Online pharmacies must conduct ‘clinical assessment’ before prescribing, say regulators


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By Costanza Pearce
Reporter

08 Nov 2019

Pharmacies that provide medicines online must conduct a ‘clinical assessment’ of customers before they prescribe them medication in order to protect patient safety, a group of healthcare bodies has said.

The General Pharmaceutical Council (GPhC) today (8 November) announced a new set of principles that aim to protect patients when accessing ‘potentially-harmful medication’ online.

The ten principles are co-authored with other healthcare bodies including the Royal Pharmaceutical Society (RPS), the Care Quality Commission (CQC) and the General Medical Council (GMC).

Pharmacists providing remote consultations or prescriptions are expected to ‘undertake an adequate clinical assessment’ and check the patient’s medical records to ensure any medication is ‘safe and appropriate’, according to the principles.

Alternatively, they must examine or test the patient to ‘verify important information… where necessary.’

In April, the GPhC announced that online pharmacies must carry out identity checks on patients and identify ‘inappropriate’ orders before dispensing medication.

 

Identify vulnerable patients

 

Pharmacists dispensing medicines online must be able to identify vulnerable patients – such as those at risk of self-harm, substance or drug use disorders and those with long-term conditions – and ‘take appropriate steps’ to protect them, the principles add.

They must also make sure they obtain informed consent from the patient, following the relevant laws and codes of practice around mental capacity.

Other principles include:

  • Raising concerns when ‘adequate’ patient safeguards are not in place, including identity checks
  • Keeping notes that ‘fully explain and justify’ decisions
  • Staying up to date with relevant training and guidance on providing medicines online
  • Making arrangements for follow-up care and sharing relevant information with other healthcare professionals involved unless the patient objects

 

‘Particular risks’

 

GPhC chief Duncan Rudkin said: ‘Online healthcare services can be convenient and helpful for patients and the public, but they also have to be provided safely so people only receive medicines that are clinically appropriate for them.

‘There are particular risks with prescribing medicines online that have to be effectively managed by the prescriber.’

He added that the principles reflect existing standards and guidance, including new guidance for pharmacist prescribers that the regulator will publish ‘in the coming weeks’.

 

‘An end to inappropriate supply’

 

RPS president Sandra Gidley said: ‘Online pharmacy has come under increased scrutiny and we must see an end to cases of inappropriate supply.

‘Patients and the public should rightly expect all online pharmacy services to be of the same quality and standard as a ‘bricks and mortar’ pharmacy.’

She added that the principles are ‘a helpful step’ to ensure that guidance and regulation that support patient safety ‘keep pace’ with changes in technology.

Last year, the GPhC consulted on whether it should take action to protect people purchasing certain medicines online including opiates, antibiotics, asthma inhalers and Botox, following ‘increasing concerns’.


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