Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Wednesday, March 03, 2021

This Has The Feel Of Another Set Of Unintended Consequences To Me. Hopefully They Will Be Short Lived!

This appeared last week.

New active ingredient prescribing rules causing medication delays: pharmacists

Some doctors are not using the updated versions of their prescribing software says the Pharmaceutical Society of Australia

23rd February 2021

By Heather Saxena

Some patients are facing delays receiving medicines because the move to active ingredient prescribing has led to an increase in invalid scripts, pharmacists say.

Under the rules that came into effect on 1 February, the active ingredients of a prescribed PBS drug must be printed first on the script.

Doctors can still specify brands, but the changes are designed to increase uptake of generic drugs and reduce medication errors.

The Federal Government has said all major medical software providers have updated their programs to comply.

But the Pharmaceutical Society of Australia says its members are reporting that hundreds of invalid scripts are being generated by doctors using older versions of the prescribing software.

The society’s digital health lead Jarrod McMaugh says that under a six month grace period pharmacists can still dispense an invalid script.

However, they are advised to first make an attempt to call the doctor to confirm their intent and to request a new prescription.

Mr McMaugh said that in some cases when the doctor could not be reached, pharmacists had decided to send patients back for a valid script.

“The pharmacist shouldn’t be put in a position where they’re considering whether the patient should get access to treatment and they break the law by not checking first, or delaying treatment,” he said.

“The volume [of invalid scripts] is not huge, but the impact can be.” 

He added members had also received a small number of “malformed scripts” generated using updated GP software.

The most common issues had related to scripts for insulin being prescribed without a brand or delivery device specified on the prescription.

There also appeared to be an occasional glitch where practice software printed multiple potential forms of an active ingredient, Mr McMaugh said.

More here:

https://www.ausdoc.com.au/news/new-active-ingredient-prescribing-rules-causing-medication-delays-pharmacists

This seems to be one of those situations where the policy intention is good but where actors who where involved in the change did not quite get it right immediately.

For the software vendors they found the change meant few prescriptions were not quite right due to not providing distinct information on what exactly was to be dispensed – despite having the generic drug name printed first. Clearly a teething problem that can be addressed as issues are identified.

For the prescriber they key is to be using the latest software but we all know how such updates can slip past and then errors will slip in.

For pharmacists it is a matter of balancing patient service and convenience with also being sure they are providing just what was intended by prescriber.

I note in passing that it is important that patients receive education as to the different appearance of the generics they may receive and understand what actual medicines they are taking. This can be a real challenge with patients who have had the same brand for years but now see a medication which is different in colour etc.

Another wrinkle is that the capacity to specify a particular brand is vital as there are poorly understood differences between some brands – especially with the psychoactive meds. (antidepressants and the like.)

All in all I am sure we will get through this – despite the short term disruption. I hope there are some studies planned for a year or two out that will measure the harms and benefits of the change!

David.

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