The emergency supply of prescription-only medicines: a survey of requests to community pharmacists and their views on the procedures

Abstract

Objectives — The provisions of the Medicines Act for the emergency supply of prescription‐only medicines (POMs) represent circumstances in which pharmacists in the UK may lawfully supply a patient with a POM without having a prescription. The objectives of this research were to establish the frequency of requests for emergency supplies from doctors and patients, and the characteristics of the requests, to investigate the procedures for emergency supply from the perspective of community pharmacists and to survey their views on the subject. Method — Data were gathered in a self‐administered structured postal questionnaire. The sample comprised community pharmacists in three health authority areas in Greater London and the surrounding area. Key findings — Over two‐thirds of the 243 respondents reported receiving requests for emergency supplies of POMs from patients at least monthly. The most commonly requested items were inhalers for asthma, followed by medication for cardiovascular disease. Many pharmacists had refused to make supplies on the basis that the situation did not constitute an emergency and/or that a prescription could be obtained. They also experienced cases in which they doubted the suitability of the requested product. Over half of the respondents reported receiving at least monthly requests from doctors to dispense an emergency supply. Refusals to supply were most commonly because the requested product was a Controlled Drug and therefore disallowed. Most respondents believed that the emergency supply procedures provided an opportunity to exercise professional judgment and were an important “safety net” for patients. Discussion — The provisions for the emergency supply of medicines are a common resort of both prescribers and patients and present pharmacists with an opportunity to exercise professional judgment. However, many pharmacists considered the procedures restrictive, believing that they should have more discretion in supplying POMs to regular patients and their representatives. Conclusion — Professional developments as envisaged by the British government and the pharmacy profession will require greater flexibility regarding the arrangements for supply of POMs.

Emergency supply of prescription-only medicines to patients by community pharmacists: a mixed methods evaluation incorporating patient, pharmacist and GP perspectives

“…A 1998 survey of CPs by O'Neill et al 3 demonstrated that requests for emergency supplies and medicine loans were being made on a frequent basis: at least monthly for three-quarters of respondents, at least weekly for half, and at least daily for 1 in 10. Respondents perceived emergency supplies as an important service, but over three-quarters felt it was open to misuse.…”

“…12–14 A review of the literature has identified only a few studies that have explored emergency supplies by community pharmacies in depth; the majority were based in the UK. 3–8 Moreover, there is a need for a holistic examination, incorporating multiple viewpoints, of how the emergency supply service at community pharmacies may best fit within current and established health and social care provision in order to best support patient care. This evaluation aims to describe the current profile of emergency supply activity in community pharmacies to explore and inform future practice.…”

Assessment of the rates and characteristics of the short-term supply of medication (Tider) from an integrated healthcare delivery system in the United States

“…The most striking characteristics associated with the patients who had a tider that we identified included having been older, male, a Medicare beneficiary, and having had a previous tider dispensing and a higher burden of chronic disease. O’Neil and colleagues reported that elderly patients most frequently requested an emergency supply of a prescription medication 5. Similarly, Morecroft and colleagues reported that older patients more frequently requested an emergency supply of a prescription medication 4.…”

“…Additionally, tiders were more likely to be dispensed on a weekend. O’Neil and colleagues reported that patients most commonly requested an emergency supply of respiratory, cardiovascular, and central nervous system medications 5. Morecroft and colleagues reported that patients most commonly requested an emergency supply of cardiovascular, respiratory, and endocrine medications and a high proportion of requests around the weekend 4.…”

“…These studies reported the characteristics of patients who received a tider4,5, the tider medications dispensed4,5, and patients’ and pharmacists’ perceptions of tiders on medication adherence 6,7. These studies had either small sample sizes or were focused on the legal implications of providing a tider 4,5,6,7. Studies detailing the cost of tider medication dispensing and contrasting the characteristics of tider and non-tider patients and medications have not been reported.…”