Should pharmacy medicines be available for self-selection by customers?

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No – this will spell the end of the P medicine category and undermine the role of the pharmacist

77% (150 votes)

No – it will be difficult to refuse a sale when the customer has already picked up the medicine

20% (39 votes)

Yes – it’s all about making shopping more convenient

2% (3 votes)

Yes – it will help make pharmacy more profitable

2% (3 votes)

Total votes: 195

Wed, 11/04/2012 - 14:34 – Ayshe Ismail

Read the article....

Read the article that inspired the poll.

Ayshe Ismail
PJ Online team

Thu, 19/04/2012 - 10:39 – Samantha Ross

I think giving the patients the choice to select medications for themselves will totally undermine the role of the pharmacist. Although we should encourage patient self care it is not appropriate for all medicines or ailments hence the GSL/P med classification. If this is passed the patients will see it as a right to choose whatever medication they like, and the pharmacist as a barrier to healthcare if they refuse a sale or ask questions to assess the suitability. If this were passed the whole pharmacist/HCA - patient consultation would be viewed by patients as a negative criticism of thier choice rather than helpful and informative. Not something encouraging for the profession, even if it would improve profits

Fri, 20/04/2012 - 10:37 – Roy Sinclair

P Medicines

The four comments on which we can vote are perhaps not the best that could have been chosen. Having P Medicines on open display will both undermine the role of the pharmacist, thus making professional control more difficult and will also make it a considerable problem when trying to refuse a sale once a product has been selected. Products on open display are available for self selection by all who are in or on the shop premises regardless of age or intent and this would make a mockery of items where pharmacists are expected to show some additional discretion with regards to whom they sell that product. P products to use an old phrase are items where the pharmacist is expected to make appropriate enquiries and as a result of those enquiries to counter prescribe the P medicine or not to - the pharmacist is in control of the mini-consultation. Worst case scenario is that open display makes it the patients decision which medicine to use and they then select it and the pharmacists decision to subsequently refuse or deny that choice and take the medicine away from the patient.

Fri, 20/04/2012 - 10:48 – Roy Sinclair

P Medicines - The Future

I doubt this would improve sales or customer selection but merely drive 'customers' (rather than patients) into the stores that currently sell 'medicines' at considerably dicounted prices and where there is no professional control.

Fri, 20/04/2012 - 21:34 – Ruth Shaw

Self selection of P medicines

Ruth Shaw "Familiarity breeds contempt" is an appropriate comment in this issue. We are all aware that the general public underestimates the potential risks of those drugs currently available at the garage, the supermarket, even the market stall, - paracetamol, aspirin, ibuprofen. If P medicines become available as a simple pick-up line, there will be nothing to differentiate them in the mind of the customer from simple coughsweets / mouthwashes etc. Unintended misuse will inevitably result. We must continue to demonstrate that there is a difference!

Sun, 22/04/2012 - 17:39 – Angela Dale

Self selection of medicines of any sort

In my experience, when a customer has self selected a medicine, they do not like being asked ANY questions about their proposed purchase. From my experience, people seem to assume that if medicines are available for self selection, then there should be no barrier to completing their purchase. Anything else is, apparently, an invasion of their privacy. Just recently, on separate occasions, I have had to refuse purchases of medicines for thrush and cystitis. It's only because I happened to be around the pharmacy counter of the stores where I was working as a locum and the pharmacy department was open that I was able to intervene. If the pharmacy had been closed or the customers had taken their purchases to the "ordinary" tills, neither of these potential problems would have been spotted. The first was a (not obviously) pregnant lady with thrush, the second was an older lady on multiple medicines for hypertension and other cardiovascular problems. I might add that it was during the working day and both would have been able to obtain some sort of advice from their GP practice. Both resented having their proposed purchases queried and one said she'd go elsewhere and she'd know what answers to give IF she was asked. If we are to carry on helping people to choose the right medicines for their problem, or refer them onwards where necessary, how is making P medicines more widely available going to help those who really need our expertise?

Mon, 23/04/2012 - 15:05 – David Tyas

Please respond to the GPhC consultation

I would urge all colleagues to respond to the GPhC consultation at http://registeredpharmacies.org/ or by emailing the GPhC at consultations@pharmacyregulation.org by May 7th, even if only to register vociferous unequivocal opposition and grave concern over the possibility of the proposed relaxation of the standards being exploited to offer P medicines for self-selection. Such a move could only endanger patients and the public, and pharmacists would be placed in an invidious position in attempting to exercise their duty of care to ensure that P sales are safe and appropriate; confrontations could ensue in the event of any refusal to sell a product that a patient has in their hands where a pharmacist deems that the sale would not be in that patient's best interests. Moreover, some patients may become tempted to walk away with such a product after simply placing money on a sales counter, while others may seize an opportunity to steal P medicines.

In my view and not least for the above reasons and those cited by others, the entire P medicine category would become untenable if self-selection, which could only be in the interests of those who might benefit from increased commercial sales, is permitted. Frankly, it simply beggars belief that this has even been proposed once more; one can only speculate as to why this is happening given the repeated utter rejection of the notion by pharmacists each and every time that it has been considered in recent years, as most recently expressed within the Responsible Pharmacist impact research.

David Tyas

Mon, 23/04/2012 - 18:00 – Cathy Cooke

Self selection of meds

Angela's comments I totally relate to as I have experienced this scenario in my community pharmacy practice. People purchasing medicines do not routinely read the packs to make sure they are appropriate for their symptoms. People also learn what responses to give in order to satisfy any questions the pharmacist may ask. I have on occasion used shock tactics to reinforce the reason for my questions - telling someone trying to purchase excessive repeat packs of Zantac that the point of referring them to their doctor is that there is a low risk they could have cancer! Once the custom has picked up a pack of medicine, in their mind they have almost completed the sale and just need to hand over the money. Trying to them tell them that they can't have it is very difficult and requires advanced negotiating skills if the customer is not to be upset. They would ba unlikely to return if they can have an easier experience elsewhere. This is neither good for the profession of pharmacy nor good for the company's business. Having medicines on self-selection categorises them in the public view as similar to other commercial products and they do not understand that the pharmacist and staff are acting in their interest by questioning them regarding their expected purchase. Yet when someone experiences adverse effects from incorrect use of a medicine (such as happened recently with an overdose of paracetamol), there is then the cry of 'why weren't we told'. Packs of medicines clearly indicate the maximum daily dose and the safe maximum period of treatment after which the consumer should refer to their doctor for a clinical assessment and diagnosis. If the public cannot manage this with GSL medicines now, putting P medicines on self-selection will make matters worse. No medicine is without risk and pharmacists provide a vital function of safely protecting the public to ensure that medicines are used correctly. Placing P medicines on self-selection display will further the erosion of public respect for medicines and directly affect the safe progress of medicines from POM to P to GSL. Cathy

Tue, 24/04/2012 - 12:43 – Kazeem Olalekan

I have just voted No!

Hello,

I have just voted No to this proposal not because I wanted to say no to the proposal but because the Yes options didn't quite capture why I would like to vote yes. I will explain:

Whilst I think patient's shopping convenience is a good value to consider, it should not override safety. And I sympathise with (and recognised) the views expressed by Angela Dale and Cathy Cooke. Nonetheless, I will have to refer to the original article that triggered this poll:

1. The GPhC is saying (and I paraphrase): We will not be too hard (in the precriptive sense not regulatory sense) on you...you set your systems up in a way that is safest for your customers. To me that is refreshing.

2. The MHRA has said (and I am paraphasing again): That the P status stays and pharmacists remain the custodian of P medicines. They are not planning any legislative changes.

3. Mike Holden is absolutely right with his comment: “The barriers don’t have to be glass cabinets and counters; the barriers can be technology,”

So this is how I see it: I think everyone is right. I think the GPhC proposal makes sense and the MHRA position makes sense. My hunch is that we, as pharmacists are anxious that we will walk into our place of work tommorow and the manager that knows little about pharmacy (or should know better) will impose a possition on us which we are uncomfortable with.

This new world of risk based approach imposes a greater burden on us at a local level. I am happy to accept that burden as I am a responsible pharmacist. What it means however, is that head office (whereever that may be) should not put each store in a corporate straight jacket.

Let me run some examples with you:

The example proposed by Angela Dale is more likely in some customer cohorts than others. I have seen it in very affluent areas and seen it in deprived areas. The outcome is the same for pharmacists - 'I don't want to listen to what you have to say'. More often than not, it is a problem arising elsewhere (i.e. not in the pharmacist's domain) and may trigger a safety issue.

The key point therefore, is that wherever the product is located, the pharmacist can be alerted to the sale of 'P' medicines either through the use of technology or physical isolation of the product (or a combibation of the two). This will have to be dealt with locally and the pharmacist is empowered to exercise judgement.

The pharmacist must bear in mind that the judgement made may trigger a complaint from the customer and he/she (pharmacist) must ready to defend that judgement.

I hope that the profession is moving on to a position where the pharmacist (the one you employ and invest training on) is trusted to make a professional decision locally.

Kazeem Olalekan
www.bookapharmacist.com