Background: The role of community pharmacists has evolved beyond the dispensing of medicines. The aim of this scoping review was to describe the interventions that expand the pharmacist’s scope of practice within a community pharmacy setting and assess their effectiveness. Methods: We performed a scoping review to identify randomised controlled trials (RCTs), published worldwide from 2013 to 2024, which focused on interventions designed to expand pharmacists’ scope of practice in the community. The review was undertaken in accordance with the Joanna Briggs Institute methodology for scoping reviews. To address the aim of this scoping review, the included RCTs were mapped to themes influenced by the Professional Practice Standards 2023 as developed by the Pharmaceutical Society of Australia: medication management, collaborative care and medication adherence. Results: Twelve studies demonstrated the potential to expand community pharmacists’ scope of practice. Two RCTs resulted in no effect of the intervention. One RCT (conducted in Italy) led to an actual change to community pharmacists’ scope of practice, with a statistically significant improvement in the proportion of patients with controlled asthma. Conclusions: On the whole, this scoping review synthesised the findings of peer-reviewed RCT studies that revealed expanding community pharmacists’ scope of practice may result in improved patient outcomes, a reduced burden for the healthcare system, and greater productivity.

Sexual and reproductive health is an important aspect of a woman’s health and her ability to access safe, effective, affordable, and acceptable forms of fertility regulation, including contraception. This commentary piece introduces the barriers and facilitators to community pharmacists’ practising in sexual and reproductive health, and compares and contrasts interventions taking place internationally, compared to key clinical trials occurring in Australia on an expanded scope of community pharmacy practice, in prescribing the oral contraceptive pill (OCP). Modelling the practices already occurring in other high-income countries, Australia is striving to remove barriers and improve accessibility to contraceptive care, by enabling community pharmacists to prescribe contraception.

Background: Australia has commenced implementing the resupply and prescribing of contraception by community pharmacists. This is to improve equitable opportunities when accessing contraceptive methods in community pharmacy settings. The aim of this study was to investigate women participants’ acceptability of the resupply and prescribing of hormonal contraceptive by community pharmacists. Methods: Participants (n = 22) were women who had visited the pharmacy for the emergency contraceptive pill or with a prescription for medical abortion medicines, and were recruited to this study using convenience sampling. Semi-structured interviews were conducted to understand participants’ perspectives on hormonal contraceptive resupply and prescribing by community pharmacists. Results: Participants endorsed the acceptability of the resupply service by highlighting its benefits including: convenience, cost-effectiveness, time-effectiveness, improved access and a reliable alternative when it is not possible to see a general practitioner (GP). Participants also acknowledged the value of GPs initially prescribing contraceptive methods, particularly due to pharmacists’ lack of access to comprehensive medical histories. Participant confidence in pharmacist prescribing of contraceptive methods was low. However, they were more inclined to support pharmacist prescribing of contraceptive methods if they knew that they had received appropriate upskilling and training, especially in the case where a contraceptive method was being prescribed for the first time. Conclusion: Although pharmacist-led resupply is seen as an acceptable service, ongoing research is needed to explore its sustainability, feasibility and long-term impact on patient outcomes. Further research is required to understand the acceptability of autonomous pharmacist prescribing.

Objectives: Australia has commenced implementing contraceptive resupply and prescribing by community pharmacists to improve equity in method access. This study aimed to investigate pharmacist’s acceptability of hormonal contraceptive resupply and prescribing. Methods: Participants were recruited via convenience sampling and had provided contraceptive counseling consistent with the ALLIANCE intervention (i.e. structured, patient-centered, effectiveness-based care) to women seeking the emergency contraceptive pill or presenting prescriptions for medical abortion medicines. This qualitative descriptive study was embedded within the ALLIANCE trial, whose process evaluation included semi-structured interviews with pharmacist participants. The interview guide, containing questions on pharmacists’ views of the resupply and prescribing service, was reviewed by the ALLIANCE Trial Chief Investigators and piloted in June 2024 with the SPHERE Pharmacy Advisory Circle. Thirteen questions were developed using the Theoretical Framework of Acceptability (TFA). Two researchers conducted line-by-line coding using an iteratively refined codebook, with codes mapped to TFA constructs to examine operationalization in pharmacists’ delivery of hormonal contraception. Key findings: Although pharmacists (n = 24) perceived that the service could be cost- and time-saving to patients, they raised concerns of unintentionally removing general practitioner (GP)-led monitoring of patients and overstepping GPs’ roles. While pharmacists felt confident in their expertise and generally supported the service, they expressed hesitation about initiating contraceptive prescriptions, for which they felt further training and access to comprehensive medical records were required. Additional barriers included increased workload pressures, lack of reimbursement, and inadequate staffing. Conclusions: Overall, providing a resupply service appears to be acceptable to community pharmacists because it relies on the GP’s initial assessment but prescribing less so. However, evaluation is needed post-implementation to explore sustainability, feasibility, and long-term impact on patient outcomes.