Challenges in pharmacy – Why do prescriptions take too much time

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Pharmacies have also joined in the provision of Tele-pharmacy services, with E-Scripts being adopted into the scope of practice globally and delivery services provided for medications under strict COVID-19 safe practices applied to ensure continued health care for patients. Picture: https://www.aarp.org/health/drugs

Have you ever gone to your local pharmacy to drop off a prescription and were given a 10- 15 minute wait, maybe a token with a number on it while you wait to be called?

You’ve probably wondered why they’re even necessary – especially if what you’re there for already comes packaged and doesn’t need to be counted out like a bottle of pills. Why can’t they just give it to you and be done with it? Why does it take so long?

While waiting time at the pharmacy is not a myth, advancements due to the current pandemic of COVID-19 such as the introduction of Telehealth into the services rendered around the country may have caused some relief or rather inconvenienced particular groups of people. Telehealth is the more practical approach to explore as social distancing, curfews and lockdowns have been enforced to prevent the spread of COVID-19.

Telehealth can be defined as the remote delivery of health care to a patient through technology. It has been used across most developed countries to deliver health care in a wide range of specialties, for numerous conditions and through varied means. (For more information on Telehealth: https://www.fijitimes.com/telehealth-technology/ )

Pharmacies have also joined in the provision of Tele-pharmacy services, with E-Scripts being adopted into the scope of practice globally and delivery services provided for medications under strict COVID-19 safe practices applied to ensure continued health care for our patients.

Alas the protocols of pharmacies and standard operating procedures on the filling of a prescription remain intact with a whole lot more going on behind the counter of your community/ hospital pharmacy than most people realise, and it doesn’t just involve printing a label and slapping on the side of a bottle.

Let’s unveil the mystery:

You’re given a prescription from your doctor. You walk into the pharmacy, lurk around the counter until the person speaking with the pharmacy technician leaves, and you “place your order,” announcing that you, too, will wait for it.

You soon find yourself flipping through magazines and browsing the greeting card section, while you’re anxiously waiting to be summoned, your pharmacy team is just getting started.

You see, while you’re checking out the latest edition of your magazines or OTC products, they’re trying to decipher your doctor’s handwriting to figure out what exactly has been prescribed, the dosage, method of delivery (i.e. oral, injection, inhalation), and the instructions for taking it.

And if it’s not clear, they’ll need to call your physician’s office to clarify. After eventually figuring out what it is you’ve been prescribed, it needs to be entered into the computer system that tracks your medication history. The pharmacist will then review what you’re currently taking and ensure what you’ve been prescribed is right for you.

They will also look for any potential hazards such as side effects or drug interactions with previously dispensed medications that could be of concern.

If there’s an issue, the pharmacist may recommend something else, and a call will have to be placed to your doctor’s office again. Once the order has been confirmed, the Pharmacist/ Pharmacy Technician will select the appropriate drug, brand, strength, form and quantity, and then package it up, review the instructions, apply cautionary labels and document everything in the system. Think this is where you get called? Not so fast!

When everything has been prepped and deemed “ready,” the overseeing pharmacist is required to do a final check to ensure your safety and well-being. But unfortunately you’re not the only person waiting to pick up a prescription, and before you can be called, the sole pharmacist must meet with another patient to discuss the changes in their medical condition and the side effects their new meds might cause. All types of patients are served from the same window.

Each type of patient consumes the pharmacist’s time differently. For example, the special needs and low immunity patients require more time since the pharmacists needs to explain thoroughly the prescription. So you’ll have to wait a bit longer.

Aside from the conventional challenges the community/ hospital pharmacies face, the emergence of COVID-19 has not spared the pharmaceutical sector from manufacturing, distribution and staffing shortages attributed to the lockdown protocols. Fiji being a Pacific Island state with a lack of these infrastructure, is dependent on overseas purchasing which has been brought to the limelight due to periodical stock outs of medications and medical consumables.

This has put a lot of pressure on the pharmacy services as we strive to prevent infection, manage supply chain, prevent stockpiling (an issue that was aided by provision of legislature), rationalise medication use and provide evidence- based medical information.

Community pharmacists have been designated an essential service and must, where possible, remain open during the pandemic to provide for the pharmaceutical care needs of the population.

Alongside premises changes, work practice changes also occurred, for example, closing for lunch breaks, and breaking staff into teams to avoid cross-infection and subsequent pharmacy closures. These measures have resulted in longer wait time for patients, contributing to patient anxiety and aggression.

While the limitations are by the many, the general public should rest assured that your pharmacist, bound by and motivated by their ethics, will find apt solutions to mitigate the challenges we currently face in terms of medication availability and dispensing.

All in all, pharmacies are extremely busy places. There are always delays, unreturned calls to doctor offices, insurance issues, and then having to explain what’s going on to patients who just don’t understand why it takes so long.

The next time you need to get a prescription filled, be sure to submit it well in advance, to avoid delays or if you’re busy; to pick up later and to always leave your contact details so that you can be reached in case of changes or when your prescription is ready for pickup.

Pharmacy and Selective Tele-health options are also available at Oceania Hospital in these trying times, so be sure to utilise them to avoid delays, and prevent any unnecessary movement to curb the spread of COVID-19. Stay home, stay safe and sanitise!

  • AVNEET NAND is a pharmacist at Oceania Hospitals Pte Ltd. The views expressed are the author’s and do not reflect the views of this newspaper.
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