While most general practitioners in New Zealand have embraced the move to electronic medication prescribing at the start of the pandemic, some have struggled to adapt.
A study from the University of Ontago, which was recently published in the New Zealand Journal of Primary Healthcare, surveyed over 160 GPs, practice nurses and nurse practitioners across the island country to know how they dealt with the change in issuing scripts. The survey ran for 16 weeks from May when the Level 4 lockdown was implemented.
The study revealed that some GPs were ill-prepared for the shift to e-prescribing, especially among those who had not adopted it as standard practise prior to the pandemic. There were concerns over the cost of installation and technical barriers; others had systems that were not compatible with those in pharmacies, leading to delays in issuing scripts.
It was also noted that the pandemic-induced lockdown had an effect on patient behaviour. According to the researchers, some GPs said their patients were “stockpiling, hoarding and panic-buying” medications due to concerns that the border closure might affect supply.
Worse, some Māori, Pacific, elderly and rural patients went on without medicines or reduced their dosages in either fear of leaving their houses to pick them up from pharmacies or the lack of funds to purchase them.
The change in medication prescribing has also caused strain on pharmacies who had to deal with the “huge increase” in prescription demand.
THE LARGER CONTEXT
New Zealand’s Ministry of Health has encouraged GPs to use e-prescribing to support efforts in arresting the spread of COVID-19. In April last year, it permitted the issuance of signature-exempt prescriptions, among new rules imposed for giving out digital scripts.
The government has developed the New Zealand ePrescription Service (NZePS) which provides a secure messaging channel for prescribing and dispensing systems to exchange prescription information electronically. The Health Ministry is working with hospital IT system providers to enable prescribers to issue e-scripts for hospital discharge, outpatient, specialists, nurse prescribers and midwife care. Medtech, MyPractice, Indici and Medimap practice management systems are currently integrated with NZePS.
As the country has once again been placed under lockdown, Dr Geraldine Wilson, the study’s lead author, urged the government to look into adopting a “more formalised” Home Medicine Service to ensure that more vulnerable patients can get their medications at home.