Register      Login
Journal of Primary Health Care Journal of Primary Health Care Society
Journal of The Royal New Zealand College of General Practitioners
RESEARCH ARTICLE (Open Access)

‘Here to stay’: changes to prescribing medication in general practice during the COVID-19 pandemic in New Zealand

Geraldine Wilson 1 , Zoe Windner 1 , Susan Bidwell 1 , Olivia Currie 1 , Anthony Dowell 2 , Andrew Adiguna Halim 3 , Les Toop 1 , Ruth Savage 1 , Umaya Ranaweera 1 , Harrison Beadel 1 , Ben Hudson 1 4
+ Author Affiliations
- Author Affiliations

1 Department of General Practice, University of Otago, Christchurch, 14 Gloucester Street, Christchurch 8140, New Zealand.

2 Department of Primary Health Care and General Practice, University of Otago, Wellington, 23a Mein Street, Wellington 6242, New Zealand.

3 Pegasus Health (Charitable) Limited, 401 Madras St, Christchurch 8013, New Zealand.

4 Corresponding author. Email: ben.hudson@otago.ac.nz

Journal of Primary Health Care 13(3) 222-230 https://doi.org/10.1071/HC21035
Published: 13 August 2021

Journal Compilation © Royal New Zealand College of General Practitioners 2021 This is an open access article licensed under a Creative Commons Attribution 4.0 International License

Abstract

INTRODUCTION: The delivery of health care by primary care general practices rapidly changed in response to the coronavirus disease 2019 (COVID-19) pandemic in early 2020.

AIM: This study explores the experience of a large group of New Zealand general practice health-care professionals with changes to prescribing medication during the COVID-19 pandemic.

METHODS: We qualitatively analysed a subtheme on prescribing medication from the General Practice Pandemic Experience New Zealand (GPPENZ) study, where general practice team members nationwide were invited to participate in five surveys over 16 weeks from 8 May 2020.

RESULTS: Overall, 78 (48%) of 164 participants enrolled in the study completed all surveys. Five themes were identified: changes to prescribing medicines; benefits of electronic prescription; technical challenges; clinical and medication supply challenges; and opportunities for the future. There was a rapid adoption of electronic prescribing as an adjunct to use of telehealth, minimising in-person consultations and paper prescription handling. Many found electronic prescribing an efficient and streamlined processes, whereas others had technical barriers and transmission to pharmacies was unreliable with sometimes incompatible systems. There was initially increased demand for repeat medications, and at the same time, concern that vulnerable patients did not have usual access to medication. The benefits of innovation at a time of crisis were recognised and respondents were optimistic that e-prescribing technical challenges could be resolved.

DISCUSSION: Improving e-prescribing technology between prescribers and dispensers, initiatives to maintain access to medication, particularly for vulnerable populations, and permanent regulatory changes will help patients continue to access their medications through future pandemic disruption.

KEYwords: Prescribing; electronic technology; general practice; pandemic.


References

[1]  Royal New Zealand College of General Practitioners. GPs open for business – but changing the way they see patients [press release]. 2020. [cited 2021 February 10]. Available from: https://www.rnzcgp.org.nz/RNZCGP/News/College_news/2020/GPs-open-for-business.aspx

[2]  New Zealand Government. Unite against COVID-19: History of the COVID-19 Alert System. 2021. [cited 2021 February 23]. Available from: https://covid19.govt.nz/alert-levels-and-updates/history-of-the-covid-19-alert-system/

[3]  Ministry of Health (NZ). New rules for electronic prescriptions to support virtual care in the community. 2020. [cited 2021 February 23]. Available from: https://www.health.govt.nz/system/files/documents/pages/covid-19-new_rules_for_electronic_prescriptions-3apr20.pdf

[4]  Pharmaceutical Management Agency (NZ). COVID-19: Dispensing frequency. 2020. [cited 2021 January 8]. Available from: https://pharmac.govt.nz/news-and-resources/covid19/dispensing-frequency/.

[5]  Pharmaceutical Management Agency (NZ). COVID-19: Medicines with amended access criteria. 2020. [cited 2021 January 8]. Available from: https://pharmac.govt.nz/news-and-resources/covid19/covid-19-information-for-prescribers/covid-19-medicines-with-amended-access-criteria/.

[6]  Ministry of Health (NZ). New Zealand ePrescription Service. 2020. [cited 2021 January 18]. Available from: https://www.health.govt.nz/our-work/digital-health/other-digital-health-initiatives/emedicines/new-zealand-eprescription-service.

[7]  Canterbury Primary Response Group. COVID-19 Updates & Resources: Director-General Waiver under Regulation 43 Medicines Regulations 1984. 2020. [cited 2021 February 10]. Available from: https://www.primaryhealthresponse.org.nz/previous_event/director-general-waiver-under-regulation-43-medicines-regulations-1984-27-march-2020/

[8]  Atmore C, Stokes T. Turning on a dime: pre- and post-COVID-19 consultation patterns in an urban general practice. N Z Med J. 2020; 133 65–75.
| 33032304PubMed |

[9]  Imlach F, McKinlay E, Middleton L, et al. Telehealth consultations in general practice during a pandemic lockdown: survey and interviews on patient experiences and preferences. BMC Fam Pract. 2020; 21 269
Telehealth consultations in general practice during a pandemic lockdown: survey and interviews on patient experiences and preferences.Crossref | GoogleScholarGoogle Scholar | 33308161PubMed |

[10]  Wilson G, Currie O, Bidwell S, et al. Empty waiting rooms: The New Zealand General Practice experience with telehealth during the COVID-19 pandemic. N Z Med J. 2021; 134 89–101.
| 34239148PubMed |

[11]  Kolb SM. Grounded theory and the constant comparative method: valid research strategies for educators. J Emerg Trends Educ Res Policy Stud. 2012; 3 83–6.

[12]  Lillis S, Lack L. Repeat prescribing policy in New Zealand general practice: making it better. J Prim Health Care. 2020; 12 373
| 33349326PubMed |

[13]  Anderson JG. Social, ethical and legal barriers to e-health. Int J Med Inform. 2007; 76 480–3.
| 17064955PubMed |

[14]  McKenna R. Using information and communications technology to enable the exchange of information between New Zealand clinicians and health providers. N Z Med J. 2010; 123 92–104.
| 20581917PubMed |

[15]  Koster ES, Philbert D, Bouvy ML. Impact of the COVID-19 epidemic on the provision of pharmaceutical care in community pharmacies. Res Social Adm Pharm. 2021; 17 2002–4.
Impact of the COVID-19 epidemic on the provision of pharmaceutical care in community pharmacies.Crossref | GoogleScholarGoogle Scholar | 33317768PubMed |

[16]  Canterbury Primary Response Group. CPRG Update for Community Pharmacy – 2 April 2020 [Internet]; 2020. [cited 2021 January 18]. Available from: https://www.primaryhealthresponse.org.nz/wp-content/uploads/2020/05/CPRG-COVID-19-Pharmacy-Update-2-April-2020_FINAL.pdf.

[17]  Bell JS, Reynolds L, Freeman C, Jackson JK. Strategies to promote access to medications during the COVID-19 pandemic. Aust J Gen Pract. 2020; 49 530–2.
Strategies to promote access to medications during the COVID-19 pandemic.Crossref | GoogleScholarGoogle Scholar | 32738870PubMed |

[18]  Baird B, Maguire D. Understanding factors that enabled digital service change in general practice during the Covid-19 pandemic. London: The King’s Fund; 2021 [cited 2021 February 16]. Available from: https://www.kingsfund.org.uk/publications/digital-service-change-general-practice-during-covid-19.