New Lockdown and Dispensary Regulations Keep Pharmacists on Their Toes

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​The Premier of Victoria, Daniel Andrews, announced a temporary “circuit breaker” lockdown on the 12th of February. The lockdown would give the concerned agencies adequate room to conduct contact tracing for the five new Covid-19 cases.

The Premier iterated that the lockdown will be “a short, sharp blast,” similar to what was implemented in Queensland. According to the release, the previous lockdown rules apply, with movements limited to essential activities only.

In the statement, Mr Andrews also emphasised the need to do everything possible to keep the virus at bay until the vaccine rollout began.

While processing the news, pharmacies became inundated with refill requests as patients rushed to their local pharmacies to stockpile medications in a panicked frenzy. But according to Anthony Tassone of the Pharmacy Guild of Australia, the stockpiling was unnecessary. It also exaggerated the shortage of medicines that were unrelated to the Covid-19 pandemic.

The lockdown ended on Friday, the 17th of February, as planned, but some rules will continue to apply. According to Mr Andrews, face masks are an ongoing insurance policy, while public gatherings and hospitality venues will return to pre-lockdown settings.

Vaccine rollout began fully on the 22nd of February as scheduled. 5,800 community pharmacies are estimated to be involved. According to the vaccine roadmap, it may be until the end of May before most of the population are vaccinated.

Pharmacists Require Substitution Support

As earlier stated, pharmacies currently experience a short supply of medications that have little to do with Covid-19. However, current dispensary regulations slow down pharmaceutical operations even further because pharmacists have limited autonomy in managing medicine shortages. When these drugs run out, GPs need to be consulted before substitutes can be dispensed.

Shane Jackson, former National President of the Pharmaceutical Society of Australia, noted in a Twitter thread that this is a waste of pharmacists’ time and GP resources. “In the middle of a global pandemic, you might think that pharmacists would be supported to help patients at the coalface,” he said. Unfortunately, patients have to get a script to get two 50mg tablets when a single 100mg is unavailable.

Dr Paul Grinzi, a GP based in North Melbourne, agreed with the logic, stating that a simple phone call would suffice.

Unfortunately, according to Anthony Tassone of the Guild, nothing can be done unless lawmakers address the regulations to give pharmacists more autonomy, and only patients can make it happen. “Pharmacists try their best to ensure continuity of care and not inconvenience patients… but ... [we] need patients to contact their local MP as they are ultimately the loser,” he reported.

Pharmaceutical Defence Limited Warns Pharmacies to Minimise Errors

However, the path to substitution support must be taken cautiously because dispensing errors can lead to grave consequences. In this light, Pharmaceutical Defence Limited (PDL) released a practice alert on the 11th of February.

The PDL urged pharmacies to consider dispensing guidelines carefully. The organisation reported that they’d received multiple reports involving dispensing errors that could be traced down to a lacking thought process and risk assessment.

“Pharmacists are considered gatekeepers for medicines and must ensure the prescribed medicine is safe and appropriate,” the insurer further stated in the practice alert.

The Pharmacy Board provides prescription codes and guidelines, and even though professionals are familiar with these guidelines, errors do happen. And as human as erring can be, it has grave consequences.

For example, one case of a dispensing error led to a patient’s discomfort, time off work, and eventually, a demand for compensation. The patient, in this case, was prescribed Efudix instead of Elidel.

In another instance, Atropine eye drops were prescribed for children and young adults despite practice alerts to ensure that the correct strength of 0.01% was dispensed.

Read: Podcast Transcript of Mahek Shah, 2021 President of VPSA

Vaccine Dispensary Errors

Dispensing errors aren’t isolated to pharmacies alone, as the Covid-19 vaccine rollout has also met unexpected delays due to the same problem.

It began with one of the private contractors hired to assist with the rollout, Healthcare Australia (HCA). HCA has started missing deadlines after one of its vaccinators mistakenly gave two elderly patients four times the recommended Pfizer vaccine dosage.

The vaccine rollout plan has also met other speed bumps with last-minute cancellations after some aged care facilities received short notice of the vaccine’s arrival. Without proper notice, informed consent can’t be gotten from residents in time, stalling the process.

Read: PSA Urges Rural and Remote Pharmacies to Check RPMA Eligibility

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