CHAPTER 5 Pharmacy and Development of Information Technology

CHAPTER 5 Pharmacy and Development of Information Technology

CHAPTER REVIEW Computerization of Pharmacy Services § Drug Inventory Control System § Electronic Prescription Online Drug Sales and Dispensing § Definition § Benefits § Risks § The Legal aspects Poison Call Centre

Computerization of pharmacy services Monitoring and controlling the flow of drugs in such an environment is a challenging job. It is observed that due to improper monitoring of drug flow, there remains a big chance of pilferage and underutilization of drugs.

Drug Inventory Control System A system which enables systematic inventory control, forecast needs and generate drug re-order to maintain adequate inventory in drug dispensaries and pharmacies. The benefits of this system are: § efficiently reduces the number of personnel. § keep track the inventory at the same time.

Drug Prescriptions How do prescriptions written? Prescriptions are either: § entered into a Computerized Physician Order Entry (CPOE) system, § handwritten on preprinted prescription forms that are assembled into pads, v Preprinted prescription on the form is text that identifies the document as a prescription, as well as the name and address of the prescribing provider (i. e. General Practitioners). § or alternatively printed onto similar forms using a computer printer.

Drug Prescriptions What is the content of a prescriptions? Must have the full name of the patient. In some country, patient's full address must also be recorded. Each prescription is dated and some authority may place a time limit on the prescription. There is the specific "recipe" of the medication and the directions for taking it. Finally there is the doctor's signature. The symbol "Rx" meaning "prescription" is a transliteration of a symbol resembling a capital R with a cross on the diagonal (℞).

Electronic Prescriptions The Electronic Prescription Service will enable prescribers – such as GPs (General Practitioners – doctors, pharmacists, dentists and vets) and practice nurses - to send prescriptions electronically to a dispenser (such as a pharmacy) of the patient’s choice. This will make the prescribing and dispensing process faster, safer and more convenient for both patients and staff. Since the prescription goes directly from the doctor to the pharmacy, e-prescribing, as it's called — the prescribed drugs might be ready when the patient arrive at the pharmacy counter.

Electronic Prescriptions The advantages of Electronic Prescription: 1. Increase Accuracy Reduce the risk of medication errors associated with illegible written prescriptions. 2. Eliminate Patient Wait Time Have a patient prescription ready by the time the patient arrives at the pharmacy.

Electronic Prescriptions The advantages of Electronic Prescription: 3. Provide Quality Patient Care § Speed up the prescription refill process by eliminating the time your pharmacy staff spends phoning or faxing refill requests, allowing your staff more time to provide patient care. Pharmacists currently spend approximately one-third of their time on the telephone with physicians clarifying prescription orders. § 4. Security Establish electronic communication between physicians and pharmacists and to provide a secure network for exchanging prescription information.

DRUG SALES AND DISPENSING "Brick and Mortar" Pharmacies Brick and mortar pharmacies can be referred as walking into your corner drug store to get a prescription filled. Like conventional drug stores, "brick and mortar" pharmacies also offer items such as shampoo, vitamins, and cosmetics, which can be delivered along with the filled prescription.

ONLINE DRUG SALES AND DISPENSING Online Pharmacies Internet equivalent of walking into your corner drug store to get a prescription filled. Do not require a preexisting physician's prescription, but offer online "consultation" services that can lead to prescriptions. The consultation generally consists of an online questionnaire. While this method theoretically serves the same purposes as a doctor's visit (patient describes condition, doctor asks questions, and patient answers), and can safely replace a doctor's visit in the case of some minor conditions, their efficacy is often questionable.

Benefits of Online Drug Sales and Dispensing 1. Reduced costs to consumers 2. Convenience § Purchasing pharmaceuticals over the Internet allows consumers to decrease costs by bypassing intermediary mark -ups. § Online drug sales promote price competition among licensed prescription drug sellers. § Increased access to prescription and non-prescription drugs for the elderly, disabled or otherwise homebound patient (for whom a trip to the pharmacy would be difficult), as well as for those who do not live close to a traditional pharmacy. § Convenience of shopping 24 hours a day.

Benefits of Online Drug Sales and Dispensing 3. Privacy Consumers can protect their medical privacy, including avoiding the embarrassment of discussing their medical conditions and purchasing drugs in a public place. 4. Reduction in Risk of Prescription Errors as compared with handwritten prescriptions. 5. Increased Access to Information Internet pharmacies can immediately provide or direct the customers to extensive information on pharmaceutical use or any related topics of interest.

Risks of Online Drug Sales and Dispensing 1. Risk of Receiving Counterfeit Pharmaceuticals (Fraud) or Otherwise Worthless § Some Internet pharmacies dispense expired, subpotent, superpotent, contaminated or counterfeit drugs. This can result in overdose or other adverse health effects. § Even those drugs that are "fake" but otherwise harmless, can cause indirect harm to patients who need the genuine drug to treat a medical condition. 2. Risk of Faulty Self-Prescribing § Self prescribing medication based on advertisements and related impersonal information sources, without ever consulting a physician in person, can increase a patient's likelihood of suffering an adverse effect, or risk of death among the worst.

Risks of Online Drug Sales and Dispensing 3. Risk of Deliberate Misuse § Consumers may purchase drugs that can be used to harm others. For example, the date rape drug GHB (gamma hydroxy butyrate) is an unapproved drug that has been sold online illegally. 4. Risk of Misleading Consumers § Web sites can be designed to make illegal or fraudulent businesses appear to be legitimate health care providers.

Legal Aspects of Online Drug Sales and Dispensing Generally, before the practitioner issues a prescription for a drug the patient has never taken before, he or she must first examine the patient to determine the appropriate treatment. Subsequently, the patient receives the drug from a registered pharmacist working in a licensed pharmacy that meets state practice standards. The Internet makes it easy for dishonest people to sell drugs to patients without these safeguards in place. A Website may appear to be associated with a legitimate pharmacy when in fact it is not. Websites that sell prescription drugs without a valid prescription deny consumers the protection provided by an examination conducted by a licensed practitioner.

Legal Aspects of Online Drug Sales and Dispensing Patients who buy prescription drugs from Websites operating outside the law are at increased risk of suffering life-threatening adverse events, such as: § § Side effects from inappropriately prescribed medications Dangerous drug interactions Contaminated drugs Impure or unknown ingredients found in unapproved drugs.

Legal Aspects of Online Drug Sales and Dispensing Under the Federal Food, Drug, and Cosmetic (FD&C) Act, FDA has the legal authority to take action against: § the importation, sale, or distribution of an adulterated or misbranded drug; § the importation, sale, or distribution of an unapproved new drug; § illegal promotion of a drug; § the sale or dispensing of a prescription drug without a valid prescription; and, § Counterfeit drugs.

POISON CALL CENTRE A Poison Centre provides 24 -hour, toll-free information and consultation for all individuals. poison A nationwide organization that sets standards and collects exposure data for poison centers across the country. Anyone that has a direct contact with a known or potential poison can receive immediate advice on what steps to take to prevent injury from that exposure. National Poison Centre, USM, Penang.

Functions of Poison Center Resource center for information on toxicity and poisoning risks Assist in management of poisoning case Education and prevention programs Collaborate with governmental and NGOs on a development of analytical methods Training health sciences students in toxicology and poisoning