Avoiding Treatment Interruptions: What Role Do Australian Community Pharmacists Play?
May
Avoiding Treatment Interruptions: What Role Do Australian Community Pharmacists Play?
Salem Hasn Abukres 0 1
Kreshnik Hoti 0 1
Jeffery David Hughes 0 1
0 School of Pharmacy, Curtin University , Perth, Western Australia , Australia , 2 Faculty of Medicine, Pharmacy Department, University of Prishtina , Prishtina, Kosovo
1 Editor: Giuseppe Vittorio De Socio, Azienda ospedaliero-universitaria di Perugia , ITALY
To explore the reported practice of Australian community pharmacists when dealing with medication supply requests in absence of a valid prescription. Self-administered questionnaire was posted to 1490 randomly selected community pharmacies across all Australian states and territories. This sample was estimated to be a 20% of all Australian community pharmacies. Three hundred eighty five pharmacists participated in the study (response rate achieved was 27.9% (there were 111 undelivered questionnaires). Respondents indicated that they were more likely to provide medications to regular customers without a valid prescription compared to non-regular customers (p<0.0001). However, supply was also influenced by the type of prescription and the medication requested. In the case of type of prescription (Standard, Authority or Private) this relates to the complexity/probability of obtaining a valid prescription from the prescriber at a later date (i.e. supply with an anticipated prescription). Decisions to supply and/or not supply related to medication type were more complex. For some cases, including medication with potential for abuse, the practice and/or the method of supply varied significantly according to age and gender of the pharmacist, and pharmacy location (p<0.05).
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Data Availability Statement: All relevant data are
within the paper and its Supporting Information files.
Funding: The authors have no support or funding to
report.
Competing Interests: The authors have declared
that no competing interests exist.
Objective
Results
Conclusions
Although being a regular customer does not guarantee a supply, results of this study rein
force the importance for patients having a regular pharmacy, where pharmacists were more
likely to continue medication supply in cases of patients presenting without a valid
prescription. We would suggest, more flexible legislation should be implemented to allow
pharmacists to continue supplying of medication when obtaining a prescription is not practical.
Introduction
Pharmacists in community pharmacies worldwide are often faced with customers requesting
supply of prescription medication without a prescription or without a current valid
prescription.[
1–3
] In this paper, ‘invalid prescription’ refers to an out of date prescription or a
prescription without any remaining repeats. In Australia, except in the case of controlled drugs,
prescriptions are valid for one year from the date of issue, or six months for controlled
medications.[
4
] When the prescription expires, the patient must see their regular prescriber or any
registered prescriber (e.g. doctor, nurse practitioner) to obtain a new prescription. However,
there are situations when obtaining an appointment with the prescriber is not practical and
this may result in treatment interruption.[
5
]
When customers run out of their prescription medicines, they may ask their regular
pharmacy (or any other pharmacy) to supply their medication without a valid prescription, based
on their last valid prescription. In this situation in Australia, pharmacists have the right to Not
Supply (NS), or supply using: (a) Owing Prescription (OP) system, or (b) Emergency Supply
(ES) system.[
6
] In the case of OP, the pharmacist is required to contact the prescriber to
approve the OP supply, if the prescriber is not contactable, the pharmacist must not use this
method. This method is funded nationally through Pharmaceutical Benefits Scheme (PBS).
The PBS is a Government subsidy system for medication costs and professional fees for all
Australian residents. Therefore, customers supplied with their one repeat of medication through
this system are not charged beyond the usual co-payments. It requires a verbal approval (and a
paper prescription within a week) by the original prescriber, and this may not be practical or
possible in some situations.[
5
] Therefore, OP is not always available. The second method of
supply (i.e. ES) does not require contact with the original prescriber. However, it only enables
pharmacists to supply a limited amount of the medication and customers are charged a
premium for the cost of medication (i.e. a broken pack fee) and a dispensing fee.[
7
] Disadvantages
of the above systems have led to a new method of supply in the absence of a valid prescription,
namely Continued Dispensing (CD). CD has been implemented in the majority of Australian
states/territories since September 2013. CD allows the dispensing of one standard pack of the
medication. However, it is currently only allowable for s (...truncated)