In this part of the series I’m going to show you the system we use in Canterbury to deal with OTC codeine misuse. This system has been endorsed by the Police and three of our professional bodies (Guild, PDA, and PSNZ), and it is built on a close co-operation between pharmacies in Canterbury. The most interesting aspect of the system is the way it enables pharmacists to fulfil their duty of preventing harm to the patient and the public while addressing all health information privacy concerns, outlined in Part II – A Practical Analysis.

If you haven’t read Part I – The Codeine Problem, and you would like a brief overview of why this is an important issue, please click and have a quick read.

Continue reading →

You may have taken law and ethics courses in the past and probably heard lots about our obligations under the Health Information Privacy Code 1994 (HIPC). If you are like me, you will have wondered just how we are meant to even remember, let alone apply all these rules in our day-to-day practice. In the second part of the series I’m going give you a practical, straight-forward overview with respect to collecting, using and disclosing information about sales of codeine containing pharmacist-only products. As I have mentioned it in Part I of the series, many of us are worried about selling codeine-containing products and all the issues around their misuse. The case of codeine containing products is a great example of the difficulty we often see when having to apply the same set of rules to a diverse class of medicines. It also highlights a more general problem that medicines are not amenable to being put into classes, because they are so diverse, they almost need product-specific rules in our practice.

Read Part I here

Continue reading →

This is the first in a series of articles focusing on the tension between drug abuse prevention and health information privacy. In our day-to-day practice we encounter this problem way too often and we are expected to get the balance right between protecting the patient (and the public) and respecting their rights under the Health Information Privacy Code. The series offers insight and guidance for pharmacists to better understand the legal issues, what’s expected of them and enabling them to make better calls in curly situations.

A number of codeine containing products are available in New Zealand as pharmacist-only medicines. As with all pharmacist-only products, the pharmacist is required to record information related to the sale under Regulation 54A of the Medicines Regulations. There is a range of reasons why these records must be kept. From the patient’s perspective perhaps the most significant reason is to have a complete medicine history for future reference. From the pharmacist’s perspective the record ensures accountability as well. In case of OTC codeine, however, the records are often used to track usage with a view to identify and prevent misuse. This sets OTC codeine products apart from other pharmacist only medicines as far as health information privacy is concerned.

Continue reading →