Sunday, September 20, 2009

Online Prescriptions

Commenting on my previous post Jenn asked:

Please explain - website generated prescriptions. We cannot get a prescription without first seeing a dr. Does this work for antibiotics for ear infections and strep? Because I would be officially jealous. I always know before the lab tests when my children have strep and the dr. never believes me until he sees the lab results. This ends up with repeated appts. and labs until I can get a positive result and meds.
The answer is a bit long for a comment, so I've turned it into another post.

Website generated prescriptions are an oddity, thanks to the swine flu pandemic. Once it became apparent flu was likely to reach epidemic levels, the government set up a swine flu helpline, available both by phone and online. The idea is that people with suspected flu bypass the usual medical system and are kept away from doctors' surgeries as much as possible, rather than turn them into a viral disaster zone. The online helpline goes through a questionnaire designed to identify people with symptoms likely to be flu, and if your symptoms tick the right boxes it generates an automatic prescription for Tamiflu. You get a unique code number for a friend or relative to take to a specified pharmacy and collect the medication. Obviously this is only intended for straightforward cases. Anyone with underlying health conditions or other risk factors is diverted back into the normal medical system.

No, we can't get prescriptions for antibiotics - or anything else except antivirals - online, convenient as that would be. However, primary care doctors here rarely bother with lab tests for ear infections or sore throats, and simply use clinical judgement as to whether or not to prescribe antibiotics. As I understand it their decision would depend on severity of the infection, length it has lasted, and past history - so for a child with a history of needing antibiotics to shift throat infections, chances are you would get them more quickly.

Speaking of antibiotics ... poor Cherub is still not well. I decided not to give her the Tamiflu as she seemed to be much better over the past couple of days, and well on the mend by this morning. This afternoon she went downhill again, with another fever, a nasty cough and noisy breathing. After a phone conversation with a nurse and a trip to the out-of-hours doctor, the conclusion was that she didn't have flu, but now has a chest infection needing antibiotics. Ugh!


Jennifer said...

Thanks for responding. I see the logic, I suppose, but does someone then monitor suspected cases or is Tamiflu supposed to knock it out without complications? (Meaning are people in danger of improper treatment because they didn't see a doctor right away?) OK, I guess you answered that already as little Cherub is sicker still. Poor baby - chest infections are frightening. We'll pray for her.

Jennifer said...

Also, I didn't mean for that to sound critical of how the government was handling the flu. I'm just always very curious about how healthcare works in other countries.

Melanie B said...

I hope poor Cherub gets better soon.

The Bookworm said...

Jenn, obviously the automated flu system has the potential for some people to fall through the cracks, but I think on balance it is better than everyone having to see a doctor. It frees the doctors up to deal with the more complicated and risky cases. While there isn't any routine follow up of flu cases, when you go to collect the prescription you get a leaflet detailing what to watch for and when it would be advisable to contact the doctor.

It seems doubtful that Cherub had the flu, though she did have flu-like symptoms. More likely it was the throaty thing we have all had that she struggled to throw off and eventually led to a secondary infection. I can't blame the automatic tamiflu system for her getting sicker as I didn't give her the antiviral in the end - she seemed to be so much better. Also I don't think I would have taken her to the doctor last week if the flu system wasn't in place. She seemed to turn the corner just at the point I would have considered it. Yesterday morning she seemed virtually back to normal. Darn chest infection!