Thank you for publishing an article on this topic.
We don't encounter articles on this important topic often.
It was interesting to go through the published article.
As prescribing is every prescribable clinician's responsibility, being mindful of the drug supply chain is essential for all the healthcare team and it would be a good idea to cover this in the medical student curriculum.
If I may suggest some points which are very much pertinent to this article.
1. It would helpful to initiate medications in generic versions as much as possible. This would help with cost, supply chain, assists with shelf storage issues in pharmacy (more brands of the same medications - more stock & storage issues) and moreover reduces confusion over brand names.
2. In this day and age, it's not onerous to embrace digital tracking / barcode tracking of medications. Also digitalising the medicine stocks in the trust. These two would help to keep tabs on the stock of any medications and also helps to track a medicine - to study its journey, helps to evaluate medicine sensitivity and others.
3. It might be a bad idea to review the duration of use of date we currently use. If a medicine is stored and transported in an acceptable temperature zone, should the use by date be extended? This itself might reduce wastage quite a lot.
4. When a patient is in hospital, in quite a few settings, POM (patients own medications) are taken from the patients and discarded (possibly this might be done due to individual trusts infection policy), only for the patient to seek further supply on their discharge from their GPs & pharmacy.
5. Quite often, patients existing medications are changed to different brands and formulations with no compelling reason. As the majority of the dispensing of the medications happens in the community, teams looking after the patients during their inpatient stay should weigh up before changing the medications.
6. Some medications are started as longterm in the discharge letter from hospitals. e.g. codeine, paracetamol. Patients assume that the hospital team have discharge them for good and they expect a regular script for these. Sometimes it might be a bad idea for the discharging team to consider advising patients to seek OTC analgesics - i.e. paracetamol.
7. Lastly, discharging clinicians sometimes need to be aware of the cost of the items they are initiating / changing and to consider cost effective alternatives.
Sometimes some of the alternative formulations might be costlier by many times. i.e. syrup / tablet / capsules. I feel on occasions one wonders if there should a maximum price slab for a medication.
I think medicine supply is very important topic, more so since Brexit when some of the historic supply chains were disrupted.
Digitalising the medicine supply might also shed light on hoarding of medicines, which on occasions might artificially inflate the cost of medications. Price of medications charged by the NHS is much more fluid than ever before, as they are fluctuating a lot, sometimes without a rational reason behind them.
I hope a review is done on this topic and articles on this are covered in journals for the benefit of all.
Rapid Response:
Re: Reducing drug waste in hospitals
Dear Editor
Thank you for publishing an article on this topic.
We don't encounter articles on this important topic often.
It was interesting to go through the published article.
As prescribing is every prescribable clinician's responsibility, being mindful of the drug supply chain is essential for all the healthcare team and it would be a good idea to cover this in the medical student curriculum.
If I may suggest some points which are very much pertinent to this article.
1. It would helpful to initiate medications in generic versions as much as possible. This would help with cost, supply chain, assists with shelf storage issues in pharmacy (more brands of the same medications - more stock & storage issues) and moreover reduces confusion over brand names.
2. In this day and age, it's not onerous to embrace digital tracking / barcode tracking of medications. Also digitalising the medicine stocks in the trust. These two would help to keep tabs on the stock of any medications and also helps to track a medicine - to study its journey, helps to evaluate medicine sensitivity and others.
3. It might be a bad idea to review the duration of use of date we currently use. If a medicine is stored and transported in an acceptable temperature zone, should the use by date be extended? This itself might reduce wastage quite a lot.
4. When a patient is in hospital, in quite a few settings, POM (patients own medications) are taken from the patients and discarded (possibly this might be done due to individual trusts infection policy), only for the patient to seek further supply on their discharge from their GPs & pharmacy.
5. Quite often, patients existing medications are changed to different brands and formulations with no compelling reason. As the majority of the dispensing of the medications happens in the community, teams looking after the patients during their inpatient stay should weigh up before changing the medications.
6. Some medications are started as longterm in the discharge letter from hospitals. e.g. codeine, paracetamol. Patients assume that the hospital team have discharge them for good and they expect a regular script for these. Sometimes it might be a bad idea for the discharging team to consider advising patients to seek OTC analgesics - i.e. paracetamol.
7. Lastly, discharging clinicians sometimes need to be aware of the cost of the items they are initiating / changing and to consider cost effective alternatives.
Sometimes some of the alternative formulations might be costlier by many times. i.e. syrup / tablet / capsules. I feel on occasions one wonders if there should a maximum price slab for a medication.
I think medicine supply is very important topic, more so since Brexit when some of the historic supply chains were disrupted.
Digitalising the medicine supply might also shed light on hoarding of medicines, which on occasions might artificially inflate the cost of medications. Price of medications charged by the NHS is much more fluid than ever before, as they are fluctuating a lot, sometimes without a rational reason behind them.
I hope a review is done on this topic and articles on this are covered in journals for the benefit of all.
Competing interests: No competing interests