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[post_content] => Case scenario
During peak hour, 19-year-old Enzo and his mother arrive to collect a new prescription for melatonin MR 2 mg. The pharmacy is highly stimulating: background music blares, customers converse loudly nearby, staff assist others in a cramped space, and general noise amplifies the chaos. While processing Enzo’s prescription and attempting to deliver verbal instructions, you observe Enzo avoiding eye contact, fidgeting intensely, and appearing overwhelmed, with reduced capacity to process verbal or non-verbal cues due to sensory overload.
Learning objectivesAfter reading this article, pharmacists should be able to:
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Yvette Anderson (she/her) BPharm, MPS, CredPharm (MMR), ANZCAP (MentalHth, Paeds), CPGx, GradCert Autism[/caption]
Neurodevelopmental disorders (NDDs) arise from differences in brain development and typically affect cognition, communication, behaviour and occupational functioning. Common NDDs include attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), referred to as autism in this article, and intellectual developmental disorder (IDD).1 Autism is characterised by persistent social interaction and communication difficulties and restricted behavioural patterns.2 Symptoms begin in early childhood; however, diagnosis can occur at any age.3 Autism affects how the brain processes information, shaping how autistic people see, understand and respond to the world around them, with marked variability in presentation, day-to-day functioning and support needs.3,4
In Australia, autism prevalence has increased due to evolving diagnostic practices and awareness,5 meaning pharmacists now routinely engage with autistic individuals as part of everyday practice.
The challenge and opportunity for pharmacy is to shift from a medical model of crisis response, treatments and cures to a neuro-affirming social model that helps autistic individuals thrive, not just survive.
A neuro-affirming social model conceptualises neurodevelopmental differences as natural variations within human diversity and rejects deficit-based assumptions that frame these differences as disorders.6 Rather than ‘correcting’ individual traits, this approach provides reasonable adjustments while supporting autonomy, community participation and wellbeing, alongside awareness of diagnostic criteria, comorbidities, communication styles, lived realities and the impact of misinformation.6 The shift to a neuro-affirming social model calls for reducing systemic and environmental barriers, while still addressing health needs.6,7
For pharmacists, it means making practice adjustments in the way that the profession engages with and provides support for autistic individuals.
According to the Australian Bureau of Statistics, approximately 290,900 Australians (1.1%) are reported to have had an autism diagnosis in 2022.5 A recent estimate by Autism Spectrum Australia (Aspect) suggested at least 1 in 40 Australians are autistic.7
Rising prevalence reflects improved awareness and diagnostic practices rather than a true increase in incidence, including better recognition in historically underdiagnosed groups such as females and older adults.7 Autism prevalence peaks in children and adolescents, particularly those aged 10–14 years, and is markedly lower in adults, acknowledging limited adult data.5,8,9
Autism prevalence rates may appear to vary among ethnic and cultural groups, reflecting inequities such as access to healthcare, effective communication, diagnostic practices and cultural perceptions.10
Prevalence remains higher in males than females, with 1.6% of males identified compared with 0.7% of females, and the greatest disparity is seen in children aged 5–9 years.5 Autism in females is frequently underdiagnosed, as characteristics may manifest differently, be masked (e.g. forced eye contact, rehearsed social scripts, suppressing stimming or copying peers), or fail to align with historically male-centred diagnostic criteria, leading to misdiagnosis as mood or personality disorders.11,12 Masking may occur due to a desire to fit in, fear of stigma or bullying, previous negative reactions to autistic behaviours, and expectations of how females are ‘supposed’ to behave.12 Increasing awareness of the under-recognition of autism in females and gender-diverse individuals, and the social drivers of masking, is anticipated to influence future prevalence estimates.4,5,11
There is no single cause of autism, and despite extensive research, aetiology remains incompletely understood. Current evidence indicates autism arises from a complex interaction between genetic susceptibility and environmental influences on neurodevelopment.13
Family history is one of the strongest predictors of autism.13,14 Researchers have identified hundreds of genes, with approximately 10–20% of cases associated with rare genetic variants arising from mutations in sperm or egg cells.14 Autism is considered polygenic, meaning overall risk typically reflects the cumulative effect of multiple inherited variants, each contributing a small effect.14
The expression of genetic susceptibility is known to be influenced by prenatal, perinatal and postnatal environmental factors.13 Environmental factors appear most relevant during the prenatal period.14 Modest associations have been reported between autism likelihood and maternal factors such as hypertension, gestational diabetes, obesity, alcohol and substance use, poor antenatal care, and infection or fever during pregnancy.15
Imprecise and inconsistent associations have been reported for folate status, exposure to some air pollutants, and the use of some medicines.15–17 Importantly, these findings are largely derived from observational studies and are subject to confounding. While some prenatal medicine exposures show more consistent associations with autism, there is no clear evidence that associations between autism and other environmental and medicine exposures represent a causal relationship, and any contribution to autism risk remains limited and uncertain.14,17
Autism is diagnosed according to Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) criteria: ‘persistent deficits in social communication and social interaction across multiple contexts’, with the presence of ‘restricted, repetitive patterns of behaviour, interests or activities’.2
‘Symptoms must be present in the early development period’, although they may only become fully apparent later in life.
‘Symptoms cause clinically significant impairment in social, occupational or other important areas of functioning’ and ‘these disturbances are not better explained by IDD’ although both can co-occur.2 The DSM-5-TR also specifies severity levels (1–3) to indicate the degree of support required.2
In Australia, individuals may pursue an autism diagnosis through public or private pathways.18 Both are typically lengthy and necessitate a degree of health literacy and English proficiency. Diagnostic assessments may be conducted by a multidisciplinary team, including paediatricians, psychiatrists, psychologists, speech pathologists and occupational therapists.4 Multiple appointments may be needed, drawing on input from family, carers or teachers.18,19
Barriers to diagnosis include limited awareness of early signs among caregivers and clinicians, long wait times and out-of-pocket costs for specialist assessment, socioeconomic and geographic disparities, and bias in recognising diverse presentations.11,20,21 Limited health literacy and the complexity of navigating multidisciplinary assessments and National Disability Insurance Scheme requirements further impede access.21 In some communities, stigma, fear of labelling, and differing cultural interpretations of behaviour may delay help-seeking.22
A best-practice diagnostic approach should promote cultural safety and sensitivity, acknowledge variations in health literacy, address socioeconomic barriers, and be grounded in person-centred care.
Autism is a spectrum, with each individual having a unique mix of strengths, challenges, interests, needs and way of interacting with the world. Autism advocate Dr Stephen Shore states, ‘If you have met one autistic person, you have met one autistic person’.23
Beyond the core featuresComorbid NDDs, and psychiatric and medical conditions can create significant challenges for autistic individuals in relation to diagnosis, selection of appropriate interventions, medicines and support services.1,24
Comorbid NDDs among autistic individuals include ADHD, developmental coordination disorder (dyspraxia), IDD, and specific learning disorders such as dyslexia, dysgraphia and dyscalculia.25 Psychiatric comorbidities are also prevalent, including anxiety, depression, obsessive-compulsive disorder, and post-traumatic stress disorder.26 These conditions can intensify social and sensory challenges, increase vulnerability to stress, and impair emotional regulation and executive functioning.
Autistic individuals experience higher rates and severity of mental and physical health comorbidities than neurotypical individuals. Neurodivergent mental health outcomes are influenced by the interaction between individual differences and environmental and societal factors.25–28 Diagnostic overshadowing, whereby mental health symptoms are erroneously attributed to autism, should be avoided.29 Comorbid conditions warrant assessment and treatment according to the same clinical standards applied to neurotypical individuals, with adaptations made to accommodate the communication, sensory and support needs of autistic people. Neurodivergent individuals experience the full range of medical comorbidities seen in the general population; however, research indicates higher prevalence of certain conditions, including gastrointestinal disorders (e.g. irritable bowel syndrome, chronic constipation), sleep disturbances, epilepsy, and immune or metabolic disorders.30 These conditions may worsen fatigue, concentration and mood regulation, while motor difficulties may contribute to musculoskeletal pain, reduced physical activity and secondary health issues.31
Physical health conditions may be underdiagnosed when the clinical focus is limited to behavioural or psychological symptoms.29
Recognising the complex interconnections between physical, psychiatric and NDD health is paramount. Pharmacists can play a vital role in this process. Effective care relies on health professionals working collaboratively to identify how comorbid conditions, treatment burden and medicines may influence behaviour, cognition and developmental outcomes.
Autism is a lifelong NDD for which there is no curative treatment.4 Clinical care focuses on supporting health, functioning and community participation, addressing comorbidities, and optimising quality of life, while recognising and respecting the individual strengths, capabilities and perspectives of autistic individuals.3
Supports and interventions are individualised and typically involve a multidisciplinary team to address evolving needs.10 Allied health professionals may include speech pathologists to support communication, occupational therapists to address sensory processing and daily living skills, and psychologists to support emotional regulation and mental health. Physiotherapists may support gross motor skills, while dietitians support feeding and nutritional adequacy, alongside specialist educational support and therapy (e.g. play therapy, art therapy).3 Effective management relies on coordinated care, regular goal review and clear communication between the autistic individual, families and carers, and the multidisciplinary team.24
There is no evidence to support the use of medicines, exclusion diets or other biological treatment for the core features of autism.32,33 To support comorbidities, psychotropic medicines, antiepileptics and sleep agents may be used short term and under specific circumstances. Off-label use is common and requires careful assessment of risk-benefit balance, adverse effects, formulation choice, monitoring, cumulative treatment burden, and very careful consideration if the medicine is being prescribed as a chemical restraint.4
Autism is subject to persistent myths that pharmacists may encounter. The most damaging is the long-debunked claim that vaccines cause autism.14 The retracted 1998 Lancet study by Andrew Wakefield that claimed a link between the measles, mumps, rubella (MMR) vaccine and autism was a small, flawed study (with only 12 participants) and was exposed for unethical processes, methodological misconduct, and undisclosed conflicts of interest.14 Despite retraction, its claims were (and continue to be) amplified, eroding trust in public health and fuelling vaccine hesitancy. A Cochrane review published in 2021 found no credible evidence of an association between MMR and MMRV vaccines and autism.34
Two medicines made headlines in 2025: paracetamol and leucovorin (folinic acid or calcium folinate) claimed as a cause and treatment of autism respectively. Antenatal paracetamol exposure was alleged to increase autism and ADHD risk; however, major studies have not demonstrated a causal relationship.9 Stronger evidence from a large Swedish population-based cohort of 2,480,797 children born between 1995 and 2019 found no association between paracetamol use during pregnancy and autism, ADHD or IDD in sibling-controlled analysis.16 Cerebral folate deficiency (CFD) has been reported in a subset of autistic individuals, related to impaired folate transport into the brain, and may be associated with symptoms of speech difficulties, seizures and IDD, often within early childhood.35,36 Leucovorin, a folinic acid derivative, has been investigated as a potential treatment for autistic children with CFD. Leucovorin can bypass impaired folate transport, increasing central nervous system folate availability.36 Although some small-scale trials indicate potential minor behavioural improvements, supporting evidence remains limited, inconsistent, and not independently replicated.15,37
As medicines experts, pharmacists are well placed to counter common myths. Responses should prioritise empathetic, respectful communication and the provision of clear, evidence-based information and resources.
Accessibility, strong communication skills, medicines expertise, understanding of health system navigation and ability to synthesise information, position pharmacists to provide continuity of care for autistic individuals. Pharmacists can serve as an integrative link within multidisciplinary teams, supporting autistic individuals and their families across the healthcare continuum.
Effective communication underpins person-centred pharmacy practice. Pharmacists supporting autistic individuals should adapt both verbal and non-verbal communication to meet diverse needs.38 Autism can influence communication and sensory processing in unique ways, with some individuals experiencing sensory sensitivities to sound, light, smell, touch and visual stimuli.3,4,33 Some autistic individuals regulate sensory input through stimming (self-stimulatory behaviour), which may present as repetitive movements or sounds such as fidgeting, rocking or hand-flapping.39 Flexibility, empathy and understanding of sensory needs ensure equitable access to healthcare and fosters the relationship between patient and pharmacist. Verbal communication with autistic individuals should be clear and structured. Pharmacists should use straightforward, unambiguous language and present information in small, logical steps, allowing time for processing and response. Offering a calm, quiet space can both minimise sensory overload and facilitate a more comfortable environment for communication.38,40
Non-verbal communication requires equal attention. Eye contact, facial expressions and gestures can carry unintended meaning for autistic individuals. Some avoid eye contact as a coping mechanism, not as disinterest.38 Pharmacists should avoid assumptions and focus on open, calm body language and a reassuring tone. Visual supports can reinforce verbal explanations to provide ongoing reference, especially for individuals who process visual information more effectively than spoken language.40
A person-centred approach requires pharmacists to recognise, respond and adapt to the communication preferences of each autistic individual. If a caregiver or support worker is present, collaboration should occur while directing communication towards the patient whenever possible.40 Empathy, flexibility and inclusive communication techniques ensure care that is respectful and accessible and upholds an individual’s dignity and autonomy.
By adopting inclusive, neuro-affirming approaches, pharmacists strengthen equity, accessibility and person-centredness within healthcare. In doing so, they uphold the profession’s commitment to compassionate, evidence-based practice and help ensure autistic Australians receive the respect, understanding and tailored support needed to achieve optimal health and wellbeing.
Case scenario continuedEnzo’s mother discloses Enzo’s autism diagnosis and requests a quiet area and slower, step-by-step instructions. You offer a consultation room with dimmed lights, minimal visual clutter and no background noise. Enzo settles, visibly calmer. In this adapted space, you employ person-centred strategies: a soft, steady voice; paced delivery; short, simple sentences; pauses after each point for processing; confirming understanding via yes/no questions or thumbs-up signals; and a clear, written handout with bullet points, icons (e.g. clock for bedtime), and appropriate font. Enzo engages, maintaining partial eye contact and nodding, while his mother clarifies. These modifications demonstrate empathy, flexibility and equitable care, minimising distress, enhancing information access and supporting Enzo’s autonomy. |
Yvette Anderson (she/her) BPharm, MPS, CredPharm (MMR), ANZCAP (MentalHth, Paeds), CPGx, GradCert Autism is an accredited clinical pharmacist with over 20 years’ experience across aged care, consultancy, community pharmacy and hospital pharmacy. In 2020, she launched The Spectrum Pharmacist to increase awareness, promote inclusion, and provide education and support for neurodevelopmental disorders.
Victor Senescall (he/him) BPharm (Hons)
Merck Manual Professional Version. Overview of learning disorders. 2024. Available from: www.merckmanuals.com/professional/pediatrics/learning-and-developmental-disorders/overview-of-learning-disorders?query=neurodevelopment%20disorders
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington (DC): American Psychiatric Publishing; 2022.
Merck Manual Professional Version. Autism spectrum disorder. 2025. Available from: www.merckmanuals.com/professional/pediatrics/learning-and-developmental-disorders/autism-spectrum-disorder
Therapeutic Guidelines. Autism spectrum disorder. Melbourne: Therapeutic Guidelines; 2021.
Australian Bureau of Statistics. Autism in Australia 2022. 2024. Available from: www.abs.gov.au/articles/autism-australia-2022
Bertilsdotter Rosqvist H, Pearson A, Pavlopoulou G, et al. The social model in autism research. Autism. 2025;29(9):2201–2204.
Autism Spectrum Australia. At least 1 in 40 Australians are autistic: new estimate by Aspect on World Autism Understanding Day. 2024. Available from: www.aspect.org.au/news/at-least-1-in-40-australians-are-autistic
Therapeutic Guidelines. Autism spectrum disorder. eTG complete. Melbourne: Therapeutic Guidelines; 2021.
Trollor J, Arnold S, Walker SE. Australian Longitudinal Study of Autism in Adulthood (ALSAA): final report. Brisbane: Autism CRC; 2022.
Rasheed Z. Autism in Australia: understanding, challenges, and support. Int J Health Sci. 2023;17(5):1–4.
Lai M-C, Amestoy A, Bishop S, et al. Improving autism identification and support for individuals assigned female at birth: clinical suggestions and research priorities. Lancet Child Adolesc Health. 2023;7(12):897–908.
National Autistic Society. Masking. 2026. Available from: www.autism.org.uk/advice-and-guidance/topics/behaviour/masking
Ostrowski J, Religioni U, Gellert B, et al. Autism spectrum disorders: etiology, epidemiology, and challenges for public health. Med Sci Monit. 2024;30.
Australian Academy of Health and Medical Sciences. Autism: an evidence brief. 2025. Available from: https://aahms.org/policy/evidence-brief-on-autism
Love C, Sominsky L, O'Hely M, et al. Prenatal environmental risk factors for autism spectrum disorder and their potential mechanisms. BMC Med. 2024;22.
Ahlqvist VH, Sjöqvist H, Dalman C, et al. Acetaminophen use during pregnancy and children's risk of autism, ADHD, and intellectual disability. JAMA. 2024;331(14):1205–1214.
de Lara I, Wagner P, Matheus G, et al. Association of prenatal exposure to antiseizure medication with risk of autism: a systematic review and meta-analysis. Seizure. 2025;130:41–47.
Government of South Australia Office for Autism. Pathways for assessment and diagnosis. 2023. Available from: www.officeforautism.sa.gov.au/autism/pathways-for-diagnosis
Autism Awareness Australia. Understanding and accessing the NDIS. 2024. Available from: www.autismawareness.com.au/navigating-autism/understanding-and-accessing-the-ndis-for-autism
Estrin GL, Milner V, Spain D, et al. Barriers to autism spectrum disorder diagnosis for young women and girls: a systematic review. Rev J Autism Dev Disord. 2021;8(4):454–470.
Allen-Meares P, Lowry B, Estrella ML, et al. Health literacy barriers in the health care system: barriers and opportunities for the profession. Health Soc Work. 2020;45(1):62–64.
Khalil A, Yatcilla J, Christie N, et al. A systematic review of help-seeking barriers for racial-ethnic minority caregivers accessing autism diagnostic and intervention services. J Racial Ethn Health Disparities. 2025.
Flannery KA, Wisner-Carlson R. Autism and education. Child Adolesc Psychiatr Clin N Am. 2020;29(2).
Autism Awareness Australia. Navigating the health system. 2024. Available from: www.autismawareness.com.au/navigating-autism/navigating-the-health-system-for-autism
Bonti E, Zerva IK, Koundourou C, et al. The high rates of comorbidity among neurodevelopmental disorders: reconsidering the clinical utility of distinct diagnostic categories. J Pers Med. 2024;14(3):300.
Lai M-C, Kassee C, Besney R, et al. Prevalence of co-occurring mental health diagnoses in the autism population: a systematic review and meta-analysis. Lancet Psychiatry. 2019;6(10):819–829.
Mazurek MO, Sadikova E, Cheak-Zamora N, et al. Health care needs, experiences, and perspectives of autistic adults. Autism Adulthood. 2023;5(1):51–62.
Barlattani T, D'Amelio C, Cavatassi A, et al. Autism spectrum disorders and psychiatric comorbidities: a narrative review. J Psychopathol. 2023;29(1):3–24.
Blair J. Diagnostic overshadowing: see beyond the diagnosis. 2017. Available from: www.intellectualdisability.info/changing-values/diagnostic-overshadowing-see-beyond-the-diagnosis
Al-Beltagi M. Autism medical comorbidities. World J Clin Pediatr. 2021;10(3):15–28.
Sung Y-S, Loh SC, Lin L-Y. Physical activity and motor performance: a comparison between young children with and without autism spectrum disorder. Neuropsychiatr Dis Treat. 2021;17:3743–3751.
Turner M. The role of drugs in the treatment of autism. Aust Prescr. 2020;43:185–190.
Mayo Clinic. Autism spectrum disorder. 2025. Available from: www.mayoclinic.org/diseases-conditions/autism-spectrum-disorder/diagnosis-treatment/drc-20352934
Di Pietrantonj C, Rivetti A, Marchione P, et al. Vaccines for measles, mumps, rubella, and varicella in children. Cochrane Database Syst Rev. 2021;(11):CD004407.
Wong A, Frye RE, Ohnemus-Kawamura B, et al. Cerebral folate deficiency. 2019. Available from: https://rarediseases.org/rare-diseases/cerebral-folate-deficiency/
Ramaekers VTH, Quadros EV. Cerebral folate deficiency syndrome: early diagnosis, intervention and treatment strategies. Nutrients. 2022;14(15):3096.
Sheppeard A. What is leucovorin, and can it cure autism? 2025. Available from: www.medicalrepublic.com.au/what-is-leucovorin-and-can-it-cure-autism/120175
Norris JE, Milton D, Heasman B. Adapting communication with autistic service users: a participatory study. Autism. 2024.
National Autistic Society. Repeated movements and behaviour (stimming). 2026. Available from: www.autism.org.uk/advice-and-guidance/topics/about-autism/repeated-movements-and-behaviour-stimming
National Autistic Society. Autism and communication. 2024. Available from: www.autism.org.uk/advice-and-guidance/topics/about-autism/autism-and-communication
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[post_content] => As fuel costs climb and shortages loom, community pharmacies are facing mounting uncertainty on supply chains, workforce mobility, and equitable patient access.
Fuel shortages and escalating petrol costs are emerging as a significant disruptor for Australian workforces – including pharmacists, with exposure to the downstream impacts potentially affecting medicines delivery, patient access to care and workforce logistics.
Addressing the national fuel crisis
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[post_content] => A national workforce planning initiative is underway to better understand how the pharmacy profession must evolve to meet changing healthcare needs – and it could soon reshape how pharmacists practise for decades to come.
Commissioned by the federal government as part of the Strategic Agreement on Pharmacist Professional Practice, PSA has engaged the University of Queensland’s Centre for Business and Economics of Health to lead a whole-of-profession workforce forecast.
To kick off the consultation process, two all-day workshops bringing pharmacy leaders together across all settings took place in Brisbane and Melbourne last week, with valuable consumer insights also included.
UQ’s Associate Professor Jean Spinks said the scale of change facing the profession makes this work both necessary and overdue.
‘An updated strategic vision for the profession is required, given there’s been massive change over the last decade – including to the profession, scope of practice and the changing needs of the population,’ she said.
The modelling approach will start with the needs of the population that can be addressed by pharmacists to estimate what the size and composition of the pharmacy workforce should look like.
Pharmacy to become a needs-based workforce
The shift towards a needs-based model marks a fundamental change in how pharmacy workforce planning is approached – placing patient need, rather than service supply, at the centre.
It also demands a broader understanding of where pharmacists can add value across the health system, particularly for priority populations.
‘How do we reach them better, and what does that mean for the required skills and competencies of our workforce?’ A/Prof Spinks asked.
Consultation has already identified a wide range of priority groups who could benefit from improved access to pharmacy services.
Key populations include people living with chronic conditions, Aboriginal and Torres Strait Islander peoples, and those experiencing homelessness or housing insecurity.
‘There’s also alcohol and drug services – particularly gaps in methadone and buprenorphine services,’ A/Prof Spinks said.
The discussions have also highlighted growing need among people living with dementia, disability and complex health conditions – and the potential for pharmacists to play a greater role in supporting these groups.
‘We discussed whether we should be more involved with NDIS [National Disability Insurance Scheme] funding channels,’ she said. ‘It’s about how we meet those needs within our existing regulations, structures and funding models – bearing in mind that we've got to think about wherever a medicine is, there should be a pharmacist.’
A profession-wide response to workforce pressure
Expanding scope of practice is placing increasing pressure on pharmacists, particularly balancing dispensing with growing service delivery demands – raising important questions about safety, quality and workforce capacity.
‘Even now with vaccination, how many scripts is it safe to dispense in a day versus how many vaccinations at the same time?’ A/Prof Spinks asked. ‘We haven't really re-examined some of those aspects of both the quality and safety of care as it relates to workforce pressures.’
The modelling therefore takes a whole-of-profession approach, spanning all practice settings and recognising the need for stronger team-based care.
‘We’re working with experts across sectors to ensure we capture hospital, community and aged care settings, and also the role of technicians and assistants,’ she said. ‘You need to be able to have additional hands on deck to support expansion into additional settings.’
For PSA’s Head of Policy and Strategy Chris Campbell FPS, the significance of this work lies in its potential to unify the profession under a shared, forward-looking plan.
‘As a government-commissioned report, it will include policy recommendations, and we hope it helps shape the direction needed to support care delivered by pharmacists wherever medicines are,’ he said.
‘This isn’t just about having the data. We also need a whole-of-workforce plan – something that’s been missing for the profession. And importantly, this isn’t PSA’s plan, it’s the profession’s plan.
‘By global standards Australia does have a really vibrant community pharmacy and hospital pharmacy sector and these are strengths that we need to build on in the future.’
Primary care in focus
One area where workforce reform is expected to have significant impact is primary care, particularly through the expansion of GP pharmacist roles.
Medicines use is rising, complexity is increasing, and so too is the risk of medicines-related harm. There’s also growing pressure on the GP workforce alongside the escalating costs of care through the Medicare Benefits Schedule (MBS) and the Pharmaceutical Benefits Scheme (PBS), said GP pharmacist Brooke Shelly FPS, 2024 PSA MIMS Credentialed Pharmacist of the Year.
‘As reflected in repeated federal budget submissions from both the Royal Australian College of General Practitioners and the Australian Medical Association, GPs are actively calling for pharmacists to be part of the team,’ she said.
‘We are asking more of medicines than ever before, yet we still haven’t consistently embedded the workforce best trained to manage them in the very setting where most prescribing occurs, general practice.
‘Where pharmacists are embedded, we are already seeing improvements in quality use of medicines, more appropriate deprescribing, and better continuity of care.’
Despite this, workforce limitations are often driven by system constraints rather than lack of pharmacist interest.
‘We often talk about the workforce being small, but that reflects the constraints of current Home Medicines Review (HMR) and Residential Medication Management Review (RMMR) programs and the system more broadly,’ she said.
‘Unlock a clear, funded pathway for the GP Pharmacist role, and you will see a rapid surge in pharmacists seeking credentialing.’
Distribution also matters; workforce challenges are not just about numbers, but about ensuring pharmacists are embedded where patient need is greatest – particularly in rural and regional communities where these models of care are often essential.
‘Ultimately, the focus now is on building the structures that allow this workforce to be embedded where it can deliver the greatest impact, while continuing to support and strengthen existing programs such as HMRs and RMMRs that remain a critical part of the broader medicines safety framework,’ she said.
Looking ahead
When the plan comes together, Professor Lisa Nissen FPS – Director, and Taylor Family Chair, of the University of Queensland's Centre for the Business and Economics of Health – said it represents a critical opportunity to rethink the role of pharmacists in Australia’s health system.
‘There has not been a structured workforce planning activity in the pharmacy profession since 2009 for the 4th Community Pharmacy Agreement,’ she said. ‘And much of this previous work and modelling also focused on traditional roles for pharmacists in supply chain activities.’
As pharmacists’ roles expand and the pharmacy workforce is increasingly utilised in patient care, a clearer understanding of the future workforce composition and size – including pharmacists, assistants and technicians – will be critical to supporting healthcare needs.
‘This will help form the foundation for PSA and other groups to strategically plan for workforce development,’ Prof Nissen said.
Consultation will continue over the coming months, with PSA maintaining an open submissions process. A series of online focus groups is also scheduled for April, including at least one session dedicated specifically to exploring workforce needs in rural and remote areas
As for the final report, tight timelines for the modelling reflect strong interest in progressing workforce reform.
‘The federal government wants the [model] delivered by 30 June,’ A/Prof Spinks said.
‘They want to move on it quickly – and that’s encouraging.’
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[post_content] => PSA has announced the winners of the South Australian and Northern Territory Pharmacist Awards, recognising outstanding pharmacists who have demonstrated excellence in their practice and dedication to improving healthcare outcomes for their communities.
‘Congratulations to [the] SA/NT award winners, who are advancing patient care in their local communities and beyond,’ said PSA SA/NT President, Adjunct Professor Manya Angley FPS.
Pharmacist of the Year – Dr Paul Tait FPS
The PSA SA/NT Branch has named Dr Paul Tait FPS as Pharmacist of the Year 2026, recognising his outstanding leadership in digital health, palliative care, research and integrated care. With more than 30 years of experience spanning hospital practice, research and professional leadership – Dr Tait is widely recognised for strengthening pharmacists’ roles within integrated multidisciplinary care teams.
Contributing to PSA’s education resources and mentoring health professionals across disciplines have enhanced pharmacists’ confidence and impact in complex care environments.
Early Career Pharmacist of the Year – Stephanie Lee MPS
Early Career Pharmacist of the Year, Stephanie Lee MPS has been recognised for innovation, expanded scope service delivery and leadership in rural healthcare. As the first community pharmacist in South Australia to administer long-acting injectable buprenorphine, she has significantly improved access to evidence-based treatment for opioid dependence, reducing barriers to care and supporting safer, more dignified patient outcomes.
Ms Lee is also a passionate advocate for community engagement, professional development, and integrated care. Through health education presentations, expanded-scope services including mental health first aid, urinary tract infection management, and oral contraceptive supply – alongside close collaboration with local hospitals – she has strengthened health literacy and care quality across her rural community of Bordertown.
Intern Pharmacist of the Year – Li Ann Ching MPS
Li Ann Ching MPS was recognised as the Intern Pharmacist of the Year for her outstanding performance and professionalism throughout her intern year, demonstrating a strong commitment to patient-centred care and expanded pharmacy services.
By delivering a wide range of professional services – including vaccination, heart health checks, travel consultations and hospital-to-home discharge reviews – Ms Ching has excelled in her commitment to patient health, while also supporting the provision of professional services in the pharmacy, such as dose administration aids and MedsChecks.
Lifetime Achievement Award – Grant Kardachi AM FPS
Grant Kardachi AM FPS was awarded the Lifetime Achievement Award in Adelaide, recognised for his extraordinary contribution to the pharmacy profession spanning over 5 decades. As a highly respected leader, advocate, and mentor, Mr Kardachi has played a pivotal role in shaping contemporary practice across Australia.
Widely regarded as a pioneer of consultant pharmacy, Mr Kardachi was a key player in the 1996 Community Pharmacy Model Practices Project, leading to the introduction of Home Medicines Reviews and Residential Medication Management Reviews. These essential healthcare services have transformed medicines stewardship and continue to improve the safe and effective use of medicines for Australians.
Serving more than 30 years of leadership, representing PSA at branch and national levels, including as National President from 2011 to 2015, Mr Kardachi has advanced professional standards, education, and patient-centred care.
PSA Gold Medal – Matthew Weimann
The PSA were also delighted to present Matthew Weimann with the prestigious PSA Gold Medal for his exceptional academic achievement. Following graduation, Mr Weimann is currently completing his intern year at The Queen Elizabeth Hospital where he is stimulated by his interactions with patients and clinical complexity.
The PSA Gold Medal recognises the student with the highest-grade point average, above 6.25, studying a Bachelor of Pharmacy at the University of South Australia. The Gold Medal has been awarded in South Australia since 1896 but only when there is a candidate that meets the stringent requirements of this award. Mr Weimann joins this elite group of pharmacists to receive the Gold Medal.
‘These award recipients represent some of the best of the pharmacy profession,’ Prof Angley said. ‘Their innovation, dedication, and passion are essential as we respond to the evolving health needs of our communities.’
[post_title] => PSA recognises pharmacists for excellence in practice
[post_excerpt] => PSA has announced the winners of the South Australian and Northern Territory Pharmacist Awards, recognising outstanding pharmacists who have demonstrated excellence in their practice and dedication to improving healthcare outcomes for their communities.
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[post_content] => From hospital wards to community pharmacies, and increasingly, digital platforms, pharmacists are there to ensure medicines are used safely – no matter the location.
As healthcare systems are confronted with growing demand, workforce pressures, and a landscape of technological change, the role of pharmacists continues to expand simultaneously in scope and significance.
PSA WA/ACT State Manager Mayli Foong MPS said that, ‘Pharmacists play a key role in supporting medicines in so many settings including hospital, residential aged care facilities, Home Medicines Reviews, community pharmacy, Aboriginal Health Services, compounding and education.’
‘The expanded scope for pharmacists in Community pharmacy is really exciting. Including expanded scope of prescribing and increased range of vaccinations that pharmacists can deliver.’
Ahead of Thank Your Pharmacist Day 2026, with the theme ‘wherever medicines are’, AP spoke to early career pharmacists to explore the breadth of their roles, and the impact they have on patient care and medicines safety every day.
Beyond the pharmacy counter
Rhiannon Price MPS, pharmacist at King Edward Memorial Hospital told AP that there is ‘no such thing as a typical day because everyday is unique.’
‘Just this week I have been actively involved in an acute case of hyperkalaemia (potassium of 7.7)... I collaborated with a physiotherapist to manage pain for a patient post caesarean section up four flights of stairs and liaised with the medical team to safely facilitate a discharge for someone that needed hospital in-home support to safely administer heparin injections,’ said Ms Price, who was awarded 2025 PSA WA Early Career Pharmacist of the Year.
[caption id="attachment_31621" align="alignright" width="167"]
Rhiannon Price, Pharmacist at King Edward Memorial Hospital.[/caption]
The stakes can be raised further in hospital compounding units, which are a cornerstone of ensuring safe medicines preparation. In these highly controlled environments, specialised medicines are prepared for some of the most vulnerable patients, said Caspar Townsend MPS, who works in Perth Children’s Hospital sterile compounding unit.
‘In the morning, we receive and prepare orders from the wards, and before anything begins, we do a full clean of the unit using multiple disinfectants,’ he said. ‘From then until about 1.00 pm, we’re focused on making those medications. In the afternoon, we move on to total parenteral nutrition bags for paediatric patients. A pharmacist will check them again outside, and then they will get bagged up and delivered to their wards.’
Mr Townsend’s journey into sterile compounding began during his internship, where he found an appreciation for the unique blend of technical skills required and hands-on approach.
‘I’m still testing my knowledge, but I also get to work with my hands, which is fun. It’s both the mental and the practical skills that I quite enjoy,’ Mr Townsend told AP.
[caption id="attachment_31633" align="alignright" width="300"]
Caspar Townsend MPS, Pharmacist at Perth Children's Hospital compounding unit[/caption]
‘Every [medicine] for every patient is going to be different. It’s tailored to them, so there’s a really high margin and risk for error. It’s all about that precision and control – making sure the medication is the right medication, it’s the right dose, it’s been compounded correctly, and [there’s] all those little checks along the way.’
Providing patients with accessible medicines content
While pharmacists operate in highly regulated clinical settings, others have an expanded reach beyond the pharmacy walls into digital spaces.
Social media has become an invaluable tool for enhancing medicines safety and public health awareness through disseminating accessible, digestible short-form content in real time.
Iraq Doali MPS (@clutchestpharmacist), a NSW-based locum pharmacist, has embraced this shift in the media landscape with his Instagram platform, and is actively bridging the gap between patients and reliable healthcare advice.
‘I wanted to reach a wider audience,’ he said. ‘I felt like a lot of the time people were missing out on crucial information because they were in too much of a rush at the pharmacy or the pharmacy was too busy,’ Mr Doali told AP.
Recognising a lack of pharmacist voices online, he saw an opportunity to contribute, ensuring patients can access timely information. ‘I realised there aren’t many pharmacists on Instagram, which is an important tool for trust and improving medicines safety,’ Mr Doali said.
His aim is to impart knowledge to patients where access to advice may be limited. ‘I [also] talk about the struggles of pharmacy, what pharmacists do, stock issues, or law changes concerning the public in pharmacy… I just want to make sure people get the information they need to get, and from a trusted healthcare professional at the same time,’ Mr Doali said.
His content has assisted in improving health literacy in terms of ‘explaining procedures and medical conditions. This helps viewers understand the profession better, expand their knowledge, and even keep them alert on the changes happening in the pharmacy world’.
The immediacy of digital platforms allows pharmacists to respond quickly to emerging issues... ‘With digital spaces and pharmacists educating about medications, you can reach out to the public when you’re anticipating stock shortages… this is something that can be addressed instantly,’ he said.
[caption id="attachment_31619" align="alignright" width="233"]
Iraq Doali, NSW-based locum pharmacist and content creator[/caption]
The leaders of tomorrow
With students mapping out the future landscape of pharmacy, AP spoke with Sebastian Harper, National President at the National Australian Pharmacy Students’ Association (NAPSA), about the role of pharmacies as crucial health hubs in rural and remote communities where GP access is limited.
‘The idea that patients can easily present to their GP is not a reality,’ said Mr Harper, who also works as an intern in Mt Isa.
‘Having pharmacists adequately trained to manage acute, everyday conditions and those treated under the Chronic Conditions Management Pilot, has been a blessing in delivering this care for our community.’
Looking ahead, he explained how the next generation of pharmacists is already preparing for a broader scope of practice.
‘It won't be long before we have a significant cohort of ECPs trained to deliver the care that communities across Australia are calling out for,’ Mr Harper said.
He believes this expansion will see pharmacists playing even more critical roles in patient treatment and preventative care. ‘I’m sure pharmacists will become the natural go-to for annual health check-ups, life-long implementation of patients' immunisation schedules, conversations about sexual health, and their pharmacies the inclusive spaces needed for traditionally health-averse demographics,’ Mr Harper said.
During his 3-year tenure on the NAPSA board, Mr Harper has seen pharmacy students committed to retaining their autonomy in a workforce that places increased demands upon young professionals.
‘In the NAPSA 2030 vision launched last year, which provides a framework for the next National President, pharmacy students are now advocating for themselves – calling for paid placements, expansion of scope and a profession that listens to their collective voice.’
Get involved in Thank Your Pharmacist Day 2026 by downloading the PSA’s TYPD26 toolkit.
[post_title] => Celebrating pharmacists wherever medicines are
[post_excerpt] => From hospital wards to community pharmacies, and increasingly, digital platforms, pharmacists are there to ensure medicines are used safely.
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[post_content] => Case scenario
During peak hour, 19-year-old Enzo and his mother arrive to collect a new prescription for melatonin MR 2 mg. The pharmacy is highly stimulating: background music blares, customers converse loudly nearby, staff assist others in a cramped space, and general noise amplifies the chaos. While processing Enzo’s prescription and attempting to deliver verbal instructions, you observe Enzo avoiding eye contact, fidgeting intensely, and appearing overwhelmed, with reduced capacity to process verbal or non-verbal cues due to sensory overload.
Learning objectivesAfter reading this article, pharmacists should be able to:
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Yvette Anderson (she/her) BPharm, MPS, CredPharm (MMR), ANZCAP (MentalHth, Paeds), CPGx, GradCert Autism[/caption]
Neurodevelopmental disorders (NDDs) arise from differences in brain development and typically affect cognition, communication, behaviour and occupational functioning. Common NDDs include attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), referred to as autism in this article, and intellectual developmental disorder (IDD).1 Autism is characterised by persistent social interaction and communication difficulties and restricted behavioural patterns.2 Symptoms begin in early childhood; however, diagnosis can occur at any age.3 Autism affects how the brain processes information, shaping how autistic people see, understand and respond to the world around them, with marked variability in presentation, day-to-day functioning and support needs.3,4
In Australia, autism prevalence has increased due to evolving diagnostic practices and awareness,5 meaning pharmacists now routinely engage with autistic individuals as part of everyday practice.
The challenge and opportunity for pharmacy is to shift from a medical model of crisis response, treatments and cures to a neuro-affirming social model that helps autistic individuals thrive, not just survive.
A neuro-affirming social model conceptualises neurodevelopmental differences as natural variations within human diversity and rejects deficit-based assumptions that frame these differences as disorders.6 Rather than ‘correcting’ individual traits, this approach provides reasonable adjustments while supporting autonomy, community participation and wellbeing, alongside awareness of diagnostic criteria, comorbidities, communication styles, lived realities and the impact of misinformation.6 The shift to a neuro-affirming social model calls for reducing systemic and environmental barriers, while still addressing health needs.6,7
For pharmacists, it means making practice adjustments in the way that the profession engages with and provides support for autistic individuals.
According to the Australian Bureau of Statistics, approximately 290,900 Australians (1.1%) are reported to have had an autism diagnosis in 2022.5 A recent estimate by Autism Spectrum Australia (Aspect) suggested at least 1 in 40 Australians are autistic.7
Rising prevalence reflects improved awareness and diagnostic practices rather than a true increase in incidence, including better recognition in historically underdiagnosed groups such as females and older adults.7 Autism prevalence peaks in children and adolescents, particularly those aged 10–14 years, and is markedly lower in adults, acknowledging limited adult data.5,8,9
Autism prevalence rates may appear to vary among ethnic and cultural groups, reflecting inequities such as access to healthcare, effective communication, diagnostic practices and cultural perceptions.10
Prevalence remains higher in males than females, with 1.6% of males identified compared with 0.7% of females, and the greatest disparity is seen in children aged 5–9 years.5 Autism in females is frequently underdiagnosed, as characteristics may manifest differently, be masked (e.g. forced eye contact, rehearsed social scripts, suppressing stimming or copying peers), or fail to align with historically male-centred diagnostic criteria, leading to misdiagnosis as mood or personality disorders.11,12 Masking may occur due to a desire to fit in, fear of stigma or bullying, previous negative reactions to autistic behaviours, and expectations of how females are ‘supposed’ to behave.12 Increasing awareness of the under-recognition of autism in females and gender-diverse individuals, and the social drivers of masking, is anticipated to influence future prevalence estimates.4,5,11
There is no single cause of autism, and despite extensive research, aetiology remains incompletely understood. Current evidence indicates autism arises from a complex interaction between genetic susceptibility and environmental influences on neurodevelopment.13
Family history is one of the strongest predictors of autism.13,14 Researchers have identified hundreds of genes, with approximately 10–20% of cases associated with rare genetic variants arising from mutations in sperm or egg cells.14 Autism is considered polygenic, meaning overall risk typically reflects the cumulative effect of multiple inherited variants, each contributing a small effect.14
The expression of genetic susceptibility is known to be influenced by prenatal, perinatal and postnatal environmental factors.13 Environmental factors appear most relevant during the prenatal period.14 Modest associations have been reported between autism likelihood and maternal factors such as hypertension, gestational diabetes, obesity, alcohol and substance use, poor antenatal care, and infection or fever during pregnancy.15
Imprecise and inconsistent associations have been reported for folate status, exposure to some air pollutants, and the use of some medicines.15–17 Importantly, these findings are largely derived from observational studies and are subject to confounding. While some prenatal medicine exposures show more consistent associations with autism, there is no clear evidence that associations between autism and other environmental and medicine exposures represent a causal relationship, and any contribution to autism risk remains limited and uncertain.14,17
Autism is diagnosed according to Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) criteria: ‘persistent deficits in social communication and social interaction across multiple contexts’, with the presence of ‘restricted, repetitive patterns of behaviour, interests or activities’.2
‘Symptoms must be present in the early development period’, although they may only become fully apparent later in life.
‘Symptoms cause clinically significant impairment in social, occupational or other important areas of functioning’ and ‘these disturbances are not better explained by IDD’ although both can co-occur.2 The DSM-5-TR also specifies severity levels (1–3) to indicate the degree of support required.2
In Australia, individuals may pursue an autism diagnosis through public or private pathways.18 Both are typically lengthy and necessitate a degree of health literacy and English proficiency. Diagnostic assessments may be conducted by a multidisciplinary team, including paediatricians, psychiatrists, psychologists, speech pathologists and occupational therapists.4 Multiple appointments may be needed, drawing on input from family, carers or teachers.18,19
Barriers to diagnosis include limited awareness of early signs among caregivers and clinicians, long wait times and out-of-pocket costs for specialist assessment, socioeconomic and geographic disparities, and bias in recognising diverse presentations.11,20,21 Limited health literacy and the complexity of navigating multidisciplinary assessments and National Disability Insurance Scheme requirements further impede access.21 In some communities, stigma, fear of labelling, and differing cultural interpretations of behaviour may delay help-seeking.22
A best-practice diagnostic approach should promote cultural safety and sensitivity, acknowledge variations in health literacy, address socioeconomic barriers, and be grounded in person-centred care.
Autism is a spectrum, with each individual having a unique mix of strengths, challenges, interests, needs and way of interacting with the world. Autism advocate Dr Stephen Shore states, ‘If you have met one autistic person, you have met one autistic person’.23
Beyond the core featuresComorbid NDDs, and psychiatric and medical conditions can create significant challenges for autistic individuals in relation to diagnosis, selection of appropriate interventions, medicines and support services.1,24
Comorbid NDDs among autistic individuals include ADHD, developmental coordination disorder (dyspraxia), IDD, and specific learning disorders such as dyslexia, dysgraphia and dyscalculia.25 Psychiatric comorbidities are also prevalent, including anxiety, depression, obsessive-compulsive disorder, and post-traumatic stress disorder.26 These conditions can intensify social and sensory challenges, increase vulnerability to stress, and impair emotional regulation and executive functioning.
Autistic individuals experience higher rates and severity of mental and physical health comorbidities than neurotypical individuals. Neurodivergent mental health outcomes are influenced by the interaction between individual differences and environmental and societal factors.25–28 Diagnostic overshadowing, whereby mental health symptoms are erroneously attributed to autism, should be avoided.29 Comorbid conditions warrant assessment and treatment according to the same clinical standards applied to neurotypical individuals, with adaptations made to accommodate the communication, sensory and support needs of autistic people. Neurodivergent individuals experience the full range of medical comorbidities seen in the general population; however, research indicates higher prevalence of certain conditions, including gastrointestinal disorders (e.g. irritable bowel syndrome, chronic constipation), sleep disturbances, epilepsy, and immune or metabolic disorders.30 These conditions may worsen fatigue, concentration and mood regulation, while motor difficulties may contribute to musculoskeletal pain, reduced physical activity and secondary health issues.31
Physical health conditions may be underdiagnosed when the clinical focus is limited to behavioural or psychological symptoms.29
Recognising the complex interconnections between physical, psychiatric and NDD health is paramount. Pharmacists can play a vital role in this process. Effective care relies on health professionals working collaboratively to identify how comorbid conditions, treatment burden and medicines may influence behaviour, cognition and developmental outcomes.
Autism is a lifelong NDD for which there is no curative treatment.4 Clinical care focuses on supporting health, functioning and community participation, addressing comorbidities, and optimising quality of life, while recognising and respecting the individual strengths, capabilities and perspectives of autistic individuals.3
Supports and interventions are individualised and typically involve a multidisciplinary team to address evolving needs.10 Allied health professionals may include speech pathologists to support communication, occupational therapists to address sensory processing and daily living skills, and psychologists to support emotional regulation and mental health. Physiotherapists may support gross motor skills, while dietitians support feeding and nutritional adequacy, alongside specialist educational support and therapy (e.g. play therapy, art therapy).3 Effective management relies on coordinated care, regular goal review and clear communication between the autistic individual, families and carers, and the multidisciplinary team.24
There is no evidence to support the use of medicines, exclusion diets or other biological treatment for the core features of autism.32,33 To support comorbidities, psychotropic medicines, antiepileptics and sleep agents may be used short term and under specific circumstances. Off-label use is common and requires careful assessment of risk-benefit balance, adverse effects, formulation choice, monitoring, cumulative treatment burden, and very careful consideration if the medicine is being prescribed as a chemical restraint.4
Autism is subject to persistent myths that pharmacists may encounter. The most damaging is the long-debunked claim that vaccines cause autism.14 The retracted 1998 Lancet study by Andrew Wakefield that claimed a link between the measles, mumps, rubella (MMR) vaccine and autism was a small, flawed study (with only 12 participants) and was exposed for unethical processes, methodological misconduct, and undisclosed conflicts of interest.14 Despite retraction, its claims were (and continue to be) amplified, eroding trust in public health and fuelling vaccine hesitancy. A Cochrane review published in 2021 found no credible evidence of an association between MMR and MMRV vaccines and autism.34
Two medicines made headlines in 2025: paracetamol and leucovorin (folinic acid or calcium folinate) claimed as a cause and treatment of autism respectively. Antenatal paracetamol exposure was alleged to increase autism and ADHD risk; however, major studies have not demonstrated a causal relationship.9 Stronger evidence from a large Swedish population-based cohort of 2,480,797 children born between 1995 and 2019 found no association between paracetamol use during pregnancy and autism, ADHD or IDD in sibling-controlled analysis.16 Cerebral folate deficiency (CFD) has been reported in a subset of autistic individuals, related to impaired folate transport into the brain, and may be associated with symptoms of speech difficulties, seizures and IDD, often within early childhood.35,36 Leucovorin, a folinic acid derivative, has been investigated as a potential treatment for autistic children with CFD. Leucovorin can bypass impaired folate transport, increasing central nervous system folate availability.36 Although some small-scale trials indicate potential minor behavioural improvements, supporting evidence remains limited, inconsistent, and not independently replicated.15,37
As medicines experts, pharmacists are well placed to counter common myths. Responses should prioritise empathetic, respectful communication and the provision of clear, evidence-based information and resources.
Accessibility, strong communication skills, medicines expertise, understanding of health system navigation and ability to synthesise information, position pharmacists to provide continuity of care for autistic individuals. Pharmacists can serve as an integrative link within multidisciplinary teams, supporting autistic individuals and their families across the healthcare continuum.
Effective communication underpins person-centred pharmacy practice. Pharmacists supporting autistic individuals should adapt both verbal and non-verbal communication to meet diverse needs.38 Autism can influence communication and sensory processing in unique ways, with some individuals experiencing sensory sensitivities to sound, light, smell, touch and visual stimuli.3,4,33 Some autistic individuals regulate sensory input through stimming (self-stimulatory behaviour), which may present as repetitive movements or sounds such as fidgeting, rocking or hand-flapping.39 Flexibility, empathy and understanding of sensory needs ensure equitable access to healthcare and fosters the relationship between patient and pharmacist. Verbal communication with autistic individuals should be clear and structured. Pharmacists should use straightforward, unambiguous language and present information in small, logical steps, allowing time for processing and response. Offering a calm, quiet space can both minimise sensory overload and facilitate a more comfortable environment for communication.38,40
Non-verbal communication requires equal attention. Eye contact, facial expressions and gestures can carry unintended meaning for autistic individuals. Some avoid eye contact as a coping mechanism, not as disinterest.38 Pharmacists should avoid assumptions and focus on open, calm body language and a reassuring tone. Visual supports can reinforce verbal explanations to provide ongoing reference, especially for individuals who process visual information more effectively than spoken language.40
A person-centred approach requires pharmacists to recognise, respond and adapt to the communication preferences of each autistic individual. If a caregiver or support worker is present, collaboration should occur while directing communication towards the patient whenever possible.40 Empathy, flexibility and inclusive communication techniques ensure care that is respectful and accessible and upholds an individual’s dignity and autonomy.
By adopting inclusive, neuro-affirming approaches, pharmacists strengthen equity, accessibility and person-centredness within healthcare. In doing so, they uphold the profession’s commitment to compassionate, evidence-based practice and help ensure autistic Australians receive the respect, understanding and tailored support needed to achieve optimal health and wellbeing.
Case scenario continuedEnzo’s mother discloses Enzo’s autism diagnosis and requests a quiet area and slower, step-by-step instructions. You offer a consultation room with dimmed lights, minimal visual clutter and no background noise. Enzo settles, visibly calmer. In this adapted space, you employ person-centred strategies: a soft, steady voice; paced delivery; short, simple sentences; pauses after each point for processing; confirming understanding via yes/no questions or thumbs-up signals; and a clear, written handout with bullet points, icons (e.g. clock for bedtime), and appropriate font. Enzo engages, maintaining partial eye contact and nodding, while his mother clarifies. These modifications demonstrate empathy, flexibility and equitable care, minimising distress, enhancing information access and supporting Enzo’s autonomy. |
Yvette Anderson (she/her) BPharm, MPS, CredPharm (MMR), ANZCAP (MentalHth, Paeds), CPGx, GradCert Autism is an accredited clinical pharmacist with over 20 years’ experience across aged care, consultancy, community pharmacy and hospital pharmacy. In 2020, she launched The Spectrum Pharmacist to increase awareness, promote inclusion, and provide education and support for neurodevelopmental disorders.
Victor Senescall (he/him) BPharm (Hons)
Merck Manual Professional Version. Overview of learning disorders. 2024. Available from: www.merckmanuals.com/professional/pediatrics/learning-and-developmental-disorders/overview-of-learning-disorders?query=neurodevelopment%20disorders
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Ahlqvist VH, Sjöqvist H, Dalman C, et al. Acetaminophen use during pregnancy and children's risk of autism, ADHD, and intellectual disability. JAMA. 2024;331(14):1205–1214.
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Khalil A, Yatcilla J, Christie N, et al. A systematic review of help-seeking barriers for racial-ethnic minority caregivers accessing autism diagnostic and intervention services. J Racial Ethn Health Disparities. 2025.
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Bonti E, Zerva IK, Koundourou C, et al. The high rates of comorbidity among neurodevelopmental disorders: reconsidering the clinical utility of distinct diagnostic categories. J Pers Med. 2024;14(3):300.
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Blair J. Diagnostic overshadowing: see beyond the diagnosis. 2017. Available from: www.intellectualdisability.info/changing-values/diagnostic-overshadowing-see-beyond-the-diagnosis
Al-Beltagi M. Autism medical comorbidities. World J Clin Pediatr. 2021;10(3):15–28.
Sung Y-S, Loh SC, Lin L-Y. Physical activity and motor performance: a comparison between young children with and without autism spectrum disorder. Neuropsychiatr Dis Treat. 2021;17:3743–3751.
Turner M. The role of drugs in the treatment of autism. Aust Prescr. 2020;43:185–190.
Mayo Clinic. Autism spectrum disorder. 2025. Available from: www.mayoclinic.org/diseases-conditions/autism-spectrum-disorder/diagnosis-treatment/drc-20352934
Di Pietrantonj C, Rivetti A, Marchione P, et al. Vaccines for measles, mumps, rubella, and varicella in children. Cochrane Database Syst Rev. 2021;(11):CD004407.
Wong A, Frye RE, Ohnemus-Kawamura B, et al. Cerebral folate deficiency. 2019. Available from: https://rarediseases.org/rare-diseases/cerebral-folate-deficiency/
Ramaekers VTH, Quadros EV. Cerebral folate deficiency syndrome: early diagnosis, intervention and treatment strategies. Nutrients. 2022;14(15):3096.
Sheppeard A. What is leucovorin, and can it cure autism? 2025. Available from: www.medicalrepublic.com.au/what-is-leucovorin-and-can-it-cure-autism/120175
Norris JE, Milton D, Heasman B. Adapting communication with autistic service users: a participatory study. Autism. 2024.
National Autistic Society. Repeated movements and behaviour (stimming). 2026. Available from: www.autism.org.uk/advice-and-guidance/topics/about-autism/repeated-movements-and-behaviour-stimming
National Autistic Society. Autism and communication. 2024. Available from: www.autism.org.uk/advice-and-guidance/topics/about-autism/autism-and-communication
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[post_content] => As fuel costs climb and shortages loom, community pharmacies are facing mounting uncertainty on supply chains, workforce mobility, and equitable patient access.
Fuel shortages and escalating petrol costs are emerging as a significant disruptor for Australian workforces – including pharmacists, with exposure to the downstream impacts potentially affecting medicines delivery, patient access to care and workforce logistics.
Addressing the national fuel crisis
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[post_content] => A national workforce planning initiative is underway to better understand how the pharmacy profession must evolve to meet changing healthcare needs – and it could soon reshape how pharmacists practise for decades to come.
Commissioned by the federal government as part of the Strategic Agreement on Pharmacist Professional Practice, PSA has engaged the University of Queensland’s Centre for Business and Economics of Health to lead a whole-of-profession workforce forecast.
To kick off the consultation process, two all-day workshops bringing pharmacy leaders together across all settings took place in Brisbane and Melbourne last week, with valuable consumer insights also included.
UQ’s Associate Professor Jean Spinks said the scale of change facing the profession makes this work both necessary and overdue.
‘An updated strategic vision for the profession is required, given there’s been massive change over the last decade – including to the profession, scope of practice and the changing needs of the population,’ she said.
The modelling approach will start with the needs of the population that can be addressed by pharmacists to estimate what the size and composition of the pharmacy workforce should look like.
Pharmacy to become a needs-based workforce
The shift towards a needs-based model marks a fundamental change in how pharmacy workforce planning is approached – placing patient need, rather than service supply, at the centre.
It also demands a broader understanding of where pharmacists can add value across the health system, particularly for priority populations.
‘How do we reach them better, and what does that mean for the required skills and competencies of our workforce?’ A/Prof Spinks asked.
Consultation has already identified a wide range of priority groups who could benefit from improved access to pharmacy services.
Key populations include people living with chronic conditions, Aboriginal and Torres Strait Islander peoples, and those experiencing homelessness or housing insecurity.
‘There’s also alcohol and drug services – particularly gaps in methadone and buprenorphine services,’ A/Prof Spinks said.
The discussions have also highlighted growing need among people living with dementia, disability and complex health conditions – and the potential for pharmacists to play a greater role in supporting these groups.
‘We discussed whether we should be more involved with NDIS [National Disability Insurance Scheme] funding channels,’ she said. ‘It’s about how we meet those needs within our existing regulations, structures and funding models – bearing in mind that we've got to think about wherever a medicine is, there should be a pharmacist.’
A profession-wide response to workforce pressure
Expanding scope of practice is placing increasing pressure on pharmacists, particularly balancing dispensing with growing service delivery demands – raising important questions about safety, quality and workforce capacity.
‘Even now with vaccination, how many scripts is it safe to dispense in a day versus how many vaccinations at the same time?’ A/Prof Spinks asked. ‘We haven't really re-examined some of those aspects of both the quality and safety of care as it relates to workforce pressures.’
The modelling therefore takes a whole-of-profession approach, spanning all practice settings and recognising the need for stronger team-based care.
‘We’re working with experts across sectors to ensure we capture hospital, community and aged care settings, and also the role of technicians and assistants,’ she said. ‘You need to be able to have additional hands on deck to support expansion into additional settings.’
For PSA’s Head of Policy and Strategy Chris Campbell FPS, the significance of this work lies in its potential to unify the profession under a shared, forward-looking plan.
‘As a government-commissioned report, it will include policy recommendations, and we hope it helps shape the direction needed to support care delivered by pharmacists wherever medicines are,’ he said.
‘This isn’t just about having the data. We also need a whole-of-workforce plan – something that’s been missing for the profession. And importantly, this isn’t PSA’s plan, it’s the profession’s plan.
‘By global standards Australia does have a really vibrant community pharmacy and hospital pharmacy sector and these are strengths that we need to build on in the future.’
Primary care in focus
One area where workforce reform is expected to have significant impact is primary care, particularly through the expansion of GP pharmacist roles.
Medicines use is rising, complexity is increasing, and so too is the risk of medicines-related harm. There’s also growing pressure on the GP workforce alongside the escalating costs of care through the Medicare Benefits Schedule (MBS) and the Pharmaceutical Benefits Scheme (PBS), said GP pharmacist Brooke Shelly FPS, 2024 PSA MIMS Credentialed Pharmacist of the Year.
‘As reflected in repeated federal budget submissions from both the Royal Australian College of General Practitioners and the Australian Medical Association, GPs are actively calling for pharmacists to be part of the team,’ she said.
‘We are asking more of medicines than ever before, yet we still haven’t consistently embedded the workforce best trained to manage them in the very setting where most prescribing occurs, general practice.
‘Where pharmacists are embedded, we are already seeing improvements in quality use of medicines, more appropriate deprescribing, and better continuity of care.’
Despite this, workforce limitations are often driven by system constraints rather than lack of pharmacist interest.
‘We often talk about the workforce being small, but that reflects the constraints of current Home Medicines Review (HMR) and Residential Medication Management Review (RMMR) programs and the system more broadly,’ she said.
‘Unlock a clear, funded pathway for the GP Pharmacist role, and you will see a rapid surge in pharmacists seeking credentialing.’
Distribution also matters; workforce challenges are not just about numbers, but about ensuring pharmacists are embedded where patient need is greatest – particularly in rural and regional communities where these models of care are often essential.
‘Ultimately, the focus now is on building the structures that allow this workforce to be embedded where it can deliver the greatest impact, while continuing to support and strengthen existing programs such as HMRs and RMMRs that remain a critical part of the broader medicines safety framework,’ she said.
Looking ahead
When the plan comes together, Professor Lisa Nissen FPS – Director, and Taylor Family Chair, of the University of Queensland's Centre for the Business and Economics of Health – said it represents a critical opportunity to rethink the role of pharmacists in Australia’s health system.
‘There has not been a structured workforce planning activity in the pharmacy profession since 2009 for the 4th Community Pharmacy Agreement,’ she said. ‘And much of this previous work and modelling also focused on traditional roles for pharmacists in supply chain activities.’
As pharmacists’ roles expand and the pharmacy workforce is increasingly utilised in patient care, a clearer understanding of the future workforce composition and size – including pharmacists, assistants and technicians – will be critical to supporting healthcare needs.
‘This will help form the foundation for PSA and other groups to strategically plan for workforce development,’ Prof Nissen said.
Consultation will continue over the coming months, with PSA maintaining an open submissions process. A series of online focus groups is also scheduled for April, including at least one session dedicated specifically to exploring workforce needs in rural and remote areas
As for the final report, tight timelines for the modelling reflect strong interest in progressing workforce reform.
‘The federal government wants the [model] delivered by 30 June,’ A/Prof Spinks said.
‘They want to move on it quickly – and that’s encouraging.’
[post_title] => How will Australia’s pharmacy workforce respond to megatrends?
[post_excerpt] => A national workforce planning initiative is underway to better understand how the pharmacy profession must evolve to meet changing needs.
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[post_content] => PSA has announced the winners of the South Australian and Northern Territory Pharmacist Awards, recognising outstanding pharmacists who have demonstrated excellence in their practice and dedication to improving healthcare outcomes for their communities.
‘Congratulations to [the] SA/NT award winners, who are advancing patient care in their local communities and beyond,’ said PSA SA/NT President, Adjunct Professor Manya Angley FPS.
Pharmacist of the Year – Dr Paul Tait FPS
The PSA SA/NT Branch has named Dr Paul Tait FPS as Pharmacist of the Year 2026, recognising his outstanding leadership in digital health, palliative care, research and integrated care. With more than 30 years of experience spanning hospital practice, research and professional leadership – Dr Tait is widely recognised for strengthening pharmacists’ roles within integrated multidisciplinary care teams.
Contributing to PSA’s education resources and mentoring health professionals across disciplines have enhanced pharmacists’ confidence and impact in complex care environments.
Early Career Pharmacist of the Year – Stephanie Lee MPS
Early Career Pharmacist of the Year, Stephanie Lee MPS has been recognised for innovation, expanded scope service delivery and leadership in rural healthcare. As the first community pharmacist in South Australia to administer long-acting injectable buprenorphine, she has significantly improved access to evidence-based treatment for opioid dependence, reducing barriers to care and supporting safer, more dignified patient outcomes.
Ms Lee is also a passionate advocate for community engagement, professional development, and integrated care. Through health education presentations, expanded-scope services including mental health first aid, urinary tract infection management, and oral contraceptive supply – alongside close collaboration with local hospitals – she has strengthened health literacy and care quality across her rural community of Bordertown.
Intern Pharmacist of the Year – Li Ann Ching MPS
Li Ann Ching MPS was recognised as the Intern Pharmacist of the Year for her outstanding performance and professionalism throughout her intern year, demonstrating a strong commitment to patient-centred care and expanded pharmacy services.
By delivering a wide range of professional services – including vaccination, heart health checks, travel consultations and hospital-to-home discharge reviews – Ms Ching has excelled in her commitment to patient health, while also supporting the provision of professional services in the pharmacy, such as dose administration aids and MedsChecks.
Lifetime Achievement Award – Grant Kardachi AM FPS
Grant Kardachi AM FPS was awarded the Lifetime Achievement Award in Adelaide, recognised for his extraordinary contribution to the pharmacy profession spanning over 5 decades. As a highly respected leader, advocate, and mentor, Mr Kardachi has played a pivotal role in shaping contemporary practice across Australia.
Widely regarded as a pioneer of consultant pharmacy, Mr Kardachi was a key player in the 1996 Community Pharmacy Model Practices Project, leading to the introduction of Home Medicines Reviews and Residential Medication Management Reviews. These essential healthcare services have transformed medicines stewardship and continue to improve the safe and effective use of medicines for Australians.
Serving more than 30 years of leadership, representing PSA at branch and national levels, including as National President from 2011 to 2015, Mr Kardachi has advanced professional standards, education, and patient-centred care.
PSA Gold Medal – Matthew Weimann
The PSA were also delighted to present Matthew Weimann with the prestigious PSA Gold Medal for his exceptional academic achievement. Following graduation, Mr Weimann is currently completing his intern year at The Queen Elizabeth Hospital where he is stimulated by his interactions with patients and clinical complexity.
The PSA Gold Medal recognises the student with the highest-grade point average, above 6.25, studying a Bachelor of Pharmacy at the University of South Australia. The Gold Medal has been awarded in South Australia since 1896 but only when there is a candidate that meets the stringent requirements of this award. Mr Weimann joins this elite group of pharmacists to receive the Gold Medal.
‘These award recipients represent some of the best of the pharmacy profession,’ Prof Angley said. ‘Their innovation, dedication, and passion are essential as we respond to the evolving health needs of our communities.’
[post_title] => PSA recognises pharmacists for excellence in practice
[post_excerpt] => PSA has announced the winners of the South Australian and Northern Territory Pharmacist Awards, recognising outstanding pharmacists who have demonstrated excellence in their practice and dedication to improving healthcare outcomes for their communities.
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[post_content] => From hospital wards to community pharmacies, and increasingly, digital platforms, pharmacists are there to ensure medicines are used safely – no matter the location.
As healthcare systems are confronted with growing demand, workforce pressures, and a landscape of technological change, the role of pharmacists continues to expand simultaneously in scope and significance.
PSA WA/ACT State Manager Mayli Foong MPS said that, ‘Pharmacists play a key role in supporting medicines in so many settings including hospital, residential aged care facilities, Home Medicines Reviews, community pharmacy, Aboriginal Health Services, compounding and education.’
‘The expanded scope for pharmacists in Community pharmacy is really exciting. Including expanded scope of prescribing and increased range of vaccinations that pharmacists can deliver.’
Ahead of Thank Your Pharmacist Day 2026, with the theme ‘wherever medicines are’, AP spoke to early career pharmacists to explore the breadth of their roles, and the impact they have on patient care and medicines safety every day.
Beyond the pharmacy counter
Rhiannon Price MPS, pharmacist at King Edward Memorial Hospital told AP that there is ‘no such thing as a typical day because everyday is unique.’
‘Just this week I have been actively involved in an acute case of hyperkalaemia (potassium of 7.7)... I collaborated with a physiotherapist to manage pain for a patient post caesarean section up four flights of stairs and liaised with the medical team to safely facilitate a discharge for someone that needed hospital in-home support to safely administer heparin injections,’ said Ms Price, who was awarded 2025 PSA WA Early Career Pharmacist of the Year.
[caption id="attachment_31621" align="alignright" width="167"] Rhiannon Price, Pharmacist at King Edward Memorial Hospital.[/caption]
The stakes can be raised further in hospital compounding units, which are a cornerstone of ensuring safe medicines preparation. In these highly controlled environments, specialised medicines are prepared for some of the most vulnerable patients, said Caspar Townsend MPS, who works in Perth Children’s Hospital sterile compounding unit.
‘In the morning, we receive and prepare orders from the wards, and before anything begins, we do a full clean of the unit using multiple disinfectants,’ he said. ‘From then until about 1.00 pm, we’re focused on making those medications. In the afternoon, we move on to total parenteral nutrition bags for paediatric patients. A pharmacist will check them again outside, and then they will get bagged up and delivered to their wards.’
Mr Townsend’s journey into sterile compounding began during his internship, where he found an appreciation for the unique blend of technical skills required and hands-on approach.
‘I’m still testing my knowledge, but I also get to work with my hands, which is fun. It’s both the mental and the practical skills that I quite enjoy,’ Mr Townsend told AP.
[caption id="attachment_31633" align="alignright" width="300"] Caspar Townsend MPS, Pharmacist at Perth Children's Hospital compounding unit[/caption]
‘Every [medicine] for every patient is going to be different. It’s tailored to them, so there’s a really high margin and risk for error. It’s all about that precision and control – making sure the medication is the right medication, it’s the right dose, it’s been compounded correctly, and [there’s] all those little checks along the way.’
Providing patients with accessible medicines content
While pharmacists operate in highly regulated clinical settings, others have an expanded reach beyond the pharmacy walls into digital spaces.
Social media has become an invaluable tool for enhancing medicines safety and public health awareness through disseminating accessible, digestible short-form content in real time.
Iraq Doali MPS (@clutchestpharmacist), a NSW-based locum pharmacist, has embraced this shift in the media landscape with his Instagram platform, and is actively bridging the gap between patients and reliable healthcare advice.
‘I wanted to reach a wider audience,’ he said. ‘I felt like a lot of the time people were missing out on crucial information because they were in too much of a rush at the pharmacy or the pharmacy was too busy,’ Mr Doali told AP.
Recognising a lack of pharmacist voices online, he saw an opportunity to contribute, ensuring patients can access timely information. ‘I realised there aren’t many pharmacists on Instagram, which is an important tool for trust and improving medicines safety,’ Mr Doali said.
His aim is to impart knowledge to patients where access to advice may be limited. ‘I [also] talk about the struggles of pharmacy, what pharmacists do, stock issues, or law changes concerning the public in pharmacy… I just want to make sure people get the information they need to get, and from a trusted healthcare professional at the same time,’ Mr Doali said.
His content has assisted in improving health literacy in terms of ‘explaining procedures and medical conditions. This helps viewers understand the profession better, expand their knowledge, and even keep them alert on the changes happening in the pharmacy world’.
The immediacy of digital platforms allows pharmacists to respond quickly to emerging issues... ‘With digital spaces and pharmacists educating about medications, you can reach out to the public when you’re anticipating stock shortages… this is something that can be addressed instantly,’ he said.
[caption id="attachment_31619" align="alignright" width="233"] Iraq Doali, NSW-based locum pharmacist and content creator[/caption]
The leaders of tomorrow
With students mapping out the future landscape of pharmacy, AP spoke with Sebastian Harper, National President at the National Australian Pharmacy Students’ Association (NAPSA), about the role of pharmacies as crucial health hubs in rural and remote communities where GP access is limited.
‘The idea that patients can easily present to their GP is not a reality,’ said Mr Harper, who also works as an intern in Mt Isa.
‘Having pharmacists adequately trained to manage acute, everyday conditions and those treated under the Chronic Conditions Management Pilot, has been a blessing in delivering this care for our community.’
Looking ahead, he explained how the next generation of pharmacists is already preparing for a broader scope of practice.
‘It won't be long before we have a significant cohort of ECPs trained to deliver the care that communities across Australia are calling out for,’ Mr Harper said.
He believes this expansion will see pharmacists playing even more critical roles in patient treatment and preventative care. ‘I’m sure pharmacists will become the natural go-to for annual health check-ups, life-long implementation of patients' immunisation schedules, conversations about sexual health, and their pharmacies the inclusive spaces needed for traditionally health-averse demographics,’ Mr Harper said.
During his 3-year tenure on the NAPSA board, Mr Harper has seen pharmacy students committed to retaining their autonomy in a workforce that places increased demands upon young professionals.
‘In the NAPSA 2030 vision launched last year, which provides a framework for the next National President, pharmacy students are now advocating for themselves – calling for paid placements, expansion of scope and a profession that listens to their collective voice.’
Get involved in Thank Your Pharmacist Day 2026 by downloading the PSA’s TYPD26 toolkit.
[post_title] => Celebrating pharmacists wherever medicines are
[post_excerpt] => From hospital wards to community pharmacies, and increasingly, digital platforms, pharmacists are there to ensure medicines are used safely.
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[post_content] => Case scenario
During peak hour, 19-year-old Enzo and his mother arrive to collect a new prescription for melatonin MR 2 mg. The pharmacy is highly stimulating: background music blares, customers converse loudly nearby, staff assist others in a cramped space, and general noise amplifies the chaos. While processing Enzo’s prescription and attempting to deliver verbal instructions, you observe Enzo avoiding eye contact, fidgeting intensely, and appearing overwhelmed, with reduced capacity to process verbal or non-verbal cues due to sensory overload.
Learning objectivesAfter reading this article, pharmacists should be able to:
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Yvette Anderson (she/her) BPharm, MPS, CredPharm (MMR), ANZCAP (MentalHth, Paeds), CPGx, GradCert Autism[/caption]
Neurodevelopmental disorders (NDDs) arise from differences in brain development and typically affect cognition, communication, behaviour and occupational functioning. Common NDDs include attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), referred to as autism in this article, and intellectual developmental disorder (IDD).1 Autism is characterised by persistent social interaction and communication difficulties and restricted behavioural patterns.2 Symptoms begin in early childhood; however, diagnosis can occur at any age.3 Autism affects how the brain processes information, shaping how autistic people see, understand and respond to the world around them, with marked variability in presentation, day-to-day functioning and support needs.3,4
In Australia, autism prevalence has increased due to evolving diagnostic practices and awareness,5 meaning pharmacists now routinely engage with autistic individuals as part of everyday practice.
The challenge and opportunity for pharmacy is to shift from a medical model of crisis response, treatments and cures to a neuro-affirming social model that helps autistic individuals thrive, not just survive.
A neuro-affirming social model conceptualises neurodevelopmental differences as natural variations within human diversity and rejects deficit-based assumptions that frame these differences as disorders.6 Rather than ‘correcting’ individual traits, this approach provides reasonable adjustments while supporting autonomy, community participation and wellbeing, alongside awareness of diagnostic criteria, comorbidities, communication styles, lived realities and the impact of misinformation.6 The shift to a neuro-affirming social model calls for reducing systemic and environmental barriers, while still addressing health needs.6,7
For pharmacists, it means making practice adjustments in the way that the profession engages with and provides support for autistic individuals.
According to the Australian Bureau of Statistics, approximately 290,900 Australians (1.1%) are reported to have had an autism diagnosis in 2022.5 A recent estimate by Autism Spectrum Australia (Aspect) suggested at least 1 in 40 Australians are autistic.7
Rising prevalence reflects improved awareness and diagnostic practices rather than a true increase in incidence, including better recognition in historically underdiagnosed groups such as females and older adults.7 Autism prevalence peaks in children and adolescents, particularly those aged 10–14 years, and is markedly lower in adults, acknowledging limited adult data.5,8,9
Autism prevalence rates may appear to vary among ethnic and cultural groups, reflecting inequities such as access to healthcare, effective communication, diagnostic practices and cultural perceptions.10
Prevalence remains higher in males than females, with 1.6% of males identified compared with 0.7% of females, and the greatest disparity is seen in children aged 5–9 years.5 Autism in females is frequently underdiagnosed, as characteristics may manifest differently, be masked (e.g. forced eye contact, rehearsed social scripts, suppressing stimming or copying peers), or fail to align with historically male-centred diagnostic criteria, leading to misdiagnosis as mood or personality disorders.11,12 Masking may occur due to a desire to fit in, fear of stigma or bullying, previous negative reactions to autistic behaviours, and expectations of how females are ‘supposed’ to behave.12 Increasing awareness of the under-recognition of autism in females and gender-diverse individuals, and the social drivers of masking, is anticipated to influence future prevalence estimates.4,5,11
There is no single cause of autism, and despite extensive research, aetiology remains incompletely understood. Current evidence indicates autism arises from a complex interaction between genetic susceptibility and environmental influences on neurodevelopment.13
Family history is one of the strongest predictors of autism.13,14 Researchers have identified hundreds of genes, with approximately 10–20% of cases associated with rare genetic variants arising from mutations in sperm or egg cells.14 Autism is considered polygenic, meaning overall risk typically reflects the cumulative effect of multiple inherited variants, each contributing a small effect.14
The expression of genetic susceptibility is known to be influenced by prenatal, perinatal and postnatal environmental factors.13 Environmental factors appear most relevant during the prenatal period.14 Modest associations have been reported between autism likelihood and maternal factors such as hypertension, gestational diabetes, obesity, alcohol and substance use, poor antenatal care, and infection or fever during pregnancy.15
Imprecise and inconsistent associations have been reported for folate status, exposure to some air pollutants, and the use of some medicines.15–17 Importantly, these findings are largely derived from observational studies and are subject to confounding. While some prenatal medicine exposures show more consistent associations with autism, there is no clear evidence that associations between autism and other environmental and medicine exposures represent a causal relationship, and any contribution to autism risk remains limited and uncertain.14,17
Autism is diagnosed according to Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) criteria: ‘persistent deficits in social communication and social interaction across multiple contexts’, with the presence of ‘restricted, repetitive patterns of behaviour, interests or activities’.2
‘Symptoms must be present in the early development period’, although they may only become fully apparent later in life.
‘Symptoms cause clinically significant impairment in social, occupational or other important areas of functioning’ and ‘these disturbances are not better explained by IDD’ although both can co-occur.2 The DSM-5-TR also specifies severity levels (1–3) to indicate the degree of support required.2
In Australia, individuals may pursue an autism diagnosis through public or private pathways.18 Both are typically lengthy and necessitate a degree of health literacy and English proficiency. Diagnostic assessments may be conducted by a multidisciplinary team, including paediatricians, psychiatrists, psychologists, speech pathologists and occupational therapists.4 Multiple appointments may be needed, drawing on input from family, carers or teachers.18,19
Barriers to diagnosis include limited awareness of early signs among caregivers and clinicians, long wait times and out-of-pocket costs for specialist assessment, socioeconomic and geographic disparities, and bias in recognising diverse presentations.11,20,21 Limited health literacy and the complexity of navigating multidisciplinary assessments and National Disability Insurance Scheme requirements further impede access.21 In some communities, stigma, fear of labelling, and differing cultural interpretations of behaviour may delay help-seeking.22
A best-practice diagnostic approach should promote cultural safety and sensitivity, acknowledge variations in health literacy, address socioeconomic barriers, and be grounded in person-centred care.
Autism is a spectrum, with each individual having a unique mix of strengths, challenges, interests, needs and way of interacting with the world. Autism advocate Dr Stephen Shore states, ‘If you have met one autistic person, you have met one autistic person’.23
Beyond the core featuresComorbid NDDs, and psychiatric and medical conditions can create significant challenges for autistic individuals in relation to diagnosis, selection of appropriate interventions, medicines and support services.1,24
Comorbid NDDs among autistic individuals include ADHD, developmental coordination disorder (dyspraxia), IDD, and specific learning disorders such as dyslexia, dysgraphia and dyscalculia.25 Psychiatric comorbidities are also prevalent, including anxiety, depression, obsessive-compulsive disorder, and post-traumatic stress disorder.26 These conditions can intensify social and sensory challenges, increase vulnerability to stress, and impair emotional regulation and executive functioning.
Autistic individuals experience higher rates and severity of mental and physical health comorbidities than neurotypical individuals. Neurodivergent mental health outcomes are influenced by the interaction between individual differences and environmental and societal factors.25–28 Diagnostic overshadowing, whereby mental health symptoms are erroneously attributed to autism, should be avoided.29 Comorbid conditions warrant assessment and treatment according to the same clinical standards applied to neurotypical individuals, with adaptations made to accommodate the communication, sensory and support needs of autistic people. Neurodivergent individuals experience the full range of medical comorbidities seen in the general population; however, research indicates higher prevalence of certain conditions, including gastrointestinal disorders (e.g. irritable bowel syndrome, chronic constipation), sleep disturbances, epilepsy, and immune or metabolic disorders.30 These conditions may worsen fatigue, concentration and mood regulation, while motor difficulties may contribute to musculoskeletal pain, reduced physical activity and secondary health issues.31
Physical health conditions may be underdiagnosed when the clinical focus is limited to behavioural or psychological symptoms.29
Recognising the complex interconnections between physical, psychiatric and NDD health is paramount. Pharmacists can play a vital role in this process. Effective care relies on health professionals working collaboratively to identify how comorbid conditions, treatment burden and medicines may influence behaviour, cognition and developmental outcomes.
Autism is a lifelong NDD for which there is no curative treatment.4 Clinical care focuses on supporting health, functioning and community participation, addressing comorbidities, and optimising quality of life, while recognising and respecting the individual strengths, capabilities and perspectives of autistic individuals.3
Supports and interventions are individualised and typically involve a multidisciplinary team to address evolving needs.10 Allied health professionals may include speech pathologists to support communication, occupational therapists to address sensory processing and daily living skills, and psychologists to support emotional regulation and mental health. Physiotherapists may support gross motor skills, while dietitians support feeding and nutritional adequacy, alongside specialist educational support and therapy (e.g. play therapy, art therapy).3 Effective management relies on coordinated care, regular goal review and clear communication between the autistic individual, families and carers, and the multidisciplinary team.24
There is no evidence to support the use of medicines, exclusion diets or other biological treatment for the core features of autism.32,33 To support comorbidities, psychotropic medicines, antiepileptics and sleep agents may be used short term and under specific circumstances. Off-label use is common and requires careful assessment of risk-benefit balance, adverse effects, formulation choice, monitoring, cumulative treatment burden, and very careful consideration if the medicine is being prescribed as a chemical restraint.4
Autism is subject to persistent myths that pharmacists may encounter. The most damaging is the long-debunked claim that vaccines cause autism.14 The retracted 1998 Lancet study by Andrew Wakefield that claimed a link between the measles, mumps, rubella (MMR) vaccine and autism was a small, flawed study (with only 12 participants) and was exposed for unethical processes, methodological misconduct, and undisclosed conflicts of interest.14 Despite retraction, its claims were (and continue to be) amplified, eroding trust in public health and fuelling vaccine hesitancy. A Cochrane review published in 2021 found no credible evidence of an association between MMR and MMRV vaccines and autism.34
Two medicines made headlines in 2025: paracetamol and leucovorin (folinic acid or calcium folinate) claimed as a cause and treatment of autism respectively. Antenatal paracetamol exposure was alleged to increase autism and ADHD risk; however, major studies have not demonstrated a causal relationship.9 Stronger evidence from a large Swedish population-based cohort of 2,480,797 children born between 1995 and 2019 found no association between paracetamol use during pregnancy and autism, ADHD or IDD in sibling-controlled analysis.16 Cerebral folate deficiency (CFD) has been reported in a subset of autistic individuals, related to impaired folate transport into the brain, and may be associated with symptoms of speech difficulties, seizures and IDD, often within early childhood.35,36 Leucovorin, a folinic acid derivative, has been investigated as a potential treatment for autistic children with CFD. Leucovorin can bypass impaired folate transport, increasing central nervous system folate availability.36 Although some small-scale trials indicate potential minor behavioural improvements, supporting evidence remains limited, inconsistent, and not independently replicated.15,37
As medicines experts, pharmacists are well placed to counter common myths. Responses should prioritise empathetic, respectful communication and the provision of clear, evidence-based information and resources.
Accessibility, strong communication skills, medicines expertise, understanding of health system navigation and ability to synthesise information, position pharmacists to provide continuity of care for autistic individuals. Pharmacists can serve as an integrative link within multidisciplinary teams, supporting autistic individuals and their families across the healthcare continuum.
Effective communication underpins person-centred pharmacy practice. Pharmacists supporting autistic individuals should adapt both verbal and non-verbal communication to meet diverse needs.38 Autism can influence communication and sensory processing in unique ways, with some individuals experiencing sensory sensitivities to sound, light, smell, touch and visual stimuli.3,4,33 Some autistic individuals regulate sensory input through stimming (self-stimulatory behaviour), which may present as repetitive movements or sounds such as fidgeting, rocking or hand-flapping.39 Flexibility, empathy and understanding of sensory needs ensure equitable access to healthcare and fosters the relationship between patient and pharmacist. Verbal communication with autistic individuals should be clear and structured. Pharmacists should use straightforward, unambiguous language and present information in small, logical steps, allowing time for processing and response. Offering a calm, quiet space can both minimise sensory overload and facilitate a more comfortable environment for communication.38,40
Non-verbal communication requires equal attention. Eye contact, facial expressions and gestures can carry unintended meaning for autistic individuals. Some avoid eye contact as a coping mechanism, not as disinterest.38 Pharmacists should avoid assumptions and focus on open, calm body language and a reassuring tone. Visual supports can reinforce verbal explanations to provide ongoing reference, especially for individuals who process visual information more effectively than spoken language.40
A person-centred approach requires pharmacists to recognise, respond and adapt to the communication preferences of each autistic individual. If a caregiver or support worker is present, collaboration should occur while directing communication towards the patient whenever possible.40 Empathy, flexibility and inclusive communication techniques ensure care that is respectful and accessible and upholds an individual’s dignity and autonomy.
By adopting inclusive, neuro-affirming approaches, pharmacists strengthen equity, accessibility and person-centredness within healthcare. In doing so, they uphold the profession’s commitment to compassionate, evidence-based practice and help ensure autistic Australians receive the respect, understanding and tailored support needed to achieve optimal health and wellbeing.
Case scenario continuedEnzo’s mother discloses Enzo’s autism diagnosis and requests a quiet area and slower, step-by-step instructions. You offer a consultation room with dimmed lights, minimal visual clutter and no background noise. Enzo settles, visibly calmer. In this adapted space, you employ person-centred strategies: a soft, steady voice; paced delivery; short, simple sentences; pauses after each point for processing; confirming understanding via yes/no questions or thumbs-up signals; and a clear, written handout with bullet points, icons (e.g. clock for bedtime), and appropriate font. Enzo engages, maintaining partial eye contact and nodding, while his mother clarifies. These modifications demonstrate empathy, flexibility and equitable care, minimising distress, enhancing information access and supporting Enzo’s autonomy. |
Yvette Anderson (she/her) BPharm, MPS, CredPharm (MMR), ANZCAP (MentalHth, Paeds), CPGx, GradCert Autism is an accredited clinical pharmacist with over 20 years’ experience across aged care, consultancy, community pharmacy and hospital pharmacy. In 2020, she launched The Spectrum Pharmacist to increase awareness, promote inclusion, and provide education and support for neurodevelopmental disorders.
Victor Senescall (he/him) BPharm (Hons)
Merck Manual Professional Version. Overview of learning disorders. 2024. Available from: www.merckmanuals.com/professional/pediatrics/learning-and-developmental-disorders/overview-of-learning-disorders?query=neurodevelopment%20disorders
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington (DC): American Psychiatric Publishing; 2022.
Merck Manual Professional Version. Autism spectrum disorder. 2025. Available from: www.merckmanuals.com/professional/pediatrics/learning-and-developmental-disorders/autism-spectrum-disorder
Therapeutic Guidelines. Autism spectrum disorder. Melbourne: Therapeutic Guidelines; 2021.
Australian Bureau of Statistics. Autism in Australia 2022. 2024. Available from: www.abs.gov.au/articles/autism-australia-2022
Bertilsdotter Rosqvist H, Pearson A, Pavlopoulou G, et al. The social model in autism research. Autism. 2025;29(9):2201–2204.
Autism Spectrum Australia. At least 1 in 40 Australians are autistic: new estimate by Aspect on World Autism Understanding Day. 2024. Available from: www.aspect.org.au/news/at-least-1-in-40-australians-are-autistic
Therapeutic Guidelines. Autism spectrum disorder. eTG complete. Melbourne: Therapeutic Guidelines; 2021.
Trollor J, Arnold S, Walker SE. Australian Longitudinal Study of Autism in Adulthood (ALSAA): final report. Brisbane: Autism CRC; 2022.
Rasheed Z. Autism in Australia: understanding, challenges, and support. Int J Health Sci. 2023;17(5):1–4.
Lai M-C, Amestoy A, Bishop S, et al. Improving autism identification and support for individuals assigned female at birth: clinical suggestions and research priorities. Lancet Child Adolesc Health. 2023;7(12):897–908.
National Autistic Society. Masking. 2026. Available from: www.autism.org.uk/advice-and-guidance/topics/behaviour/masking
Ostrowski J, Religioni U, Gellert B, et al. Autism spectrum disorders: etiology, epidemiology, and challenges for public health. Med Sci Monit. 2024;30.
Australian Academy of Health and Medical Sciences. Autism: an evidence brief. 2025. Available from: https://aahms.org/policy/evidence-brief-on-autism
Love C, Sominsky L, O'Hely M, et al. Prenatal environmental risk factors for autism spectrum disorder and their potential mechanisms. BMC Med. 2024;22.
Ahlqvist VH, Sjöqvist H, Dalman C, et al. Acetaminophen use during pregnancy and children's risk of autism, ADHD, and intellectual disability. JAMA. 2024;331(14):1205–1214.
de Lara I, Wagner P, Matheus G, et al. Association of prenatal exposure to antiseizure medication with risk of autism: a systematic review and meta-analysis. Seizure. 2025;130:41–47.
Government of South Australia Office for Autism. Pathways for assessment and diagnosis. 2023. Available from: www.officeforautism.sa.gov.au/autism/pathways-for-diagnosis
Autism Awareness Australia. Understanding and accessing the NDIS. 2024. Available from: www.autismawareness.com.au/navigating-autism/understanding-and-accessing-the-ndis-for-autism
Estrin GL, Milner V, Spain D, et al. Barriers to autism spectrum disorder diagnosis for young women and girls: a systematic review. Rev J Autism Dev Disord. 2021;8(4):454–470.
Allen-Meares P, Lowry B, Estrella ML, et al. Health literacy barriers in the health care system: barriers and opportunities for the profession. Health Soc Work. 2020;45(1):62–64.
Khalil A, Yatcilla J, Christie N, et al. A systematic review of help-seeking barriers for racial-ethnic minority caregivers accessing autism diagnostic and intervention services. J Racial Ethn Health Disparities. 2025.
Flannery KA, Wisner-Carlson R. Autism and education. Child Adolesc Psychiatr Clin N Am. 2020;29(2).
Autism Awareness Australia. Navigating the health system. 2024. Available from: www.autismawareness.com.au/navigating-autism/navigating-the-health-system-for-autism
Bonti E, Zerva IK, Koundourou C, et al. The high rates of comorbidity among neurodevelopmental disorders: reconsidering the clinical utility of distinct diagnostic categories. J Pers Med. 2024;14(3):300.
Lai M-C, Kassee C, Besney R, et al. Prevalence of co-occurring mental health diagnoses in the autism population: a systematic review and meta-analysis. Lancet Psychiatry. 2019;6(10):819–829.
Mazurek MO, Sadikova E, Cheak-Zamora N, et al. Health care needs, experiences, and perspectives of autistic adults. Autism Adulthood. 2023;5(1):51–62.
Barlattani T, D'Amelio C, Cavatassi A, et al. Autism spectrum disorders and psychiatric comorbidities: a narrative review. J Psychopathol. 2023;29(1):3–24.
Blair J. Diagnostic overshadowing: see beyond the diagnosis. 2017. Available from: www.intellectualdisability.info/changing-values/diagnostic-overshadowing-see-beyond-the-diagnosis
Al-Beltagi M. Autism medical comorbidities. World J Clin Pediatr. 2021;10(3):15–28.
Sung Y-S, Loh SC, Lin L-Y. Physical activity and motor performance: a comparison between young children with and without autism spectrum disorder. Neuropsychiatr Dis Treat. 2021;17:3743–3751.
Turner M. The role of drugs in the treatment of autism. Aust Prescr. 2020;43:185–190.
Mayo Clinic. Autism spectrum disorder. 2025. Available from: www.mayoclinic.org/diseases-conditions/autism-spectrum-disorder/diagnosis-treatment/drc-20352934
Di Pietrantonj C, Rivetti A, Marchione P, et al. Vaccines for measles, mumps, rubella, and varicella in children. Cochrane Database Syst Rev. 2021;(11):CD004407.
Wong A, Frye RE, Ohnemus-Kawamura B, et al. Cerebral folate deficiency. 2019. Available from: https://rarediseases.org/rare-diseases/cerebral-folate-deficiency/
Ramaekers VTH, Quadros EV. Cerebral folate deficiency syndrome: early diagnosis, intervention and treatment strategies. Nutrients. 2022;14(15):3096.
Sheppeard A. What is leucovorin, and can it cure autism? 2025. Available from: www.medicalrepublic.com.au/what-is-leucovorin-and-can-it-cure-autism/120175
Norris JE, Milton D, Heasman B. Adapting communication with autistic service users: a participatory study. Autism. 2024.
National Autistic Society. Repeated movements and behaviour (stimming). 2026. Available from: www.autism.org.uk/advice-and-guidance/topics/about-autism/repeated-movements-and-behaviour-stimming
National Autistic Society. Autism and communication. 2024. Available from: www.autism.org.uk/advice-and-guidance/topics/about-autism/autism-and-communication
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[post_content] => As fuel costs climb and shortages loom, community pharmacies are facing mounting uncertainty on supply chains, workforce mobility, and equitable patient access.
Fuel shortages and escalating petrol costs are emerging as a significant disruptor for Australian workforces – including pharmacists, with exposure to the downstream impacts potentially affecting medicines delivery, patient access to care and workforce logistics.
Addressing the national fuel crisis
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[post_content] => A national workforce planning initiative is underway to better understand how the pharmacy profession must evolve to meet changing healthcare needs – and it could soon reshape how pharmacists practise for decades to come.
Commissioned by the federal government as part of the Strategic Agreement on Pharmacist Professional Practice, PSA has engaged the University of Queensland’s Centre for Business and Economics of Health to lead a whole-of-profession workforce forecast.
To kick off the consultation process, two all-day workshops bringing pharmacy leaders together across all settings took place in Brisbane and Melbourne last week, with valuable consumer insights also included.
UQ’s Associate Professor Jean Spinks said the scale of change facing the profession makes this work both necessary and overdue.
‘An updated strategic vision for the profession is required, given there’s been massive change over the last decade – including to the profession, scope of practice and the changing needs of the population,’ she said.
The modelling approach will start with the needs of the population that can be addressed by pharmacists to estimate what the size and composition of the pharmacy workforce should look like.
Pharmacy to become a needs-based workforce
The shift towards a needs-based model marks a fundamental change in how pharmacy workforce planning is approached – placing patient need, rather than service supply, at the centre.
It also demands a broader understanding of where pharmacists can add value across the health system, particularly for priority populations.
‘How do we reach them better, and what does that mean for the required skills and competencies of our workforce?’ A/Prof Spinks asked.
Consultation has already identified a wide range of priority groups who could benefit from improved access to pharmacy services.
Key populations include people living with chronic conditions, Aboriginal and Torres Strait Islander peoples, and those experiencing homelessness or housing insecurity.
‘There’s also alcohol and drug services – particularly gaps in methadone and buprenorphine services,’ A/Prof Spinks said.
The discussions have also highlighted growing need among people living with dementia, disability and complex health conditions – and the potential for pharmacists to play a greater role in supporting these groups.
‘We discussed whether we should be more involved with NDIS [National Disability Insurance Scheme] funding channels,’ she said. ‘It’s about how we meet those needs within our existing regulations, structures and funding models – bearing in mind that we've got to think about wherever a medicine is, there should be a pharmacist.’
A profession-wide response to workforce pressure
Expanding scope of practice is placing increasing pressure on pharmacists, particularly balancing dispensing with growing service delivery demands – raising important questions about safety, quality and workforce capacity.
‘Even now with vaccination, how many scripts is it safe to dispense in a day versus how many vaccinations at the same time?’ A/Prof Spinks asked. ‘We haven't really re-examined some of those aspects of both the quality and safety of care as it relates to workforce pressures.’
The modelling therefore takes a whole-of-profession approach, spanning all practice settings and recognising the need for stronger team-based care.
‘We’re working with experts across sectors to ensure we capture hospital, community and aged care settings, and also the role of technicians and assistants,’ she said. ‘You need to be able to have additional hands on deck to support expansion into additional settings.’
For PSA’s Head of Policy and Strategy Chris Campbell FPS, the significance of this work lies in its potential to unify the profession under a shared, forward-looking plan.
‘As a government-commissioned report, it will include policy recommendations, and we hope it helps shape the direction needed to support care delivered by pharmacists wherever medicines are,’ he said.
‘This isn’t just about having the data. We also need a whole-of-workforce plan – something that’s been missing for the profession. And importantly, this isn’t PSA’s plan, it’s the profession’s plan.
‘By global standards Australia does have a really vibrant community pharmacy and hospital pharmacy sector and these are strengths that we need to build on in the future.’
Primary care in focus
One area where workforce reform is expected to have significant impact is primary care, particularly through the expansion of GP pharmacist roles.
Medicines use is rising, complexity is increasing, and so too is the risk of medicines-related harm. There’s also growing pressure on the GP workforce alongside the escalating costs of care through the Medicare Benefits Schedule (MBS) and the Pharmaceutical Benefits Scheme (PBS), said GP pharmacist Brooke Shelly FPS, 2024 PSA MIMS Credentialed Pharmacist of the Year.
‘As reflected in repeated federal budget submissions from both the Royal Australian College of General Practitioners and the Australian Medical Association, GPs are actively calling for pharmacists to be part of the team,’ she said.
‘We are asking more of medicines than ever before, yet we still haven’t consistently embedded the workforce best trained to manage them in the very setting where most prescribing occurs, general practice.
‘Where pharmacists are embedded, we are already seeing improvements in quality use of medicines, more appropriate deprescribing, and better continuity of care.’
Despite this, workforce limitations are often driven by system constraints rather than lack of pharmacist interest.
‘We often talk about the workforce being small, but that reflects the constraints of current Home Medicines Review (HMR) and Residential Medication Management Review (RMMR) programs and the system more broadly,’ she said.
‘Unlock a clear, funded pathway for the GP Pharmacist role, and you will see a rapid surge in pharmacists seeking credentialing.’
Distribution also matters; workforce challenges are not just about numbers, but about ensuring pharmacists are embedded where patient need is greatest – particularly in rural and regional communities where these models of care are often essential.
‘Ultimately, the focus now is on building the structures that allow this workforce to be embedded where it can deliver the greatest impact, while continuing to support and strengthen existing programs such as HMRs and RMMRs that remain a critical part of the broader medicines safety framework,’ she said.
Looking ahead
When the plan comes together, Professor Lisa Nissen FPS – Director, and Taylor Family Chair, of the University of Queensland's Centre for the Business and Economics of Health – said it represents a critical opportunity to rethink the role of pharmacists in Australia’s health system.
‘There has not been a structured workforce planning activity in the pharmacy profession since 2009 for the 4th Community Pharmacy Agreement,’ she said. ‘And much of this previous work and modelling also focused on traditional roles for pharmacists in supply chain activities.’
As pharmacists’ roles expand and the pharmacy workforce is increasingly utilised in patient care, a clearer understanding of the future workforce composition and size – including pharmacists, assistants and technicians – will be critical to supporting healthcare needs.
‘This will help form the foundation for PSA and other groups to strategically plan for workforce development,’ Prof Nissen said.
Consultation will continue over the coming months, with PSA maintaining an open submissions process. A series of online focus groups is also scheduled for April, including at least one session dedicated specifically to exploring workforce needs in rural and remote areas
As for the final report, tight timelines for the modelling reflect strong interest in progressing workforce reform.
‘The federal government wants the [model] delivered by 30 June,’ A/Prof Spinks said.
‘They want to move on it quickly – and that’s encouraging.’
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[post_content] => PSA has announced the winners of the South Australian and Northern Territory Pharmacist Awards, recognising outstanding pharmacists who have demonstrated excellence in their practice and dedication to improving healthcare outcomes for their communities.
‘Congratulations to [the] SA/NT award winners, who are advancing patient care in their local communities and beyond,’ said PSA SA/NT President, Adjunct Professor Manya Angley FPS.
Pharmacist of the Year – Dr Paul Tait FPS
The PSA SA/NT Branch has named Dr Paul Tait FPS as Pharmacist of the Year 2026, recognising his outstanding leadership in digital health, palliative care, research and integrated care. With more than 30 years of experience spanning hospital practice, research and professional leadership – Dr Tait is widely recognised for strengthening pharmacists’ roles within integrated multidisciplinary care teams.
Contributing to PSA’s education resources and mentoring health professionals across disciplines have enhanced pharmacists’ confidence and impact in complex care environments.
Early Career Pharmacist of the Year – Stephanie Lee MPS
Early Career Pharmacist of the Year, Stephanie Lee MPS has been recognised for innovation, expanded scope service delivery and leadership in rural healthcare. As the first community pharmacist in South Australia to administer long-acting injectable buprenorphine, she has significantly improved access to evidence-based treatment for opioid dependence, reducing barriers to care and supporting safer, more dignified patient outcomes.
Ms Lee is also a passionate advocate for community engagement, professional development, and integrated care. Through health education presentations, expanded-scope services including mental health first aid, urinary tract infection management, and oral contraceptive supply – alongside close collaboration with local hospitals – she has strengthened health literacy and care quality across her rural community of Bordertown.
Intern Pharmacist of the Year – Li Ann Ching MPS
Li Ann Ching MPS was recognised as the Intern Pharmacist of the Year for her outstanding performance and professionalism throughout her intern year, demonstrating a strong commitment to patient-centred care and expanded pharmacy services.
By delivering a wide range of professional services – including vaccination, heart health checks, travel consultations and hospital-to-home discharge reviews – Ms Ching has excelled in her commitment to patient health, while also supporting the provision of professional services in the pharmacy, such as dose administration aids and MedsChecks.
Lifetime Achievement Award – Grant Kardachi AM FPS
Grant Kardachi AM FPS was awarded the Lifetime Achievement Award in Adelaide, recognised for his extraordinary contribution to the pharmacy profession spanning over 5 decades. As a highly respected leader, advocate, and mentor, Mr Kardachi has played a pivotal role in shaping contemporary practice across Australia.
Widely regarded as a pioneer of consultant pharmacy, Mr Kardachi was a key player in the 1996 Community Pharmacy Model Practices Project, leading to the introduction of Home Medicines Reviews and Residential Medication Management Reviews. These essential healthcare services have transformed medicines stewardship and continue to improve the safe and effective use of medicines for Australians.
Serving more than 30 years of leadership, representing PSA at branch and national levels, including as National President from 2011 to 2015, Mr Kardachi has advanced professional standards, education, and patient-centred care.
PSA Gold Medal – Matthew Weimann
The PSA were also delighted to present Matthew Weimann with the prestigious PSA Gold Medal for his exceptional academic achievement. Following graduation, Mr Weimann is currently completing his intern year at The Queen Elizabeth Hospital where he is stimulated by his interactions with patients and clinical complexity.
The PSA Gold Medal recognises the student with the highest-grade point average, above 6.25, studying a Bachelor of Pharmacy at the University of South Australia. The Gold Medal has been awarded in South Australia since 1896 but only when there is a candidate that meets the stringent requirements of this award. Mr Weimann joins this elite group of pharmacists to receive the Gold Medal.
‘These award recipients represent some of the best of the pharmacy profession,’ Prof Angley said. ‘Their innovation, dedication, and passion are essential as we respond to the evolving health needs of our communities.’
[post_title] => PSA recognises pharmacists for excellence in practice
[post_excerpt] => PSA has announced the winners of the South Australian and Northern Territory Pharmacist Awards, recognising outstanding pharmacists who have demonstrated excellence in their practice and dedication to improving healthcare outcomes for their communities.
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[post_content] => From hospital wards to community pharmacies, and increasingly, digital platforms, pharmacists are there to ensure medicines are used safely – no matter the location.
As healthcare systems are confronted with growing demand, workforce pressures, and a landscape of technological change, the role of pharmacists continues to expand simultaneously in scope and significance.
PSA WA/ACT State Manager Mayli Foong MPS said that, ‘Pharmacists play a key role in supporting medicines in so many settings including hospital, residential aged care facilities, Home Medicines Reviews, community pharmacy, Aboriginal Health Services, compounding and education.’
‘The expanded scope for pharmacists in Community pharmacy is really exciting. Including expanded scope of prescribing and increased range of vaccinations that pharmacists can deliver.’
Ahead of Thank Your Pharmacist Day 2026, with the theme ‘wherever medicines are’, AP spoke to early career pharmacists to explore the breadth of their roles, and the impact they have on patient care and medicines safety every day.
Beyond the pharmacy counter
Rhiannon Price MPS, pharmacist at King Edward Memorial Hospital told AP that there is ‘no such thing as a typical day because everyday is unique.’
‘Just this week I have been actively involved in an acute case of hyperkalaemia (potassium of 7.7)... I collaborated with a physiotherapist to manage pain for a patient post caesarean section up four flights of stairs and liaised with the medical team to safely facilitate a discharge for someone that needed hospital in-home support to safely administer heparin injections,’ said Ms Price, who was awarded 2025 PSA WA Early Career Pharmacist of the Year.
[caption id="attachment_31621" align="alignright" width="167"] Rhiannon Price, Pharmacist at King Edward Memorial Hospital.[/caption]
The stakes can be raised further in hospital compounding units, which are a cornerstone of ensuring safe medicines preparation. In these highly controlled environments, specialised medicines are prepared for some of the most vulnerable patients, said Caspar Townsend MPS, who works in Perth Children’s Hospital sterile compounding unit.
‘In the morning, we receive and prepare orders from the wards, and before anything begins, we do a full clean of the unit using multiple disinfectants,’ he said. ‘From then until about 1.00 pm, we’re focused on making those medications. In the afternoon, we move on to total parenteral nutrition bags for paediatric patients. A pharmacist will check them again outside, and then they will get bagged up and delivered to their wards.’
Mr Townsend’s journey into sterile compounding began during his internship, where he found an appreciation for the unique blend of technical skills required and hands-on approach.
‘I’m still testing my knowledge, but I also get to work with my hands, which is fun. It’s both the mental and the practical skills that I quite enjoy,’ Mr Townsend told AP.
[caption id="attachment_31633" align="alignright" width="300"] Caspar Townsend MPS, Pharmacist at Perth Children's Hospital compounding unit[/caption]
‘Every [medicine] for every patient is going to be different. It’s tailored to them, so there’s a really high margin and risk for error. It’s all about that precision and control – making sure the medication is the right medication, it’s the right dose, it’s been compounded correctly, and [there’s] all those little checks along the way.’
Providing patients with accessible medicines content
While pharmacists operate in highly regulated clinical settings, others have an expanded reach beyond the pharmacy walls into digital spaces.
Social media has become an invaluable tool for enhancing medicines safety and public health awareness through disseminating accessible, digestible short-form content in real time.
Iraq Doali MPS (@clutchestpharmacist), a NSW-based locum pharmacist, has embraced this shift in the media landscape with his Instagram platform, and is actively bridging the gap between patients and reliable healthcare advice.
‘I wanted to reach a wider audience,’ he said. ‘I felt like a lot of the time people were missing out on crucial information because they were in too much of a rush at the pharmacy or the pharmacy was too busy,’ Mr Doali told AP.
Recognising a lack of pharmacist voices online, he saw an opportunity to contribute, ensuring patients can access timely information. ‘I realised there aren’t many pharmacists on Instagram, which is an important tool for trust and improving medicines safety,’ Mr Doali said.
His aim is to impart knowledge to patients where access to advice may be limited. ‘I [also] talk about the struggles of pharmacy, what pharmacists do, stock issues, or law changes concerning the public in pharmacy… I just want to make sure people get the information they need to get, and from a trusted healthcare professional at the same time,’ Mr Doali said.
His content has assisted in improving health literacy in terms of ‘explaining procedures and medical conditions. This helps viewers understand the profession better, expand their knowledge, and even keep them alert on the changes happening in the pharmacy world’.
The immediacy of digital platforms allows pharmacists to respond quickly to emerging issues... ‘With digital spaces and pharmacists educating about medications, you can reach out to the public when you’re anticipating stock shortages… this is something that can be addressed instantly,’ he said.
[caption id="attachment_31619" align="alignright" width="233"] Iraq Doali, NSW-based locum pharmacist and content creator[/caption]
The leaders of tomorrow
With students mapping out the future landscape of pharmacy, AP spoke with Sebastian Harper, National President at the National Australian Pharmacy Students’ Association (NAPSA), about the role of pharmacies as crucial health hubs in rural and remote communities where GP access is limited.
‘The idea that patients can easily present to their GP is not a reality,’ said Mr Harper, who also works as an intern in Mt Isa.
‘Having pharmacists adequately trained to manage acute, everyday conditions and those treated under the Chronic Conditions Management Pilot, has been a blessing in delivering this care for our community.’
Looking ahead, he explained how the next generation of pharmacists is already preparing for a broader scope of practice.
‘It won't be long before we have a significant cohort of ECPs trained to deliver the care that communities across Australia are calling out for,’ Mr Harper said.
He believes this expansion will see pharmacists playing even more critical roles in patient treatment and preventative care. ‘I’m sure pharmacists will become the natural go-to for annual health check-ups, life-long implementation of patients' immunisation schedules, conversations about sexual health, and their pharmacies the inclusive spaces needed for traditionally health-averse demographics,’ Mr Harper said.
During his 3-year tenure on the NAPSA board, Mr Harper has seen pharmacy students committed to retaining their autonomy in a workforce that places increased demands upon young professionals.
‘In the NAPSA 2030 vision launched last year, which provides a framework for the next National President, pharmacy students are now advocating for themselves – calling for paid placements, expansion of scope and a profession that listens to their collective voice.’
Get involved in Thank Your Pharmacist Day 2026 by downloading the PSA’s TYPD26 toolkit.
[post_title] => Celebrating pharmacists wherever medicines are
[post_excerpt] => From hospital wards to community pharmacies, and increasingly, digital platforms, pharmacists are there to ensure medicines are used safely.
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[post_content] => Case scenario
During peak hour, 19-year-old Enzo and his mother arrive to collect a new prescription for melatonin MR 2 mg. The pharmacy is highly stimulating: background music blares, customers converse loudly nearby, staff assist others in a cramped space, and general noise amplifies the chaos. While processing Enzo’s prescription and attempting to deliver verbal instructions, you observe Enzo avoiding eye contact, fidgeting intensely, and appearing overwhelmed, with reduced capacity to process verbal or non-verbal cues due to sensory overload.
Learning objectivesAfter reading this article, pharmacists should be able to:
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Yvette Anderson (she/her) BPharm, MPS, CredPharm (MMR), ANZCAP (MentalHth, Paeds), CPGx, GradCert Autism[/caption]
Neurodevelopmental disorders (NDDs) arise from differences in brain development and typically affect cognition, communication, behaviour and occupational functioning. Common NDDs include attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), referred to as autism in this article, and intellectual developmental disorder (IDD).1 Autism is characterised by persistent social interaction and communication difficulties and restricted behavioural patterns.2 Symptoms begin in early childhood; however, diagnosis can occur at any age.3 Autism affects how the brain processes information, shaping how autistic people see, understand and respond to the world around them, with marked variability in presentation, day-to-day functioning and support needs.3,4
In Australia, autism prevalence has increased due to evolving diagnostic practices and awareness,5 meaning pharmacists now routinely engage with autistic individuals as part of everyday practice.
The challenge and opportunity for pharmacy is to shift from a medical model of crisis response, treatments and cures to a neuro-affirming social model that helps autistic individuals thrive, not just survive.
A neuro-affirming social model conceptualises neurodevelopmental differences as natural variations within human diversity and rejects deficit-based assumptions that frame these differences as disorders.6 Rather than ‘correcting’ individual traits, this approach provides reasonable adjustments while supporting autonomy, community participation and wellbeing, alongside awareness of diagnostic criteria, comorbidities, communication styles, lived realities and the impact of misinformation.6 The shift to a neuro-affirming social model calls for reducing systemic and environmental barriers, while still addressing health needs.6,7
For pharmacists, it means making practice adjustments in the way that the profession engages with and provides support for autistic individuals.
According to the Australian Bureau of Statistics, approximately 290,900 Australians (1.1%) are reported to have had an autism diagnosis in 2022.5 A recent estimate by Autism Spectrum Australia (Aspect) suggested at least 1 in 40 Australians are autistic.7
Rising prevalence reflects improved awareness and diagnostic practices rather than a true increase in incidence, including better recognition in historically underdiagnosed groups such as females and older adults.7 Autism prevalence peaks in children and adolescents, particularly those aged 10–14 years, and is markedly lower in adults, acknowledging limited adult data.5,8,9
Autism prevalence rates may appear to vary among ethnic and cultural groups, reflecting inequities such as access to healthcare, effective communication, diagnostic practices and cultural perceptions.10
Prevalence remains higher in males than females, with 1.6% of males identified compared with 0.7% of females, and the greatest disparity is seen in children aged 5–9 years.5 Autism in females is frequently underdiagnosed, as characteristics may manifest differently, be masked (e.g. forced eye contact, rehearsed social scripts, suppressing stimming or copying peers), or fail to align with historically male-centred diagnostic criteria, leading to misdiagnosis as mood or personality disorders.11,12 Masking may occur due to a desire to fit in, fear of stigma or bullying, previous negative reactions to autistic behaviours, and expectations of how females are ‘supposed’ to behave.12 Increasing awareness of the under-recognition of autism in females and gender-diverse individuals, and the social drivers of masking, is anticipated to influence future prevalence estimates.4,5,11
There is no single cause of autism, and despite extensive research, aetiology remains incompletely understood. Current evidence indicates autism arises from a complex interaction between genetic susceptibility and environmental influences on neurodevelopment.13
Family history is one of the strongest predictors of autism.13,14 Researchers have identified hundreds of genes, with approximately 10–20% of cases associated with rare genetic variants arising from mutations in sperm or egg cells.14 Autism is considered polygenic, meaning overall risk typically reflects the cumulative effect of multiple inherited variants, each contributing a small effect.14
The expression of genetic susceptibility is known to be influenced by prenatal, perinatal and postnatal environmental factors.13 Environmental factors appear most relevant during the prenatal period.14 Modest associations have been reported between autism likelihood and maternal factors such as hypertension, gestational diabetes, obesity, alcohol and substance use, poor antenatal care, and infection or fever during pregnancy.15
Imprecise and inconsistent associations have been reported for folate status, exposure to some air pollutants, and the use of some medicines.15–17 Importantly, these findings are largely derived from observational studies and are subject to confounding. While some prenatal medicine exposures show more consistent associations with autism, there is no clear evidence that associations between autism and other environmental and medicine exposures represent a causal relationship, and any contribution to autism risk remains limited and uncertain.14,17
Autism is diagnosed according to Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) criteria: ‘persistent deficits in social communication and social interaction across multiple contexts’, with the presence of ‘restricted, repetitive patterns of behaviour, interests or activities’.2
‘Symptoms must be present in the early development period’, although they may only become fully apparent later in life.
‘Symptoms cause clinically significant impairment in social, occupational or other important areas of functioning’ and ‘these disturbances are not better explained by IDD’ although both can co-occur.2 The DSM-5-TR also specifies severity levels (1–3) to indicate the degree of support required.2
In Australia, individuals may pursue an autism diagnosis through public or private pathways.18 Both are typically lengthy and necessitate a degree of health literacy and English proficiency. Diagnostic assessments may be conducted by a multidisciplinary team, including paediatricians, psychiatrists, psychologists, speech pathologists and occupational therapists.4 Multiple appointments may be needed, drawing on input from family, carers or teachers.18,19
Barriers to diagnosis include limited awareness of early signs among caregivers and clinicians, long wait times and out-of-pocket costs for specialist assessment, socioeconomic and geographic disparities, and bias in recognising diverse presentations.11,20,21 Limited health literacy and the complexity of navigating multidisciplinary assessments and National Disability Insurance Scheme requirements further impede access.21 In some communities, stigma, fear of labelling, and differing cultural interpretations of behaviour may delay help-seeking.22
A best-practice diagnostic approach should promote cultural safety and sensitivity, acknowledge variations in health literacy, address socioeconomic barriers, and be grounded in person-centred care.
Autism is a spectrum, with each individual having a unique mix of strengths, challenges, interests, needs and way of interacting with the world. Autism advocate Dr Stephen Shore states, ‘If you have met one autistic person, you have met one autistic person’.23
Beyond the core featuresComorbid NDDs, and psychiatric and medical conditions can create significant challenges for autistic individuals in relation to diagnosis, selection of appropriate interventions, medicines and support services.1,24
Comorbid NDDs among autistic individuals include ADHD, developmental coordination disorder (dyspraxia), IDD, and specific learning disorders such as dyslexia, dysgraphia and dyscalculia.25 Psychiatric comorbidities are also prevalent, including anxiety, depression, obsessive-compulsive disorder, and post-traumatic stress disorder.26 These conditions can intensify social and sensory challenges, increase vulnerability to stress, and impair emotional regulation and executive functioning.
Autistic individuals experience higher rates and severity of mental and physical health comorbidities than neurotypical individuals. Neurodivergent mental health outcomes are influenced by the interaction between individual differences and environmental and societal factors.25–28 Diagnostic overshadowing, whereby mental health symptoms are erroneously attributed to autism, should be avoided.29 Comorbid conditions warrant assessment and treatment according to the same clinical standards applied to neurotypical individuals, with adaptations made to accommodate the communication, sensory and support needs of autistic people. Neurodivergent individuals experience the full range of medical comorbidities seen in the general population; however, research indicates higher prevalence of certain conditions, including gastrointestinal disorders (e.g. irritable bowel syndrome, chronic constipation), sleep disturbances, epilepsy, and immune or metabolic disorders.30 These conditions may worsen fatigue, concentration and mood regulation, while motor difficulties may contribute to musculoskeletal pain, reduced physical activity and secondary health issues.31
Physical health conditions may be underdiagnosed when the clinical focus is limited to behavioural or psychological symptoms.29
Recognising the complex interconnections between physical, psychiatric and NDD health is paramount. Pharmacists can play a vital role in this process. Effective care relies on health professionals working collaboratively to identify how comorbid conditions, treatment burden and medicines may influence behaviour, cognition and developmental outcomes.
Autism is a lifelong NDD for which there is no curative treatment.4 Clinical care focuses on supporting health, functioning and community participation, addressing comorbidities, and optimising quality of life, while recognising and respecting the individual strengths, capabilities and perspectives of autistic individuals.3
Supports and interventions are individualised and typically involve a multidisciplinary team to address evolving needs.10 Allied health professionals may include speech pathologists to support communication, occupational therapists to address sensory processing and daily living skills, and psychologists to support emotional regulation and mental health. Physiotherapists may support gross motor skills, while dietitians support feeding and nutritional adequacy, alongside specialist educational support and therapy (e.g. play therapy, art therapy).3 Effective management relies on coordinated care, regular goal review and clear communication between the autistic individual, families and carers, and the multidisciplinary team.24
There is no evidence to support the use of medicines, exclusion diets or other biological treatment for the core features of autism.32,33 To support comorbidities, psychotropic medicines, antiepileptics and sleep agents may be used short term and under specific circumstances. Off-label use is common and requires careful assessment of risk-benefit balance, adverse effects, formulation choice, monitoring, cumulative treatment burden, and very careful consideration if the medicine is being prescribed as a chemical restraint.4
Autism is subject to persistent myths that pharmacists may encounter. The most damaging is the long-debunked claim that vaccines cause autism.14 The retracted 1998 Lancet study by Andrew Wakefield that claimed a link between the measles, mumps, rubella (MMR) vaccine and autism was a small, flawed study (with only 12 participants) and was exposed for unethical processes, methodological misconduct, and undisclosed conflicts of interest.14 Despite retraction, its claims were (and continue to be) amplified, eroding trust in public health and fuelling vaccine hesitancy. A Cochrane review published in 2021 found no credible evidence of an association between MMR and MMRV vaccines and autism.34
Two medicines made headlines in 2025: paracetamol and leucovorin (folinic acid or calcium folinate) claimed as a cause and treatment of autism respectively. Antenatal paracetamol exposure was alleged to increase autism and ADHD risk; however, major studies have not demonstrated a causal relationship.9 Stronger evidence from a large Swedish population-based cohort of 2,480,797 children born between 1995 and 2019 found no association between paracetamol use during pregnancy and autism, ADHD or IDD in sibling-controlled analysis.16 Cerebral folate deficiency (CFD) has been reported in a subset of autistic individuals, related to impaired folate transport into the brain, and may be associated with symptoms of speech difficulties, seizures and IDD, often within early childhood.35,36 Leucovorin, a folinic acid derivative, has been investigated as a potential treatment for autistic children with CFD. Leucovorin can bypass impaired folate transport, increasing central nervous system folate availability.36 Although some small-scale trials indicate potential minor behavioural improvements, supporting evidence remains limited, inconsistent, and not independently replicated.15,37
As medicines experts, pharmacists are well placed to counter common myths. Responses should prioritise empathetic, respectful communication and the provision of clear, evidence-based information and resources.
Accessibility, strong communication skills, medicines expertise, understanding of health system navigation and ability to synthesise information, position pharmacists to provide continuity of care for autistic individuals. Pharmacists can serve as an integrative link within multidisciplinary teams, supporting autistic individuals and their families across the healthcare continuum.
Effective communication underpins person-centred pharmacy practice. Pharmacists supporting autistic individuals should adapt both verbal and non-verbal communication to meet diverse needs.38 Autism can influence communication and sensory processing in unique ways, with some individuals experiencing sensory sensitivities to sound, light, smell, touch and visual stimuli.3,4,33 Some autistic individuals regulate sensory input through stimming (self-stimulatory behaviour), which may present as repetitive movements or sounds such as fidgeting, rocking or hand-flapping.39 Flexibility, empathy and understanding of sensory needs ensure equitable access to healthcare and fosters the relationship between patient and pharmacist. Verbal communication with autistic individuals should be clear and structured. Pharmacists should use straightforward, unambiguous language and present information in small, logical steps, allowing time for processing and response. Offering a calm, quiet space can both minimise sensory overload and facilitate a more comfortable environment for communication.38,40
Non-verbal communication requires equal attention. Eye contact, facial expressions and gestures can carry unintended meaning for autistic individuals. Some avoid eye contact as a coping mechanism, not as disinterest.38 Pharmacists should avoid assumptions and focus on open, calm body language and a reassuring tone. Visual supports can reinforce verbal explanations to provide ongoing reference, especially for individuals who process visual information more effectively than spoken language.40
A person-centred approach requires pharmacists to recognise, respond and adapt to the communication preferences of each autistic individual. If a caregiver or support worker is present, collaboration should occur while directing communication towards the patient whenever possible.40 Empathy, flexibility and inclusive communication techniques ensure care that is respectful and accessible and upholds an individual’s dignity and autonomy.
By adopting inclusive, neuro-affirming approaches, pharmacists strengthen equity, accessibility and person-centredness within healthcare. In doing so, they uphold the profession’s commitment to compassionate, evidence-based practice and help ensure autistic Australians receive the respect, understanding and tailored support needed to achieve optimal health and wellbeing.
Case scenario continuedEnzo’s mother discloses Enzo’s autism diagnosis and requests a quiet area and slower, step-by-step instructions. You offer a consultation room with dimmed lights, minimal visual clutter and no background noise. Enzo settles, visibly calmer. In this adapted space, you employ person-centred strategies: a soft, steady voice; paced delivery; short, simple sentences; pauses after each point for processing; confirming understanding via yes/no questions or thumbs-up signals; and a clear, written handout with bullet points, icons (e.g. clock for bedtime), and appropriate font. Enzo engages, maintaining partial eye contact and nodding, while his mother clarifies. These modifications demonstrate empathy, flexibility and equitable care, minimising distress, enhancing information access and supporting Enzo’s autonomy. |
Yvette Anderson (she/her) BPharm, MPS, CredPharm (MMR), ANZCAP (MentalHth, Paeds), CPGx, GradCert Autism is an accredited clinical pharmacist with over 20 years’ experience across aged care, consultancy, community pharmacy and hospital pharmacy. In 2020, she launched The Spectrum Pharmacist to increase awareness, promote inclusion, and provide education and support for neurodevelopmental disorders.
Victor Senescall (he/him) BPharm (Hons)
Merck Manual Professional Version. Overview of learning disorders. 2024. Available from: www.merckmanuals.com/professional/pediatrics/learning-and-developmental-disorders/overview-of-learning-disorders?query=neurodevelopment%20disorders
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington (DC): American Psychiatric Publishing; 2022.
Merck Manual Professional Version. Autism spectrum disorder. 2025. Available from: www.merckmanuals.com/professional/pediatrics/learning-and-developmental-disorders/autism-spectrum-disorder
Therapeutic Guidelines. Autism spectrum disorder. Melbourne: Therapeutic Guidelines; 2021.
Australian Bureau of Statistics. Autism in Australia 2022. 2024. Available from: www.abs.gov.au/articles/autism-australia-2022
Bertilsdotter Rosqvist H, Pearson A, Pavlopoulou G, et al. The social model in autism research. Autism. 2025;29(9):2201–2204.
Autism Spectrum Australia. At least 1 in 40 Australians are autistic: new estimate by Aspect on World Autism Understanding Day. 2024. Available from: www.aspect.org.au/news/at-least-1-in-40-australians-are-autistic
Therapeutic Guidelines. Autism spectrum disorder. eTG complete. Melbourne: Therapeutic Guidelines; 2021.
Trollor J, Arnold S, Walker SE. Australian Longitudinal Study of Autism in Adulthood (ALSAA): final report. Brisbane: Autism CRC; 2022.
Rasheed Z. Autism in Australia: understanding, challenges, and support. Int J Health Sci. 2023;17(5):1–4.
Lai M-C, Amestoy A, Bishop S, et al. Improving autism identification and support for individuals assigned female at birth: clinical suggestions and research priorities. Lancet Child Adolesc Health. 2023;7(12):897–908.
National Autistic Society. Masking. 2026. Available from: www.autism.org.uk/advice-and-guidance/topics/behaviour/masking
Ostrowski J, Religioni U, Gellert B, et al. Autism spectrum disorders: etiology, epidemiology, and challenges for public health. Med Sci Monit. 2024;30.
Australian Academy of Health and Medical Sciences. Autism: an evidence brief. 2025. Available from: https://aahms.org/policy/evidence-brief-on-autism
Love C, Sominsky L, O'Hely M, et al. Prenatal environmental risk factors for autism spectrum disorder and their potential mechanisms. BMC Med. 2024;22.
Ahlqvist VH, Sjöqvist H, Dalman C, et al. Acetaminophen use during pregnancy and children's risk of autism, ADHD, and intellectual disability. JAMA. 2024;331(14):1205–1214.
de Lara I, Wagner P, Matheus G, et al. Association of prenatal exposure to antiseizure medication with risk of autism: a systematic review and meta-analysis. Seizure. 2025;130:41–47.
Government of South Australia Office for Autism. Pathways for assessment and diagnosis. 2023. Available from: www.officeforautism.sa.gov.au/autism/pathways-for-diagnosis
Autism Awareness Australia. Understanding and accessing the NDIS. 2024. Available from: www.autismawareness.com.au/navigating-autism/understanding-and-accessing-the-ndis-for-autism
Estrin GL, Milner V, Spain D, et al. Barriers to autism spectrum disorder diagnosis for young women and girls: a systematic review. Rev J Autism Dev Disord. 2021;8(4):454–470.
Allen-Meares P, Lowry B, Estrella ML, et al. Health literacy barriers in the health care system: barriers and opportunities for the profession. Health Soc Work. 2020;45(1):62–64.
Khalil A, Yatcilla J, Christie N, et al. A systematic review of help-seeking barriers for racial-ethnic minority caregivers accessing autism diagnostic and intervention services. J Racial Ethn Health Disparities. 2025.
Flannery KA, Wisner-Carlson R. Autism and education. Child Adolesc Psychiatr Clin N Am. 2020;29(2).
Autism Awareness Australia. Navigating the health system. 2024. Available from: www.autismawareness.com.au/navigating-autism/navigating-the-health-system-for-autism
Bonti E, Zerva IK, Koundourou C, et al. The high rates of comorbidity among neurodevelopmental disorders: reconsidering the clinical utility of distinct diagnostic categories. J Pers Med. 2024;14(3):300.
Lai M-C, Kassee C, Besney R, et al. Prevalence of co-occurring mental health diagnoses in the autism population: a systematic review and meta-analysis. Lancet Psychiatry. 2019;6(10):819–829.
Mazurek MO, Sadikova E, Cheak-Zamora N, et al. Health care needs, experiences, and perspectives of autistic adults. Autism Adulthood. 2023;5(1):51–62.
Barlattani T, D'Amelio C, Cavatassi A, et al. Autism spectrum disorders and psychiatric comorbidities: a narrative review. J Psychopathol. 2023;29(1):3–24.
Blair J. Diagnostic overshadowing: see beyond the diagnosis. 2017. Available from: www.intellectualdisability.info/changing-values/diagnostic-overshadowing-see-beyond-the-diagnosis
Al-Beltagi M. Autism medical comorbidities. World J Clin Pediatr. 2021;10(3):15–28.
Sung Y-S, Loh SC, Lin L-Y. Physical activity and motor performance: a comparison between young children with and without autism spectrum disorder. Neuropsychiatr Dis Treat. 2021;17:3743–3751.
Turner M. The role of drugs in the treatment of autism. Aust Prescr. 2020;43:185–190.
Mayo Clinic. Autism spectrum disorder. 2025. Available from: www.mayoclinic.org/diseases-conditions/autism-spectrum-disorder/diagnosis-treatment/drc-20352934
Di Pietrantonj C, Rivetti A, Marchione P, et al. Vaccines for measles, mumps, rubella, and varicella in children. Cochrane Database Syst Rev. 2021;(11):CD004407.
Wong A, Frye RE, Ohnemus-Kawamura B, et al. Cerebral folate deficiency. 2019. Available from: https://rarediseases.org/rare-diseases/cerebral-folate-deficiency/
Ramaekers VTH, Quadros EV. Cerebral folate deficiency syndrome: early diagnosis, intervention and treatment strategies. Nutrients. 2022;14(15):3096.
Sheppeard A. What is leucovorin, and can it cure autism? 2025. Available from: www.medicalrepublic.com.au/what-is-leucovorin-and-can-it-cure-autism/120175
Norris JE, Milton D, Heasman B. Adapting communication with autistic service users: a participatory study. Autism. 2024.
National Autistic Society. Repeated movements and behaviour (stimming). 2026. Available from: www.autism.org.uk/advice-and-guidance/topics/about-autism/repeated-movements-and-behaviour-stimming
National Autistic Society. Autism and communication. 2024. Available from: www.autism.org.uk/advice-and-guidance/topics/about-autism/autism-and-communication
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[post_content] => As fuel costs climb and shortages loom, community pharmacies are facing mounting uncertainty on supply chains, workforce mobility, and equitable patient access.
Fuel shortages and escalating petrol costs are emerging as a significant disruptor for Australian workforces – including pharmacists, with exposure to the downstream impacts potentially affecting medicines delivery, patient access to care and workforce logistics.
Addressing the national fuel crisis
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[post_content] => A national workforce planning initiative is underway to better understand how the pharmacy profession must evolve to meet changing healthcare needs – and it could soon reshape how pharmacists practise for decades to come.
Commissioned by the federal government as part of the Strategic Agreement on Pharmacist Professional Practice, PSA has engaged the University of Queensland’s Centre for Business and Economics of Health to lead a whole-of-profession workforce forecast.
To kick off the consultation process, two all-day workshops bringing pharmacy leaders together across all settings took place in Brisbane and Melbourne last week, with valuable consumer insights also included.
UQ’s Associate Professor Jean Spinks said the scale of change facing the profession makes this work both necessary and overdue.
‘An updated strategic vision for the profession is required, given there’s been massive change over the last decade – including to the profession, scope of practice and the changing needs of the population,’ she said.
The modelling approach will start with the needs of the population that can be addressed by pharmacists to estimate what the size and composition of the pharmacy workforce should look like.
Pharmacy to become a needs-based workforce
The shift towards a needs-based model marks a fundamental change in how pharmacy workforce planning is approached – placing patient need, rather than service supply, at the centre.
It also demands a broader understanding of where pharmacists can add value across the health system, particularly for priority populations.
‘How do we reach them better, and what does that mean for the required skills and competencies of our workforce?’ A/Prof Spinks asked.
Consultation has already identified a wide range of priority groups who could benefit from improved access to pharmacy services.
Key populations include people living with chronic conditions, Aboriginal and Torres Strait Islander peoples, and those experiencing homelessness or housing insecurity.
‘There’s also alcohol and drug services – particularly gaps in methadone and buprenorphine services,’ A/Prof Spinks said.
The discussions have also highlighted growing need among people living with dementia, disability and complex health conditions – and the potential for pharmacists to play a greater role in supporting these groups.
‘We discussed whether we should be more involved with NDIS [National Disability Insurance Scheme] funding channels,’ she said. ‘It’s about how we meet those needs within our existing regulations, structures and funding models – bearing in mind that we've got to think about wherever a medicine is, there should be a pharmacist.’
A profession-wide response to workforce pressure
Expanding scope of practice is placing increasing pressure on pharmacists, particularly balancing dispensing with growing service delivery demands – raising important questions about safety, quality and workforce capacity.
‘Even now with vaccination, how many scripts is it safe to dispense in a day versus how many vaccinations at the same time?’ A/Prof Spinks asked. ‘We haven't really re-examined some of those aspects of both the quality and safety of care as it relates to workforce pressures.’
The modelling therefore takes a whole-of-profession approach, spanning all practice settings and recognising the need for stronger team-based care.
‘We’re working with experts across sectors to ensure we capture hospital, community and aged care settings, and also the role of technicians and assistants,’ she said. ‘You need to be able to have additional hands on deck to support expansion into additional settings.’
For PSA’s Head of Policy and Strategy Chris Campbell FPS, the significance of this work lies in its potential to unify the profession under a shared, forward-looking plan.
‘As a government-commissioned report, it will include policy recommendations, and we hope it helps shape the direction needed to support care delivered by pharmacists wherever medicines are,’ he said.
‘This isn’t just about having the data. We also need a whole-of-workforce plan – something that’s been missing for the profession. And importantly, this isn’t PSA’s plan, it’s the profession’s plan.
‘By global standards Australia does have a really vibrant community pharmacy and hospital pharmacy sector and these are strengths that we need to build on in the future.’
Primary care in focus
One area where workforce reform is expected to have significant impact is primary care, particularly through the expansion of GP pharmacist roles.
Medicines use is rising, complexity is increasing, and so too is the risk of medicines-related harm. There’s also growing pressure on the GP workforce alongside the escalating costs of care through the Medicare Benefits Schedule (MBS) and the Pharmaceutical Benefits Scheme (PBS), said GP pharmacist Brooke Shelly FPS, 2024 PSA MIMS Credentialed Pharmacist of the Year.
‘As reflected in repeated federal budget submissions from both the Royal Australian College of General Practitioners and the Australian Medical Association, GPs are actively calling for pharmacists to be part of the team,’ she said.
‘We are asking more of medicines than ever before, yet we still haven’t consistently embedded the workforce best trained to manage them in the very setting where most prescribing occurs, general practice.
‘Where pharmacists are embedded, we are already seeing improvements in quality use of medicines, more appropriate deprescribing, and better continuity of care.’
Despite this, workforce limitations are often driven by system constraints rather than lack of pharmacist interest.
‘We often talk about the workforce being small, but that reflects the constraints of current Home Medicines Review (HMR) and Residential Medication Management Review (RMMR) programs and the system more broadly,’ she said.
‘Unlock a clear, funded pathway for the GP Pharmacist role, and you will see a rapid surge in pharmacists seeking credentialing.’
Distribution also matters; workforce challenges are not just about numbers, but about ensuring pharmacists are embedded where patient need is greatest – particularly in rural and regional communities where these models of care are often essential.
‘Ultimately, the focus now is on building the structures that allow this workforce to be embedded where it can deliver the greatest impact, while continuing to support and strengthen existing programs such as HMRs and RMMRs that remain a critical part of the broader medicines safety framework,’ she said.
Looking ahead
When the plan comes together, Professor Lisa Nissen FPS – Director, and Taylor Family Chair, of the University of Queensland's Centre for the Business and Economics of Health – said it represents a critical opportunity to rethink the role of pharmacists in Australia’s health system.
‘There has not been a structured workforce planning activity in the pharmacy profession since 2009 for the 4th Community Pharmacy Agreement,’ she said. ‘And much of this previous work and modelling also focused on traditional roles for pharmacists in supply chain activities.’
As pharmacists’ roles expand and the pharmacy workforce is increasingly utilised in patient care, a clearer understanding of the future workforce composition and size – including pharmacists, assistants and technicians – will be critical to supporting healthcare needs.
‘This will help form the foundation for PSA and other groups to strategically plan for workforce development,’ Prof Nissen said.
Consultation will continue over the coming months, with PSA maintaining an open submissions process. A series of online focus groups is also scheduled for April, including at least one session dedicated specifically to exploring workforce needs in rural and remote areas
As for the final report, tight timelines for the modelling reflect strong interest in progressing workforce reform.
‘The federal government wants the [model] delivered by 30 June,’ A/Prof Spinks said.
‘They want to move on it quickly – and that’s encouraging.’
[post_title] => How will Australia’s pharmacy workforce respond to megatrends?
[post_excerpt] => A national workforce planning initiative is underway to better understand how the pharmacy profession must evolve to meet changing needs.
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[post_content] => PSA has announced the winners of the South Australian and Northern Territory Pharmacist Awards, recognising outstanding pharmacists who have demonstrated excellence in their practice and dedication to improving healthcare outcomes for their communities.
‘Congratulations to [the] SA/NT award winners, who are advancing patient care in their local communities and beyond,’ said PSA SA/NT President, Adjunct Professor Manya Angley FPS.
Pharmacist of the Year – Dr Paul Tait FPS
The PSA SA/NT Branch has named Dr Paul Tait FPS as Pharmacist of the Year 2026, recognising his outstanding leadership in digital health, palliative care, research and integrated care. With more than 30 years of experience spanning hospital practice, research and professional leadership – Dr Tait is widely recognised for strengthening pharmacists’ roles within integrated multidisciplinary care teams.
Contributing to PSA’s education resources and mentoring health professionals across disciplines have enhanced pharmacists’ confidence and impact in complex care environments.
Early Career Pharmacist of the Year – Stephanie Lee MPS
Early Career Pharmacist of the Year, Stephanie Lee MPS has been recognised for innovation, expanded scope service delivery and leadership in rural healthcare. As the first community pharmacist in South Australia to administer long-acting injectable buprenorphine, she has significantly improved access to evidence-based treatment for opioid dependence, reducing barriers to care and supporting safer, more dignified patient outcomes.
Ms Lee is also a passionate advocate for community engagement, professional development, and integrated care. Through health education presentations, expanded-scope services including mental health first aid, urinary tract infection management, and oral contraceptive supply – alongside close collaboration with local hospitals – she has strengthened health literacy and care quality across her rural community of Bordertown.
Intern Pharmacist of the Year – Li Ann Ching MPS
Li Ann Ching MPS was recognised as the Intern Pharmacist of the Year for her outstanding performance and professionalism throughout her intern year, demonstrating a strong commitment to patient-centred care and expanded pharmacy services.
By delivering a wide range of professional services – including vaccination, heart health checks, travel consultations and hospital-to-home discharge reviews – Ms Ching has excelled in her commitment to patient health, while also supporting the provision of professional services in the pharmacy, such as dose administration aids and MedsChecks.
Lifetime Achievement Award – Grant Kardachi AM FPS
Grant Kardachi AM FPS was awarded the Lifetime Achievement Award in Adelaide, recognised for his extraordinary contribution to the pharmacy profession spanning over 5 decades. As a highly respected leader, advocate, and mentor, Mr Kardachi has played a pivotal role in shaping contemporary practice across Australia.
Widely regarded as a pioneer of consultant pharmacy, Mr Kardachi was a key player in the 1996 Community Pharmacy Model Practices Project, leading to the introduction of Home Medicines Reviews and Residential Medication Management Reviews. These essential healthcare services have transformed medicines stewardship and continue to improve the safe and effective use of medicines for Australians.
Serving more than 30 years of leadership, representing PSA at branch and national levels, including as National President from 2011 to 2015, Mr Kardachi has advanced professional standards, education, and patient-centred care.
PSA Gold Medal – Matthew Weimann
The PSA were also delighted to present Matthew Weimann with the prestigious PSA Gold Medal for his exceptional academic achievement. Following graduation, Mr Weimann is currently completing his intern year at The Queen Elizabeth Hospital where he is stimulated by his interactions with patients and clinical complexity.
The PSA Gold Medal recognises the student with the highest-grade point average, above 6.25, studying a Bachelor of Pharmacy at the University of South Australia. The Gold Medal has been awarded in South Australia since 1896 but only when there is a candidate that meets the stringent requirements of this award. Mr Weimann joins this elite group of pharmacists to receive the Gold Medal.
‘These award recipients represent some of the best of the pharmacy profession,’ Prof Angley said. ‘Their innovation, dedication, and passion are essential as we respond to the evolving health needs of our communities.’
[post_title] => PSA recognises pharmacists for excellence in practice
[post_excerpt] => PSA has announced the winners of the South Australian and Northern Territory Pharmacist Awards, recognising outstanding pharmacists who have demonstrated excellence in their practice and dedication to improving healthcare outcomes for their communities.
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[post_content] => From hospital wards to community pharmacies, and increasingly, digital platforms, pharmacists are there to ensure medicines are used safely – no matter the location.
As healthcare systems are confronted with growing demand, workforce pressures, and a landscape of technological change, the role of pharmacists continues to expand simultaneously in scope and significance.
PSA WA/ACT State Manager Mayli Foong MPS said that, ‘Pharmacists play a key role in supporting medicines in so many settings including hospital, residential aged care facilities, Home Medicines Reviews, community pharmacy, Aboriginal Health Services, compounding and education.’
‘The expanded scope for pharmacists in Community pharmacy is really exciting. Including expanded scope of prescribing and increased range of vaccinations that pharmacists can deliver.’
Ahead of Thank Your Pharmacist Day 2026, with the theme ‘wherever medicines are’, AP spoke to early career pharmacists to explore the breadth of their roles, and the impact they have on patient care and medicines safety every day.
Beyond the pharmacy counter
Rhiannon Price MPS, pharmacist at King Edward Memorial Hospital told AP that there is ‘no such thing as a typical day because everyday is unique.’
‘Just this week I have been actively involved in an acute case of hyperkalaemia (potassium of 7.7)... I collaborated with a physiotherapist to manage pain for a patient post caesarean section up four flights of stairs and liaised with the medical team to safely facilitate a discharge for someone that needed hospital in-home support to safely administer heparin injections,’ said Ms Price, who was awarded 2025 PSA WA Early Career Pharmacist of the Year.
[caption id="attachment_31621" align="alignright" width="167"] Rhiannon Price, Pharmacist at King Edward Memorial Hospital.[/caption]
The stakes can be raised further in hospital compounding units, which are a cornerstone of ensuring safe medicines preparation. In these highly controlled environments, specialised medicines are prepared for some of the most vulnerable patients, said Caspar Townsend MPS, who works in Perth Children’s Hospital sterile compounding unit.
‘In the morning, we receive and prepare orders from the wards, and before anything begins, we do a full clean of the unit using multiple disinfectants,’ he said. ‘From then until about 1.00 pm, we’re focused on making those medications. In the afternoon, we move on to total parenteral nutrition bags for paediatric patients. A pharmacist will check them again outside, and then they will get bagged up and delivered to their wards.’
Mr Townsend’s journey into sterile compounding began during his internship, where he found an appreciation for the unique blend of technical skills required and hands-on approach.
‘I’m still testing my knowledge, but I also get to work with my hands, which is fun. It’s both the mental and the practical skills that I quite enjoy,’ Mr Townsend told AP.
[caption id="attachment_31633" align="alignright" width="300"] Caspar Townsend MPS, Pharmacist at Perth Children's Hospital compounding unit[/caption]
‘Every [medicine] for every patient is going to be different. It’s tailored to them, so there’s a really high margin and risk for error. It’s all about that precision and control – making sure the medication is the right medication, it’s the right dose, it’s been compounded correctly, and [there’s] all those little checks along the way.’
Providing patients with accessible medicines content
While pharmacists operate in highly regulated clinical settings, others have an expanded reach beyond the pharmacy walls into digital spaces.
Social media has become an invaluable tool for enhancing medicines safety and public health awareness through disseminating accessible, digestible short-form content in real time.
Iraq Doali MPS (@clutchestpharmacist), a NSW-based locum pharmacist, has embraced this shift in the media landscape with his Instagram platform, and is actively bridging the gap between patients and reliable healthcare advice.
‘I wanted to reach a wider audience,’ he said. ‘I felt like a lot of the time people were missing out on crucial information because they were in too much of a rush at the pharmacy or the pharmacy was too busy,’ Mr Doali told AP.
Recognising a lack of pharmacist voices online, he saw an opportunity to contribute, ensuring patients can access timely information. ‘I realised there aren’t many pharmacists on Instagram, which is an important tool for trust and improving medicines safety,’ Mr Doali said.
His aim is to impart knowledge to patients where access to advice may be limited. ‘I [also] talk about the struggles of pharmacy, what pharmacists do, stock issues, or law changes concerning the public in pharmacy… I just want to make sure people get the information they need to get, and from a trusted healthcare professional at the same time,’ Mr Doali said.
His content has assisted in improving health literacy in terms of ‘explaining procedures and medical conditions. This helps viewers understand the profession better, expand their knowledge, and even keep them alert on the changes happening in the pharmacy world’.
The immediacy of digital platforms allows pharmacists to respond quickly to emerging issues... ‘With digital spaces and pharmacists educating about medications, you can reach out to the public when you’re anticipating stock shortages… this is something that can be addressed instantly,’ he said.
[caption id="attachment_31619" align="alignright" width="233"] Iraq Doali, NSW-based locum pharmacist and content creator[/caption]
The leaders of tomorrow
With students mapping out the future landscape of pharmacy, AP spoke with Sebastian Harper, National President at the National Australian Pharmacy Students’ Association (NAPSA), about the role of pharmacies as crucial health hubs in rural and remote communities where GP access is limited.
‘The idea that patients can easily present to their GP is not a reality,’ said Mr Harper, who also works as an intern in Mt Isa.
‘Having pharmacists adequately trained to manage acute, everyday conditions and those treated under the Chronic Conditions Management Pilot, has been a blessing in delivering this care for our community.’
Looking ahead, he explained how the next generation of pharmacists is already preparing for a broader scope of practice.
‘It won't be long before we have a significant cohort of ECPs trained to deliver the care that communities across Australia are calling out for,’ Mr Harper said.
He believes this expansion will see pharmacists playing even more critical roles in patient treatment and preventative care. ‘I’m sure pharmacists will become the natural go-to for annual health check-ups, life-long implementation of patients' immunisation schedules, conversations about sexual health, and their pharmacies the inclusive spaces needed for traditionally health-averse demographics,’ Mr Harper said.
During his 3-year tenure on the NAPSA board, Mr Harper has seen pharmacy students committed to retaining their autonomy in a workforce that places increased demands upon young professionals.
‘In the NAPSA 2030 vision launched last year, which provides a framework for the next National President, pharmacy students are now advocating for themselves – calling for paid placements, expansion of scope and a profession that listens to their collective voice.’
Get involved in Thank Your Pharmacist Day 2026 by downloading the PSA’s TYPD26 toolkit.
[post_title] => Celebrating pharmacists wherever medicines are
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Australian Pharmacist is the official journal for Pharmaceutical Society of Australia Ltd.
