A SASA is a written direction that authorises a health practitioner to administer or supply a medicine to any patient under specified conditions. Pharmacists are strongly advised to read and understand the conditions listed in the SASA before providing the service.
Pharmacists must complete one of the accredited trainings available before offering the service.
WA resupply protocol
The WA Department of Health has published the Pharmacist Resupply of Oral Contraceptive Pills Pilot – Western Australian Protocol after extensive consultations with the pilot working party. Pharmacists should read and understand the document in conjunction with the training and current clinical guidelines.
Pharmacy requirements
Pharmacists must meet professional practice standards and ensure that the consultation is conducted in an area that protects the patient’s privacy and confidentiality. During history taking, it is important to ensure that the patient is comfortable disclosing sensitive information that may be critical to the clinical assessment.
WA Scope - exclusion
Pharmacists providing the service must ensure that they are familiar with the WA scope. Patients must be referred to a medical practitioner if they have any of the following, or if the pharmacist is in doubt of the safety and appropriateness of the resupply.
- Age <16 years or ≥40 years.
- Dosage forms other than oral formulations requested.
- Patient has not been taking the same OCP continuously for at least 2 years, e.g. switching hormones, post-partum, poor adherence.
- Patient has not had an OCP review by a medical or nurse practitioner for over 2 years.
- Patient has taken a pill break for more than 2 weeks at a time or more than 4 weeks cumulatively in the past 12 months. Alternative contraceptive methods should be considered.
- Patient is taking an OCP with high dose estrogen (50 microg of ethinylestradiol).
- Patient is taking an OCP with estetrol, mestranol, or cyproterone.
- Patient is potentially pregnant.
- Patient has unexplained and un-investigated vaginal bleeding or acute, severe menstrual bleeding. Should be referred for investigation.
- STI screening is indicated (although OCP may still be resupplied by the pharmacist, referral is required).
- Patient has conditions in UKMEC Category 3 or 4.
- Significant drug interactions are identified.
Refer to the clinical protocol for more information.
Allowable hormones and limits
Ensure proper history taking during the consultation. The allowable hormones in WA are different to the same initiatives in other Australian jurisdictions, pharmacists must refer to the WA protocol during the resupply.
Pharmacists must be able to verify the previous prescription by sighting it or through other physical or electronic records. The resupplied quantity must also ensure that the patient has the OCP reviewed by a medical or nurse practitioner at least every 2 years.
Record keeping and referral
The pharmacist must keep a clinical record of the consultation and provide a service summary to the patient. This can be done using a pharmacy practice software, or the pharmacist may choose other forms of digital or paper record keeping methods.
Patients should be encouraged to present the service summary to their GP to have the resupply recorded on their personal medical history. In some cases, patients may need to be referred because they were unsuitable to have their OCP resupplied based on the consultation. The service summary can provide valuable information to the medical practitioner for their clinical assessment.
Where the patient has consented, the pharmacist may forward the service summary or referral letter to the patient's usual GP.
Interim arrangement on MedAdvisor
MedAdvisor is working on adding the Service Summary function to the OCP resupply form. It is estimated that the function will be available by mid-June 2024. Pharmacists providing the OCP resupply service using MedAdvisor are advised to generate a GP letter as an alternative, specifying the patient identity, medicine, and quantity resupplied.
My Health Record
The SASA mandates that the dispensing record is transmitted to My Health Record. This should occur automatically via the dispensing software that has been configured correctly. For dispensing software-specific information, pharmacists should consult the software vendor.
The purpose of the mandate is to ensure that relevant patient details were obtained, and the pharmacist’s HPI-I is linked to the dispensing record to allow the transmission to occur. Patients can adjust viewing rights in their My Health Record based on their own preferences.
Some people may have opted out of using My Health Record or have recently arrived in Australia. It is important to note that people without My Health Record are not excluded from accessing the service.
Fees and charges
Pharmacists should make sure that the patient understood the costs involved when offering the service and inform them that free consultations are available through bulk-billing general practitioners.
Gender diversity and cultural safety
Transgender and gender diverse (TGD) people presumed female at birth are not excluded, but pharmacists must ensure that the service that they provide is safe, sensitive, responsive, and accessible. TGD individuals seeking contraceptive care may also need to engage with other health services. Pharmacists should refer or assist patients in seeking out these services where appropriate.
Pharmacists must complete relevant cultural safety and gender diversity training relevant to their place of practice, reflect on their competency and provide the service in an inclusive and culturally safe manner.
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Last reviewed: 31-05-2024