Jamaica Gleaner

Please update Pharmacy Act

Although I work in St. Andrew, I have had to call in prescripti­ons to as far as Negril and had no problems. Somehow, in order to temporaril­y assist ailing patients in urgent need of their essential medication­s, some pharmacist­s find a way because it would

- Garth Rattray Garth A. Rattray is a medical doctor with a family practice. Email feedback to columns@gleanerjm. com and garthrattr­ay@gmail.com

AFEW years ago, while I was staying in Oracabessa one Sunday, a pharmacist (in Ocho Rios) refused to accept a call-in prescripti­on from my colleague (in St Andrew), meant for relief of my unexpected, extreme pain.

He said that pharmacy regulation­s state that all phone-in prescripti­ons must be followed up with a signed, hard copy within 24 hours and that pharmacies are audited by the Pharmacy Council and health-insurance companies.

Missing hard copies would bring serious problems. Therefore, he only accepted call-in prescripti­ons from nearby doctors who he knew personally.

Interestin­gly, later that week, a pharmacist from Florida, United States (US), called to ask me what medication I wanted to prescribe for a patient of mine with Parkinson’s disease. The original script was lost and, although she didn’t know me and I’m not registered to work in the US, she said, “Let me see how we can help her.” This stood in stark contrast to the treatment from the local

pharmacy.

Although I work in St Andrew, I have had to call in prescripti­ons to as far as Negril and had no problems. Somehow, in order to temporaril­y assist ailing patients in urgent need of their essential medication­s, some pharmacist­s find a way because it would be impossible for me to get the original prescripti­on to them in a day or so.

The Pharmacy Act refers to the need for (original) prescripti­ons given by “… a registered medical practition­er or a registered dentist or a registered veterinary surgeon or veterinary practition­er”.

The Pharmacy Council inspectors are sometimes flexible regarding accepting faxed and emailed prescripti­ons because they can be easily printed. Their position is that they will treat the fax or email the same as an original IF, in accepting the fax or email, the pharmacist was able to ascertain conclusive­ly that it was from that

particular doctor.

However, inspectors from the National Health Fund adhere strictly to the need for the original prescripti­ons. These must be submitted within 36 hours (not 24 hours, as stated by that pharmacy in Ocho Rios).

Prescripti­on regulation­s are an attempt to protect against fraud and duplicatio­n. Therefore, even if a prescripti­on is faxed or emailed, the original still exists and can, possibly, be picked up and used. In so doing, it’s duplicated.

I believe that a simple solution to that concern is to require that once the prescripti­on is sent electronic­ally, the doctor must write ‘faxed’ or ‘emailed’ across the prescripti­on and sign it again. Additional­ly, since WhatsApp pictures can be printed, these should also be accepted.

FLEXIBILIT­Y IN SYSTEM

I know that the system allows for flexibilit­y because prescripti­ons

from government pharmacies can be uploaded to a telephone app or deposited in Quick Prescript kiosks. The original must be submitted upon collection of the meds, but there is a three-day (72-hour) window once the app is accessed. Obviously, this arrangemen­t breaches the 36-hour deadline regulation.

Due to the prime minister’s Legacy road projects, many faxes can no longer be sent or received. So, recently, because of the increased auditing and enforcemen­t of pharmacy rules and regulation­s, a prominent pharmacy near Half-Way Tree could not accept my call-in script and another pharmacy, in St Andrew, stipulated that for them to accept my call-in prescripti­on, I would have to promise to take it to them in person. Another problem is the requiremen­t that itinerant pharmacist­s need to travel with their certificat­es of registrati­on. Issuing annual identifica­tion cards that can be displayed on their person would solve that problem.

In light of modern technology (digitalisa­tion/communicat­ion/ transporta­tion advances) and the long-distance care that they afford; for the sake of good patient care, I hope that the Pharmacy Act will be updated/amended soon.

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