[5,15] The DTP is a document containing a list of drugs that have been approved for use in rural hospitals or isolated practice areas by endorsed/authorised healthcare providers, and states the conditions and

restrictions under which the drugs can be used.[5,15] The Primary Clinical Care Manual[15] provides clear and concise clinical care guidelines in accordance with the Regulation for rural healthcare providers to implement the DTP. Although prescribing roles have been established for a range of healthcare providers, pharmacists in Australia currently do not have prescribing endorsements for Prescription Medicines, even in rural areas. The recently released Australian Pharmacy Council (APC) report from the Remote Rural Pharmacists Project has identified that legislation inhibits Nintedanib supplier pharmacists by not allowing them to prescribe medications for the management of chronic disease.[4] SB203580 The APC report therefore recommended that remote pharmacists be authorised to prescribe by protocol.[4] While the debate about,

and development of, pharmacists’ prescribing is still underway,[16,17] the Fifth Community Pharmacy Agreement between the Department of Health and Ageing and the Pharmacy Guild of Australia has recommended a ‘medication continuance protocol’ for community pharmacists to initiate continuing therapy (i.e. supply based on previous prescription or medication order) of a 1-month or single-pack supply of medication, provided that the patient has been stabilised on the medication therapy.[17] A similar model (the Medication Maintenance model) was proposed in 2007 for aged-care settings.[16] While this framework is developed for both metropolitan and rural setting, this is anticipated to temporarily ease access to medications when or where prescribers are unavailable and the

consumer is in short supply. It is foreseen that the implementation of this initiative would attract PBS subsidy, which would require changes to the PBS. It would also require the current drugs and poisons legislation (the Regulation in Queensland) to be amended to allow pharmacists Rucaparib price to implement the protocol without an existing or valid prescription. This step involves information transfer from the prescriber to the subsequent healthcare providers involved in the medication pathway, adhering to the legal prescribing and prescription requirements within the jurisdiction of practice.[2] In addition to the extended prescribing rights, provisions in the Regulation also allow some flexibility to facilitate prescribing and dispensing of medications, which is applicable to both metropolitan and rural areas. The Regulation allows for verbal or facsimile orders from prescribers, provided that a written order is received by the dispensing pharmacy within 7 days (sections 81, 97, 192).