Natalie Gauld1, Fiona Kelly, John Shaw. 1. Department of General Practice and Primary Healthcare, University of Auckland, Private Bag 92019, Auckland Mail Centre, New Zealand. n.gauld@auckland.ac.nz
Abstract
OBJECTIVES: in 2007, New Zealand became the first country to make oseltamivir (Tamiflu) available off prescription. Strict rules for supply were developed to ensure that potential public health benefits were balanced against possible risks. We wished to explore the success of implementing this unique decision through elucidating pharmacists' attitudes to and experiences of non-prescription supply of oseltamivir. METHODS: semi-structured interviews with a maximum variation sample of 26 community pharmacists were conducted and analysed using a framework approach. RESULTS: most participants were positive about non-prescription availability of oseltamivir with the majority appearing to apply the rules successfully. However, some rules were difficult to recall and/or frustrating. Supply did not appear to be driven by potential for commercial gain and the inappropriate requests were manageable. Some of these were driven by other health professionals. Pharmacists valued the manufacturer-supplied 'Pharmacist Protocol' and 'Consultation Record' and kept them ready for use. Certain rules potentially restricted consumer access and pharmacists were generally conservative about recommending the medicine. CONCLUSIONS: while pharmacists welcomed non-prescription oseltamivir, the rules for supply frustrated pharmacists and limited potential public health benefits. If medicines are reclassified with various rules of supply, multiple reminders of the rules for supply to pharmacists and other health professionals are desirable along with the rationale for such rules. Protocols and/or consultation pads for use at time of supply are likely to be valued and are an important aid where there is a risk of faulty recall of rules. Research in the first year of availability may highlight issues to address.
OBJECTIVES: in 2007, New Zealand became the first country to make oseltamivir (Tamiflu) available off prescription. Strict rules for supply were developed to ensure that potential public health benefits were balanced against possible risks. We wished to explore the success of implementing this unique decision through elucidating pharmacists' attitudes to and experiences of non-prescription supply of oseltamivir. METHODS: semi-structured interviews with a maximum variation sample of 26 community pharmacists were conducted and analysed using a framework approach. RESULTS: most participants were positive about non-prescription availability of oseltamivir with the majority appearing to apply the rules successfully. However, some rules were difficult to recall and/or frustrating. Supply did not appear to be driven by potential for commercial gain and the inappropriate requests were manageable. Some of these were driven by other health professionals. Pharmacists valued the manufacturer-supplied 'Pharmacist Protocol' and 'Consultation Record' and kept them ready for use. Certain rules potentially restricted consumer access and pharmacists were generally conservative about recommending the medicine. CONCLUSIONS: while pharmacists welcomed non-prescription oseltamivir, the rules for supply frustrated pharmacists and limited potential public health benefits. If medicines are reclassified with various rules of supply, multiple reminders of the rules for supply to pharmacists and other health professionals are desirable along with the rationale for such rules. Protocols and/or consultation pads for use at time of supply are likely to be valued and are an important aid where there is a risk of faulty recall of rules. Research in the first year of availability may highlight issues to address.