Dietitian prescriber — extended role

What: Dietitian prescribers work in a variety of settings including in multidisciplinary clinical health teams. They are trained to provide therapeutic nutrition for medical treatment for conditions including renal (kidney) disease, diabetes, cardiovascular disease and cancer across a variety of settings, including paediatric or aged care nutrition.

Dietitians have been able to ‘prescribe’ subsidised non-prescription items for therapeutic nutrition for outpatients since December 2011, but not medicines classified as prescription under the Medicines Act 1981. The new Medicines (Designated Prescriber – Dietitians) Regulations 2015 (the Regulations) will mean that suitably trained dietitians will now be able to prescribe three prescription medicines (high-dose vitamin D, high-dose zinc and high-dose pancreatic enzymes) for the management of chronic illnesses after diagnosis by a medical practitioner.

Why: To improve patients’ access to health services by making best use of dietitians’ full capability. Patients will receive better, timelier access to the prescription medicines through dietitian prescribing. The efficiency and flexibility of the health workforce is also improved by maximising the expertise of dietitians. This is in line with other areas – prescribers other than doctors include nurse practitioners, optometrists, midwives, dentists, diabetes nurses and pharmacists.

Where: Dietitians working in multidisciplinary teams in a variety of settings including hospitals, outpatient clinics, primary care or the community.

Training required: The Dietitians Board specifies the requirements in the New Zealand Gazette for dietitian prescribers under the Regulations. These may be a Dietetic Master’s degree from the University of Otago, Massey University or the University of Auckland, conferred after January 2014; or for all other New Zealand registered dietitians, the successful completion of the Dietitians Board Prescriber Training Course which demonstrates the knowledge to safely prescribe dietetic prescription medicines and knowledge of the regulatory framework for prescribing.

Prescriber status: On 31 March 2015 there were 418 out of 611 practising dietitians with an endorsement by the Dietitians Board to prescribe. All prescribers are required to make an annual declaration about meeting the Dietitians Board’s requirements to maintain competence, including for prescribing. 

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