An idea to save doctors the training

Doctors need more training to be able to recognise OTC addiction? This could be true, but isn’t it us who witness this issue on a daily basis?

Now I have an idea, it’s probably not an original idea, but it is still an idea.

I was never a fan of an identity card, but I am a fan of an NHS card. A card which records a patients name, address, date of birth, medical number, and their medication history.

When I say medication history I am talking about all the medication prescribed by their doctor, and any medication they buy, all the way down to GSL; from pharmacy or any store. This is the only logical way I can think of dealing with over the counter addiction.

It is too easy to use a number of pharmacies in one town, or numerous towns to get a serious amount of tablets. I refuse people on a daily basis thanks to my staff noticing they buy the same tablet every week. I offer alternatives and advice but they usually end up walking out disgruntled. Now I know they have not just went home defeated. Addiction dictates they will go and find it from a different source.

The card will have to be presented both to buy medication and when going to the doctor. This way the pharmacist knows the drug history of any patients presenting with an acute prescription from a different area, or someone coming into the shop looking to buy a medication. It also allows Doctors and Nurses to know what medication someone being admitted is taking, without having to take drug histories from patients, family and possibly numerous pharmacies or GP surgery.

It will flag up if the patient is overusing OTC medication through timescales and maximum doses allowed during a period. Concordance will be measured, and therefore we can be informed if the patient is under or over-dosing.

Now the current way for patients to overcome pharmacists or pharmacy staff who recognise them, is to use someone else to buy the medication for them. This will curb that slightly as well, as it will go on their card, which means they will only be allowed a certain amount as well, and may deter them as they won’t want to be seen buying a lot of medication. It also tackles those people who buy online from different online pharmacies as this card number will have to be entered to purchase, and from checking the records will also flag them up as overusing their medication.

I know in Scotland there is a registration process for their minor ailments service, where only one chemist is to be used, but this I hear from my colleagues north of the border, this usually doesn’t happen, and patients register in a different pharmacy all the time. This will negate this, and let patients have their choice of pharmacies, but will still lead to a continuous record being held.

It is a huge task and job, but surely a simple chip on a card could deal with this amount of information, a photograph will make it a good ID for all substance misuse patients, and for others collecting medication or requesting an emergency supply (an easier life for new pharmacists or locums). And most importantly of all we can keep patients safe, and identify those who may be addicted or becoming addicted to a medication. With knowledgeable patients now the norm thanks to the Internet, patients know which medications will give them a desired affect. We are not human lie detectors as much as we try to be and we need all the help we can get to identify patients who are addicted to certain medications.

Maybe this way Doctors won’t need extra training; we won’t continue to be exasperated at how easy it is to get addictive medication and our patients quality of life will increase.