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Therapeutic Prescribing

From 1 July 2014, the Medicines Amendment Act 2013 and Misuse of Drugs Amendment Regulations 2014 came into effect.

These amendments:

  • name nurse practitioners and optometrists as authorised prescribers
  • create a new delegated prescriber category
  • change the definition of medicines and medical devices
  • change the restrictions on nurse practitioners’ prescribing of controlled drugs
  • change the controlled drugs that midwives can prescribe
  • allow for controlled drug prescriptions to be generated electronically.

The changes to the Act name optometrists as authorised prescribers. This change enables optometrists to prescribe all medicines appropriate to their scope of practice, rather than limiting them to a list of medicines specified in regulation. This recognises the safe and appropriate prescribing practice of optometrists over the past nine years.

In anticipation of the above mentioned changes, the Board developed guidelines for optometrists for prescribing in glaucoma. The guidelines set out what the pre-requisites are for optometrists before they may commence treatment of glaucoma using glaucoma medications and in what circumstances referral to an ophthalmologist is required. The guidelines are intended to assist optometrists to prescribe medications that control intra-ocular pressure, with the goal of preserving optic nerve structure, visual function, and the patient’s quality of life, within accepted best-practice standards and to identify those patients who are suitable to treat independently.

Click here to view the guidelines. Please visit the ‘Glaucoma Prescribing’ page of the website for further information on being approved for glaucoma prescribing.

Optometrist prescribers should click here and ensure they are familiar with this important information about prescribing.

Optometrist prescribers should click here and familiarise themselves with the Guidelines on the prescribing of corticosteroids.

Practitioners who are unsure whether they are able to prescribe should contact the Board for advice on 04 474 0705.

 

Collaborative Care

The Board recognises that not all prescribing optometrists will wish to apply to the Board for approval to independently prescribe for glaucoma patients, and that they may prefer to form a collaborative care relationship with their ophthalmologist colleague/s to assist in managing the care of glaucoma patients.

The Board has therefore developed a statement to ensure that all prescribing optometrists, irrespective of their decision to apply for approval to prescribe independently or not, are aware of the distinction between collaborative care and independent prescribing.

Please click here to view the statement.

If you have questions after reading this statement, please contact the Board’s office for further clarification.

 

Use of Atropine

The Board has developed guidelines for prescribing optometrists on the safe use of topical atropine for myopia control. Click here to view the guidelines.

 

Medicine guidelines

The Board has developed guidelines for prescribing optometrists on:

  • Allergic Eye Disease – click here to view this document
  • Herpes Simplex Virus (HSV) Keratitis – click here to view this document
  • Herpes Zoster Ophthalmicus – click here to view this document
  • Acute Angle Closure – click here to view this document
  • Pain Management – click here to view this document
  • Meibomian Gland Dysfunction – click here to view this document
  • Blepharitis – click here to view this document
  • Lid Swelling – click here to view this document

These guideline documents are not exhaustive, are available as a reference guide for practitioners, and should be considered ‘living’ documents that will be added to over time.  Conditions outside those described in these guidelines may be deemed out of scope for independent optometric management and require referral to a medical practitioner.  If in doubt, please check with the Board for advice.

 

Occular therapeutics training available

The following training providers offer Graduate Certificate(s) in Occular Therapeutics for those who wish to obtain a therapeutics qualification that would enable them to prescribe medicines within their scope of practice:

The Australian College of Optometry (ACO) – More information on this qualification can be found by clicking here and visiting the ACO website.

The University of Melbourne – More information on this qualification can be found by clicking here and visiting the university website.

The University of New South Wales – More information on this qualification can be found by clicking here and visiting the university website.

 

Once a practitioner has achieved one of these qualifications they can apply to the Board for authority to prescribe medicines. Click here to access this application form.

 

Prescription pads

The issuing of prescription pads to optometrists is managed by the New Zealand Association of Optometrists (NZAO). Optometrists who are new to prescribing or require more prescription pads should contact NZAO on 0800 439 322 or email info@nzao.co.nz.

 

Useful Links

Medsafe Website – click here to directly access the Medsafe website.

Board Statement on Internet Medicine – click here to review this statement.