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NSW research trials report outcomes for women's health: pharmacist-led UTI and oral contraceptive services

Two landmark University of Newcastle-led research trials have provided evidence on the safety and effectiveness of pharmacist-led management of uncomplicated urinary tract infections (UTIs) and oral contraceptive resupply in women – helping to facilitate timely access to care and referral to GPs when clinically needed.

The final reports of the statewide trials:

‘Management of Urinary Tract Infections by Community Pharmacists’ (PATH-UTI) shows the pharmacist-led model delivered accessible UTI care to more than 17,000 women over 10 months.
'Resupply of Oral Contraception by Community Pharmacists’ (PATH-OC) shows the pharmacist-led model delivered accessible oral contraceptive care to more than 1,900 women over 12 months.

The data could help guide decisions about how pharmacist-led UTI and oral contraceptive resupply services could be set up and maintained in NSW, depending on future policy, oversight and monitoring.

Chief investigator, the University of Newcastle’s Associate Professor Sarah Dineen-Griffin, of the HMRI Population Health Research Group, led a consortium of 13 partner organisations incorporating peak pharmacy bodies and medical organisations, consumer organisations and universities.

The research was undertaken by the University of Newcastle, The George Institute for Global Health, HMRI, UNSW, UTS, UNE and CSU, across NSW and ACT. The multi-disciplinary team included experts in primary care, collaborative practice, women’s health, Aboriginal and Torres Strait Islander health, regional and rural health, antimicrobial resistance and stewardship, and implementation of services in community pharmacy.

Associate Professor Dineen-Griffin said the evaluation provided data on patient outcomes, referral patterns and healthcare use.

“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,” she 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.”

The PATH-UTI and PATH-OC trials are some of the largest studies to date on pharmacist management of uncomplicated UTIs and resupply of oral contraceptives for women. Funded by the NSW Government, the trials involved more than 1000 pharmacies across metropolitan, regional, rural NSW and the ACT, delivering more than 19,000 consultations.

The reports synthesise findings across multiple evaluation streams, identifying critical considerations for the ongoing design, governance, monitoring and potential scaling of pharmacist led UTI and oral contraceptive resupply services.

Key results from the UTI trial include:

More than 17,000 women aged 18 to 65 years participated in the trial
Nine out of 10 women reported being satisfied to very satisfied with the pharmacy service
79.4 per cent of participants reported complete symptom resolution within seven days
7.3 per cent of participants were referred to a GP or emergency department
Around 5 per cent of participants reported common side effects, and 0.3 per cent of participants reported serious adverse events, consistent with reported rates in previous research
99 per cent of pharmacist consultations followed clinical protocols
Data showed no unexpected rise in antimicrobial resistance post the study.

The pharmacist-led UTI service was accessible

71 per cent of pharmacy consultations occurred in metropolitan areas
26 per cent of pharmacy consultations occurred in rural towns
85 per cent of patients said cost would not limit access for future use
Indigenous community members participating in the qualitative evaluation indicated they valued the service for its convenience and access
Indigenous participants and health services highlighted the need for continuity of care, culturally appropriate support, and a requirement to align with existing programs like Closing the Gap.

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:

1,946 women took part in the trial, with 18 to 25 years the most common age group
Participants reported highly positive experiences, with an average score of 91.6 out of 100
99.7 per cent of pharmacist consultations followed clinical protocols
At seven‑day follow‑up, 99 per cent of women did not report any side effects
Hospital utilisation was low, with no hospitalisations or emergency department presentations for oral contraceptive‑related adverse events
6.9 per cent of participants were referred to a GP
Around 7 per cent of participants saw another healthcare professional in the first four weeks after the pharmacy consultation
77.8 per cent of patients said cost would not limit access for future use
Indigenous community members valued the service for its convenience and rapid access, while highlighting the need for continuity of care and tailored support
No participation occurred in remote or very remote areas, indicating the need for rural‑specific solutions.

Collaboration between pharmacists and GPs

Both trials emphasised strong collaboration between pharmacists and GPs.

“Our interviews made it clear that trust between GPs and community pharmacists is essential,” Associate Professor Dineen Griffin said.

Associate Professor Sarah Dineen-Griffin_placemaker

Evidence-based solutions shaping the future of primary care

Associate Professor Dineen-Griffin said the reports provided a comprehensive, evidence-informed basis for sustaining and enhancing pharmacist-led UTI care and oral contraceptive resupply services, within an appropriate policy, governance and monitoring framework.

University of Newcastle Interim Deputy Vice-Chancellor, Research and Innovation, Professor Juanita Todd commended the pharmacy trials’ impact.

“The University of Newcastle’s research is helping shape the future of primary care in Australia - contributing evidence that could guide how pharmacist led services can be delivered for women’s health conditions.

“This research, led by Associate Professor Sarah Dineen-Griffin, reflects our university’s commitment to evidence-based solutions that improve health outcomes, particularly for underserved communities. It is rewarding to see this work translate into real-world change across NSW communities,” Professor Todd said.

From 1 June 2024, all pharmacists with suitable facilities in NSW, who had undergone the required training, were able to continue providing consultations and prescriptions for these medications following the closure of the trials.

Both reports are available here.

HMRI is a partnership between the University of Newcastle, Hunter New England Health and the community.

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