Mail-only medications will cause problems for Labrador seniors, worries town official
A change to the way community clinics dispense medication will be hard on seniors, says a Labrador town clerk.
Labrador-Grenfell Health put a stop earlier this year to medication dispensing at community clinics on Labrador's south coast, meaning anybody needing a prescription filled has to order it from a local pharmacy and wait for it to arrive in the mail.
Hard on seniors
St. Lewis clerk Lorraine Poole said she fears the change may mean gaps in refills, especially for seniors.
"My worry, and council's worry, and the town's worry, I guess, is about the seniors, who sometimes don't understand their medications properly," she said. "They're used to going to the nurses, and the nurse explains things to them and gives them their medication and gives them instructions."
But Dr. Gabe Woollam, vice-president of medical services for Labrador-Grenfell Health, said the health authority has no choice.
They just said, 'OK, we're going to do this, we're just going to rip off the Band-Aid,' and here it is. - Lorraine Poole
The health authority had been dispensing medications at clinics for years because of poor access to pharmacies, he said, but in the last couple of years, it has become clear from two regulatory bodies — the Association of Registered Nurses of N.L. and the Pharmacy Board of N.L. — that to meet current regulatory and safety standards, that had to stop.
"The reason we decided to start in those communities is because over the past few years, access to community pharmacies has really improved in those areas, with one pharmacy on site and a number of pharmacies that are willing to either deliver to patients in person or by mail," said Woollam.
"So we felt that that was the best place to start with this transition. Our goal is to stop dispensing medications through our community clinics by some time in 2019, and we're doing this in a step-wise approach to ensure that it's done in the safest manner."
Poole said the change was too sudden.
"Was it a good decision? Not really," said Poole. "We could have been, sort of, weaned into it, but I guess they just said, 'OK, we're going to do this, we're just going to rip off the Band-Aid,' and here it is."
Woollam said clinic nurses started talking to patients earlier this year that the change was coming.
"The nurses have been able to field a number of questions from patients," he said, adding that clinics will also be able to assist seniors in dealing with pharmacies and refilling prescriptions.
Transportation issues
Poole said she's also concerned about the medications arriving by mail. Right now, if she calls her pharmacy on, say, a Tuesday afternoon to refill her medication, she'll have it Wednesday morning — if the mail is on time.
"One of our biggest concerns is in the wintertime," said Poole.
"The roads, they're blocked sometimes for three and four days, so your medications aren't going to get through. Even if they do come through the mail, the mail truck is not going to get through."
If somebody has an acute problem and they're seen in the clinic and need antibiotics or something right now, the clinics continue to be prepared to provide those medications. - Dr. Gabe Woollam
Woollam acknowledges that transportation can be a problem, but said the clinics will still have medication on hand for acute problems and when there's a refill gap.
"The clinics will stock small quantities of certain medications to ensure that patients can continue safely should they run out of medications that they absolutely need," he said, adding the change is mainly around chronic medications, not acute care.
"The clinics will still be providing medications for acute medical illnesses, so if somebody has an acute problem and they're seen in the clinic and need antibiotics or something right now, the clinics continue to be prepared to provide those medications."
Change will improve safety, says health authority
Labrador-Grenfell Health "no longer has a choice" to let clinics dispense the medications, Woolam said, but added there are benefits to the change.
"One of the important things that I think will improve the safety of patients' prescriptions is that now they will be dealing directly with a pharmacy, and a pharmacist will be involved in dispensing all of those medications," he said.
"The pharmacists are trained to review prescription medications for interactions with other drugs or other substances people may be taking."
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