Wednesday, February 23, 2011

Mandatory recording of P medicines in Singapore

Health Science Authority would be implementing mandatory recording of Pharmacy only medicines starting from 1 April 2011 (selected medicines) and extending to ALL P medicines starting 1 Oct 2011. Follow link here to HSA site.

Unarguably, this falls in line with good professional practice of ensuring safety in the supply of medicines but foresee-ably it would also translate to some very practical issues as follow:

1) Longer pharmacy waiting time, reduced work efficiency due to extra documentations

--> Are we implementing queue number system (like what some hokkien mee stores at hawker center already have) so that customers will not quarrel over who came first?
Or are we going to have more than 1 computer and pharmacist/technician around at all times because 1 computer is definitely not enough to do Rx, price check and P-item recording simultaneously?
Are we (pharmacists) going to get protection against 'verbal abuse' by those impatient customers?

2) More angry patients, especially foreigners who don't understand our LAW

--> Should HSA come up with some explanatory poster, leaflet, hotline or public media to counsel, educate or appease these group of people about what is called 'safe and responsible use of medicines'? Or are more precious time going to be wasted for pharmacists to help to justify HSA's regulation to these disgruntled purchasers?

3) Patients would see it as another 'barrier' to the access of P medicines

--> Especially so for certain P medicines which are readily available over-the-counter overseas... We are a global society and people are bound to compare (and question).

Another thing I am perplexed about is - HSA states that these records would enable proper tracking of medication use especially in the event of polypharmacy. However, unless the a centralized computerized-recording system is in place, how are we (or the HSA) to find out or track if these medicine purchasers are going polypharmacy? An ideal recording system would be one that entails accurate capturing of purchaser's data (i.e. barcode scanning of NRIC to prevent duplications) and one that is standardized across all the private retail pharmacies in Singapore. Even better if it can allow scanning of P medicine's barcode so that it saves time from manual keying. Unfortunately, we don't have that... would HSA be able to support or sponsor such system in the near future for private retailers?

As healthcare professionals, it has always been part of our duty and responsibility to ensure patients are using the medicines for the right indication and give appropriate counselings (verbally as of present). This has been so in the past and present, with and without mandatory recording. Another question is - how do we know that this implementation would really result in a significant enhancement in the safe and responsible use of medicines to justify the extra measure?

I think that time spent on public awareness and counseling in terms of medication safety are much more meaningful than the act of robotic recording. The fine balance between good pharmacy practice and practicality of mandatory recording of P medicines awaits to be struck by the support of HSA, better IT system and increase in pharmacy manpower. Till then we shall see that it achieves its noble purpose...

For those who buy pharmacy medicines in Singapore take a poll here on what you think.
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