Pharmacist-led care for urinary tract infections (UTIs) and oral contraceptive resupply has been shown to be safe, effective and highly valued by women, according to the findings of two landmark NSW research trials led by Associate Professor Sarah Dineen-Griffin from the University of Newcastle and HMRI’s Population Health Research Program.
The final reports from the statewide PATH-UTI and PATH-OC trials represent some of the largest studies to date of pharmacist-led management of uncomplicated UTIs and oral contraceptive resupply, helping inform future models of care for women across NSW and the ACT.
Led by researchers from the University of Newcastle and HMRI, the studies evaluated services delivered through more than 1,000 pharmacies across metropolitan, regional and rural NSW and the ACT, involving more than 19,000 consultations over the course of the trials.
The University of Newcastle coordinated a consortium of 13 partner organisations, bringing together universities, pharmacy bodies, medical organisations and consumer groups to evaluate patient outcomes, referral pathways, healthcare utilisation, safety and implementation of the services.
The research brought together expertise in primary care, women’s health, implementation science, Aboriginal and Torres Strait Islander health, regional and rural health, antimicrobial stewardship and health services research.
Associate Professor Dineen-Griffin said the findings demonstrated that pharmacist-led services could improve access to timely care while maintaining strong clinical oversight and referral pathways.
“Our findings show that patients really value having pharmacists manage uncomplicated UTIs and oral contraceptive resupply, reflected in the high satisfaction reported across both studies,” Associate Professor Dineen-Griffin said.
“Women from cities, regional towns and most rural areas accessed the services, and pharmacists referred them to their GP when required by the clinical guidelines.”
More than 17,000 women aged 18 to 65 years participated in the PATH-UTI trial, with almost eight in ten reporting complete symptom resolution within seven days and nine in ten reporting they were satisfied or very satisfied with the service.
The PATH-OC trial involved almost 2,000 women seeking oral contraceptive resupply through community pharmacies, with participants reporting highly positive experiences and very low rates of side effects and adverse events.
The reports also highlighted the importance of collaboration between pharmacists and GPs, continuity of care and culturally appropriate service delivery, particularly for Aboriginal and Torres Strait Islander communities.
Building the evidence through data and evaluation
HMRI played a key role in generating the evidence underpinning both trials through its expertise in data management, health informatics and health economic evaluation.
HMRI’s Data Management team supported the establishment of the study databases and data collection systems that enabled researchers to securely capture and manage information.
HMRI Acting Head of Data Management & Health Informatics, Shaun Grady, said robust data infrastructure was essential to ensuring the quality and reliability of the research findings.
“These studies generated a large volume of real-world data across a wide geographic area and multiple healthcare settings,” Mr Grady said.
“Our role was to help establish systems that supported consistent, high-quality data collection and management, providing researchers with the information needed to evaluate patient outcomes, service delivery and referral pathways with confidence.”
HMRI’s Health Economics team led the economic evaluation of the trials, assessing the costs, outcomes and potential system-wide impacts of pharmacist-led care for women accessing UTI treatment and oral contraceptive resupply services.
The economic modelling found that shifting uncomplicated UTI care from general practice and emergency departments to community pharmacies could save the health system an estimated $2.2 million to $2.3 million annually, while maintaining safe and effective care.
HMRI Head of Health Economics, Dr Victoria McCreanor, said economic evaluation was an important part of understanding the full impact of new healthcare models.
“Health economic analysis helps decision-makers understand not only whether a service works, but also how resources can be used most effectively to improve health outcomes,” Dr McCreanor said.
“By examining both costs and outcomes, we can provide evidence that supports sustainable healthcare delivery and helps inform future policy and investment decisions.”
Informing future models of care
The reports identified several important considerations for the future design, governance and monitoring of pharmacist-led services, including ensuring continuity of care, maintaining strong collaboration between pharmacists and GPs, and supporting culturally appropriate care for Aboriginal and Torres Strait Islander communities.
The findings also highlighted opportunities to improve access to healthcare for women, particularly in regional and rural communities where timely access to a GP can sometimes be challenging.
With pharmacist-led UTI and oral contraceptive services now continuing in NSW following the conclusion of the trials, the research provides a strong evidence base to inform ongoing service delivery and future policy decisions.
The studies demonstrate the value of collaboration between researchers, clinicians, pharmacists, consumers and health service partners in developing practical, evidence-based solutions that improve access to care and health outcomes for communities across NSW.
Key results from the UTI trial include:
The pharmacist-led UTI service was accessible
Economic modelling:
The shift in use from GPs and emergency departments to pharmacist-led UTI care could save the health system an estimated $2.2–$2.3 million annually, although some costs may move to patients once the service operates outside trial conditions.
Key findings from the oral contraceptive trial include:
