis prescription or dispense events are not visible. Other reasons the script may not be visible include:
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[post_date] => 2025-07-09 10:22:04
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[post_content] => Endometriosis, affecting approximately one in seven Australian women, remains under-recognised, under-funded and misunderstood.
Despite the profound impact endometriosis has on health and wellbeing, its diagnosis and management is complex – with an average of 6–8 years between the onset of symptoms and diagnosis.
‘This delay is where pharmacists have a crucial role in recognising the symptoms of endometriosis and referring women promptly for diagnosis and treatment,’ said Grace Wong, Medication Safety Pharmacist at The Royal Women's Hospital – who will be leading a session on Championing change for endometriosis care at PSA25 next month.
Why does endometriosis take so long to diagnose?
There are several interrelated factors at play. Historically, a definitive diagnosis of endometriosis required laparoscopic surgery with histopathological confirmation.
But the limited availability of trained gynaecologists to perform these procedures has created a bottleneck in timely diagnosis.
Additionally, the variable and often non-specific nature of endometriosis symptoms – such as chronic pelvic pain, fatigue, dysmenorrhea, cyclical hematuria, dysuria and gastrointestinal disturbances – can lead to misdiagnosis of other conditions such as irritable bowel syndrome.
Patients experiencing chronic pelvic or abdominal pain may present repeatedly for symptom relief, with opioids or high-dose non-steroidal anti-inflammatory drugs (NSAIDs) often supplied without further investigation into the underlying cause. This pattern not only delays appropriate diagnosis but also increases the risk of adverse effects and medicine overuse.
Societal stigmas surrounding menstruation can lead many to normalise menstrual pain, delaying medical attention.
‘Removing stigma and making women feel confident and comfortable to speak to their pharmacist for advice is something pharmacists and pharmacy support staff can continue to improve,’ Wong said.
When should endometriosis be suspected?
Endometriosis should be considered in anyone of reproductive age presenting with persistent pelvic pain – especially when it’s acyclical, unresponsive to first-line treatments, or associated with other gynaecological symptoms such as dyspareunia (painful intercourse) or dysmenorrhoea.
Atypical symptoms of endometriosis include:
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[post_content] => On 1 July 2025, new vaping standards came into force for all therapeutic vaping products for smoking cessation and nicotine dependence.
The Therapeutic Goods Administration's (TGA’s) strengthened standards, designed to reduce harm from vape use, are the culmination of the national vaping reforms, said PSA Project Manager Nikita Dalla Venezia, who worked closely on the PSA’s Professional practice guidelines for pharmacists: nicotine dependence support.
‘Because the changes were fairly substantial, my understanding is that they were staggered,’ she said. ‘This is just the next step of that comprehensive approach to mitigating risk for people who use therapeutic vapes.’
The principal purpose of the reforms is to minimise youth uptake of vaping – an objective that, according to the Cancer Council’s iterative Generation Vape study, appears to be succeeding.
‘In Wave 7 of the study, which came out after the reforms were introduced, over 50% of youths said they would decline a vape if offered one from a friend, which is a substantial increase from Wave 2 data (less than 40%) that was collected prior to the reforms,’ Ms Dalla Venezia said.
What key changes are introduced in the updated standards?
Changes to the packaging, labelling and design of vaping products have been introduced.
Vaping devices and accessories now need to appear as therapeutic products to reduce their appeal for recreational use among both adolescents and adults, Ms Dalla Venezia said.
‘The packaging needs to be plain, and the design has to be simple with very limited colours,’ she said.
New labelling, usage instructions and information leaflets are also required, along with name restrictions.
‘The permitted ingredients have changed, to now only include nicotine, propylene glycol glycerol, and water,’ she said. ‘And the only flavours allowed are mint, menthol or tobacco.’
Vaping devices and accessories must also meet stricter standards for:
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[post_content] => Pharmacist scope of practice is expanding at a rapid rate. With more services, training courses and learning opportunities on offer – it can be difficult to know which direction to choose.
Australian Pharmacist spoke with Bridget Totterman MPS – multi-pharmacy owner and PSA Board Director – about how she’s paving her own path to become a pharmacist prescriber.
Tell us about your journey to becoming a prescribing pharmacist.
It’s still ongoing! I’m currently enrolled in PSA’s Pharmacist Prescribing Scope of Practice Training Program – which is in-depth, and certainly challenging, but in a good way.
I chose the PSA course because it’s self-paced and the team is so supportive. I know PSA will continue to support me through the implementation of new services, and beyond.
The training has two arms – a prescribing and clinical practice training program.
The prescribing component involves theory-based learning focused on the prescribing cycle, including information gathering, clinical decision making, communicating decisions to patients and other healthcare professionals and reviewing those decisions.
Meanwhile, the clinical component focuses on differential diagnosis. While we learn about that at uni, the clinical training takes a more rigorous approach. It reminds us of the step-by-step process, practical implications and alternative explanations for each symptom.
Even if you’re 99% confident in a patient’s diagnosis, it’s great to challenge yourself and think about what else it could be. This helps to build confidence in the diagnosis and offer the appropriate treatment plan. It also highlights red flags for certain conditions and reiterates the need for referral in these cases – ensuring we are always working as part of a broader healthcare team in the best interests of the patient.
Are you offering expanded services in your pharmacies?
Some of our pharmacists have completed the training and are already practicing as prescribing pharmacists.
As of 1 July 2025, the Queensland pharmacy prescribing pilots became permanent for listed acute conditions and medication management services, such as therapeutic substitution and adaptation, and PBS Continued Dispensing Arrangements. So appropriately trained pharmacists can prescribe hormonal contraception and medicines for a raft of acute conditions, such as ear infections and skin conditions. They can also prescribe and administer travel vaccines and provide smoking cessation and weight management services.
If someone comes into the pharmacy with shingles, our trained pharmacists can now prescribe the right treatment for the patient. We all know time is of the essence when it comes to antivirals, and if patients have to wait to see their GP, they may miss the window where treatment is effective.
What impact has this had on patients and staff?
Patients have always found pharmacy convenient. Every day of the week, patients can walk in and speak to a trained healthcare professional – no appointment needed. With expanded scope and the ability to prescribe more medicines, we now have more tools in our belt to provide quality healthcare solutions to our patients in a timely manner.
It's also great for pharmacists’ professional satisfaction. We had a team meeting at one of my pharmacies last week, and the whole team was so excited to get behind the prescribing pharmacists so we can all help patients access the healthcare they need in a timely way.
Our amazing pharmacy assistants have also jumped on board and are of vital assistance in triaging patients and letting them know care is available. It lifts everyone's confidence and reminds us why we love this profession and why we chose pharmacy in the first place – to help patients.
What would you say to pharmacists apprehensive about prescribing?
Come to PSA25! Listen to the speakers on the scope of practice panels and talk to people offering these services from different states and territories.
Back in 2014, I was lucky enough to be one of the first pharmacists to participate in the Queensland Pharmacist Immunisation Pilot, allowing us to administer flu vaccines to patients.
At the time, I had pharmacists working for me who said, ‘I’ll never be able to vaccinate. I couldn't imagine putting a needle in someone’s arm’. But now they are smashing out vaccinations. While it’s normal to be hesitant, remember that PSA has a long history of supporting pharmacists every step of the way, wherever your scope of practice takes you.
You don't have to see the whole staircase, just take the first step. And if you’re comfortable, the next step. Who knows where it'll take you.
Which aspect of scope of practice expansion excites you the most?
Helping more people, more quickly. It’s disheartening when red tape gets in the way – like when a mum walks into the pharmacy at 10:00 pm on a Friday with a sick child, no access to a GP, and you’re limited in your ability to help.
Hopefully, scope of practice expansion will help to expand the workforce by attracting more pharmacists to our profession. And if we're all doing more, that should help to improve the healthcare access crisis we're experiencing at the moment.
What services are you keen to see pharmacists branch into?
Preventative care. I think we can have a huge impact on patients’ lives through weight management and smoking cessation. We chat to people all day, every day. While they may feel uncomfortable discussing their weight in other healthcare settings, speaking with the friendly pharmacist they've seen every week for the past 20 years might put them more at ease.
Where do you see scope of practice going nationally?
I'm hoping it will be a domino effect. I don't want to see resources wasted with people trying to reinvent the wheel. Other states and other jurisdictions should adopt guidelines and protocols that have been proven to work. We need consistency across the country, and while that may take time, we should aim to make the process as seamless as possible. Let's just take what works and roll it out.
What scope of practice sessions or panels are you excited to see at PSA25?
There's so many. I always look forward to hearing from Penny Shakespeare, Deputy Secretary for Health Resourcing at the Department of Health, Disability and Ageing – who's participating in the first Policy Panel on Friday morning (1 August).
Professor Bruce Warner, Honorary Professor of Pharmacy Policy and Practice at theUniversity of Nottingham in the UK, will also be sharing his experiences from an international perspective. I love hearing from people who are actually practicing at full scope.
Pharmacists enhancing Palliative Care across the Health Neighbourhood is another session I hope pharmacists will go along to. Now that PSA’s ASPIRE Palliative Care Foundation Training Program is freely available, pharmacists interested in that field make such a difference in people's lives.
Why is it important to connect with other pharmacists at industry events like PSA25?
To connect with others in our profession. Who knows, you might meet your next employer or someone you want to go into business with. You might even end up with a lifelong mentor or a mentee. It's all about connection, positivity and uplifting each other.
Learn more about expanding your scope of practice from Bridget Totterman and others at PSA25, held in Sydney from 1–3 August. Register here to attend.
[post_title] => Taking the first steps into pharmacist prescribing
[post_excerpt] => Any pharmacist can become a pharmacist prescriber, according to this expert. Here’s how to forge your own path.
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[post_content] => A practical workflow for cancelling tokens, updating profiles and preventing repeat-token errors at every dispense.
Electronic prescriptions are safe, secure and generally convenient for patients and
health practitioners.1 This convenience largely stems from the rapid transfer of
prescriptions and their digital tokens without the need for a physical paper
prescription.
This transfer is so fast there’s often no lag between a dispensing label being printed
and the patient receiving a new repeat token on their phone via SMS. So what
happens if that repeat is sent to the wrong number?
What happens if a pharmacy sends a token to the wrong phone number?
The wrong person will receive the token. While the design of tokens (no name,
limited information) limits the likelihood of a privacy breach, it provides the recipient
with unauthorised access to the prescription (and therefore unauthorised access to
the prescribed medicine).
What can cause the token to be associated with the wrong phone number?
A person’s phone numbers in dispensing software may be incorrect when:
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[post_content] => The Australian Health Practitioner Regulation Agency (AHPRA) has cracked down on medicinal cannabis, with new guidance to tighten up the rules and put practitioners ‘on notice’.
Poor prescribing practices have placed patients at significant harm, with AHPRA stepping in to remind prescribers and dispensers that medicinal cannabis should be treated as any other Controlled Drug (Schedule 8 medicine).
‘We don’t prescribe opioids to every patient who asks for them, and medicinal cannabis is no different,’ said Medical Board of Australia Chair, Dr Susan O’Dwyer. ‘Patient demand is no indicator of clinical need.’
AHPRA has already taken action against 57 medical practitioners, pharmacists and nurses over medicinal cannabis prescribing practices, with AHPRA CEO Justin Untersteiner confirming that the regulator is currently investigating 60 more.
Australian Pharmacist investigates the issue and pharmacists' obligations going forward.
Booming business, bad practice
Demand for medicinal cannabis has grown significantly in recent years. Australians spent approximately $402 million on medicinal cannabis in the first half of 2024, nearly matching the $448 million spent in all of 2023.
This surge in demand has led to a significant upswing in prescribing, with APHRA identifying eight practitioners who issued more than 10,000 scripts over a 6-month, and one who appears to have issued more than 17,000 scripts.
Nearly all medicinal cannabis products are unapproved Schedule 8 medicines, meaning prescribers must use the Special Access Scheme or Authorised Prescriber pathway to prescribe them.
But the development of closed loop arrangements, where medicinal cannabis is prescribed via telehealth appointments, has meant that the required level of scrutiny and investigation by prescribing doctors has perhaps not been conducted, said PSA National Vice President and Pharmacy Council of New South Wales Board Member Caroline Diamantis FPS.
[caption id="attachment_24130" align="alignright" width="267"] Caroline Diamantis FPS[/caption]
‘Prescribers need to assess if there is a therapeutic need for the prescription and ensure they've developed appropriate management plans.’
AHPRA has said that poor professional standards have been applied, particularly around the volume of medicinal cannabis being prescribed and dispensed.
‘They are looking for stronger safeguards around prescribing, real-time prescription monitoring (RTPM) and S8 controls – prioritising therapeutic need over commercial convenience,’ Ms Diamantis said.
The other concern is around various business models that have been ‘conveniently’ created around the demand for medicinal cannabis.
‘AHPRA’s concern is that the prescriber and dispenser obligations for therapeutic suitability have been overlooked,’ she added.
Part and parcel of this new business model is the delivery service for medicinal cannabis adopted by some pharmacists.
‘The very real concern is there's minimal human contact,’ she said. ‘The patient does not have an opportunity to speak with the dispensing pharmacist about any concerns or questions.’
A real danger for patients
Medicinal cannabis comes in various dosage formulations with various levels of activity including gummies, tinctures or vaporisers.
Patients can sometimes walk away with several different dose forms without prescribers investigating their:
‘It’s illegal in NSW to dispense an S8 unregistered item on a fax or email. YOu either need a token or a real paper script.' CAROLINE DIAMANTIS FPSHowever, pharmacists should also be aware there may be gaps in these records. While all electronic prescriptions and computer-generated paper scripts with an eScript barcode will automatically be recorded in RTPM as unapproved therapeutic goods, human coding errors mean sometimes medicinal cannabis prescription or dispense events are not visible. Other reasons the script may not be visible include:
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[post_content] => Endometriosis, affecting approximately one in seven Australian women, remains under-recognised, under-funded and misunderstood.
Despite the profound impact endometriosis has on health and wellbeing, its diagnosis and management is complex – with an average of 6–8 years between the onset of symptoms and diagnosis.
‘This delay is where pharmacists have a crucial role in recognising the symptoms of endometriosis and referring women promptly for diagnosis and treatment,’ said Grace Wong, Medication Safety Pharmacist at The Royal Women's Hospital – who will be leading a session on Championing change for endometriosis care at PSA25 next month.
Why does endometriosis take so long to diagnose?
There are several interrelated factors at play. Historically, a definitive diagnosis of endometriosis required laparoscopic surgery with histopathological confirmation.
But the limited availability of trained gynaecologists to perform these procedures has created a bottleneck in timely diagnosis.
Additionally, the variable and often non-specific nature of endometriosis symptoms – such as chronic pelvic pain, fatigue, dysmenorrhea, cyclical hematuria, dysuria and gastrointestinal disturbances – can lead to misdiagnosis of other conditions such as irritable bowel syndrome.
Patients experiencing chronic pelvic or abdominal pain may present repeatedly for symptom relief, with opioids or high-dose non-steroidal anti-inflammatory drugs (NSAIDs) often supplied without further investigation into the underlying cause. This pattern not only delays appropriate diagnosis but also increases the risk of adverse effects and medicine overuse.
Societal stigmas surrounding menstruation can lead many to normalise menstrual pain, delaying medical attention.
‘Removing stigma and making women feel confident and comfortable to speak to their pharmacist for advice is something pharmacists and pharmacy support staff can continue to improve,’ Wong said.
When should endometriosis be suspected?
Endometriosis should be considered in anyone of reproductive age presenting with persistent pelvic pain – especially when it’s acyclical, unresponsive to first-line treatments, or associated with other gynaecological symptoms such as dyspareunia (painful intercourse) or dysmenorrhoea.
Atypical symptoms of endometriosis include:
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[post_content] => On 1 July 2025, new vaping standards came into force for all therapeutic vaping products for smoking cessation and nicotine dependence.
The Therapeutic Goods Administration's (TGA’s) strengthened standards, designed to reduce harm from vape use, are the culmination of the national vaping reforms, said PSA Project Manager Nikita Dalla Venezia, who worked closely on the PSA’s Professional practice guidelines for pharmacists: nicotine dependence support.
‘Because the changes were fairly substantial, my understanding is that they were staggered,’ she said. ‘This is just the next step of that comprehensive approach to mitigating risk for people who use therapeutic vapes.’
The principal purpose of the reforms is to minimise youth uptake of vaping – an objective that, according to the Cancer Council’s iterative Generation Vape study, appears to be succeeding.
‘In Wave 7 of the study, which came out after the reforms were introduced, over 50% of youths said they would decline a vape if offered one from a friend, which is a substantial increase from Wave 2 data (less than 40%) that was collected prior to the reforms,’ Ms Dalla Venezia said.
What key changes are introduced in the updated standards?
Changes to the packaging, labelling and design of vaping products have been introduced.
Vaping devices and accessories now need to appear as therapeutic products to reduce their appeal for recreational use among both adolescents and adults, Ms Dalla Venezia said.
‘The packaging needs to be plain, and the design has to be simple with very limited colours,’ she said.
New labelling, usage instructions and information leaflets are also required, along with name restrictions.
‘The permitted ingredients have changed, to now only include nicotine, propylene glycol glycerol, and water,’ she said. ‘And the only flavours allowed are mint, menthol or tobacco.’
Vaping devices and accessories must also meet stricter standards for:
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Australian Pharmacist is the official journal for Pharmaceutical Society of Australia Ltd.
