31 July 2019

Chain of command rules when GPs supply meds

Pharmaceuticals Practice Management

How many medications does your practice really have on site? Think about your doctor’s bag, your filing cabinet, your fridge.

Medications are everywhere in general practice, but clinics don’t always have a unified system for managing these items.   

To address this issue, the RACGP’s new resource, called “Medication management and supply: A guide for general practice”, aims to make the process easier.   

“What struck me when we were working on the guide was how often general practice teams handle, administer and dispense medications,” Dr Edwin Kruys, a GP who writes the Doctor’s Bag blog, said.

“Think, for example, about immunisations, emergency drugs, corticosteroid injections, medications used for surgical interventions and wound care, long-acting injectable antipsychotics, injectable disease-modifying anti-rheumatic drugs, injectable anticoagulants, hormone implants, vitamin B12 injections, iron infusions, allergy immunotherapy, topical antibiotics, topical anaesthetics and pharmaceutical samples – the list goes on!”

The resources for how to manage medication supply in practice had previously been scattered, he said.
“Practices may be under the impression that they have to put all the pieces of the puzzle together or have to reinvent the wheel,” Dr Kruys said.

The new guide puts everything in one place, with practical information about how to assign responsibilities between a team, how to record inventory, where to find the relevant legislation, and how to label medicines using Tall Man lettering so look-alike, sounds-alike medications don’t get mixed up. 

“As we say in the guide, a good system ensures that team members know who is responsible for each process associated with the management, supply and administration of medicines,” Dr Kruys said.

“The practice can then monitor performance associated with particular responsibilities and determine whether any support and training is required, and team members know when to escalate issues,” he said.

In Australia, the prescription and supply of medications is usually divided between doctors and pharmacists to reduce conflicts of interest.

But GP clinics could supply medications directly to patients when usual supply via the pharmacy was impractical or impossible, such as during an emergency or in remote areas, Dr Kruys said.