Wednesday, November 30, 2016

This Sounds Rather Like A Success On The Part Of The Pharmacy Guild. I Hope The App Is Making A Real Difference.

This popped up last week.

MedsASSIST tops 4 million transactions

More than four million transactions have now been recorded in MedsASSIST, the Pharmacy Guild says.

As of yesterday (21 November) the codeine real-time recording and monitoring system had clocked up over four million transactions, and of these two per cent were for a deny/non-supply.
Guild data also shows that 86% of consumers who had made five or more purchases were recommended to take follow-up action, such as a referral to a doctor or pain specialist, pain management care plan, drug or alcohol service, to assist them to seek further help in managing pain and addiction.
“There is strong evidence that MedsASSIST is having an effect as intended and reducing inappropriate OTC codeine use for people who might be at risk of codeine dependency, while maintaining access for legitimate use,” the Pharmacy Guild says.
The Guild is working with Painaustralia and a number of Primary Health Networks to develop further resources to assist pharmacists and their patients to pursue alternative treatment options where chronic pain and/or dependence are suspected/apparent.
The TGA’s decision on whether or not to upschedule codeine-containing preparations which are currently OTC to doctor prescription only has been tipped to take place in the next few weeks, with Health Minister Sussan Ley telling the recent ASMI conference that the final decision would likely come before the end of the year.
However, the Guild’s commissioned report, “Fiscal impacts of codeine changes by Cadence Economics November 2015,” estimates an additional 8.7 million GP visits a year would be generated as a result of moving codeine medicines to prescription only.  
The MBS outlay of the additional GP visits is estimated to be $316.44 million each year, the Guild says.
These figures do not take into account losses in time and productivity for patients.
Costs to the PBS are also not included as these medicines would not be subsidised, although there is the potential that the higher strength, PBS-subsidised alternatives might be prescribed more often, the Guild says. Other industry sources have also indicated that they would expect this outcome.
More here:
Here is a basic outline of how the system works:

How MedsASSIST works

The pharmacist will assess the therapeutic need of a codeine medicine for the individual patient in accordance with the current practice for the supply of Pharmacist Only Medicines.
  1. The pharmacist will assess the therapeutic need of a codeine medicine for the individual patient in accordance with the current practice for the supply of Pharmacist Only Medicines.
  2. The pharmacist will then ask for a photographic ID and seek consent to record the ID number in the system which is protected, controlled and operated by the Pharmacy Guild of Australia. It is only the unique number on the photographic ID that is recorded in the system. The system does not record other details such as name, date of birth and address.
  3. If the patient does not consent to providing a photographic ID card number for recording and monitoring in the system, the pharmacist may choose not to supply the medicine because they cannot be sure it is safe to do so. In such circumstances, the pharmacist may elect to offer alternative medicines or recommend other treatment options including referral.
  4. The pharmacist also records the name and the quantity of the requested codeine medicine and reviews any previous purchases of codeine medicine.
  5. If a supply is made based on therapeutic needs, the reason for use and recommended duration of use will be recorded in the system.
  6. If the pharmacist decides it is not therapeutically appropriate to supply a codeine medicine, they will explain the reason for this decision and may provide further clinical information or recommendations to support your health. This will also be recorded in the system.
I note that the first 2 million transactions took till mid-August 2016 so the system is seemingly getting increasing use.
It will be good to see evidence of broad clinical impact in due course. Of course OTC codeine is a very commonly purchased medicine. I wonder how many packs are purchased each year?

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