Figure 1
Medical Protection Society structure for assessing risk in repeat prescribing.
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INTRODUCTIONRepeat prescribing is common in New Zealand general practice. Research also suggests that repeat prescribing is a process prone to error. All New Zealand general practices have to comply with requirements to have a repeat prescribing policy, with the details of the policy to be designed by the practice. AIMTo inform the development of p...
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Citations
... 21,22 While existing health pathways offer guidance for managing patients with CKD in primary care, the practical adoption and implementation of this guidance remain uncertain. 20,[23][24][25] Factors such as rising case complexity, clinical inertia, varying patient engagement and challenges in maintaining longitudinal follow-up within the primary care context may contribute to this uncertainty. 1,20,[23][24][25][26][27] There has been a parallel growth of wait lists for secondary renal care, which has been exacerbated by increasing demand following the pandemic period. ...
... 20,[23][24][25] Factors such as rising case complexity, clinical inertia, varying patient engagement and challenges in maintaining longitudinal follow-up within the primary care context may contribute to this uncertainty. 1,20,[23][24][25][26][27] There has been a parallel growth of wait lists for secondary renal care, which has been exacerbated by increasing demand following the pandemic period. 27 The prioritisation of first specialist assessment appointments, a key performance indicator (KPI), typically takes precedence over follow-up appointments, which may contribute to more fragmented longitudinal management of patients with advanced or complicated CKD. ...
The burden of chronic kidney disease is increasing throughout New Zealand, resulting in growing strain on patients, families and the healthcare system. The population of South Auckland is the most diverse in New Zealand and it is particularly vulnerable to the effects of chronic kidney disease due to its demography and its many communities that endure significant hardships. This article explores the prevailing challenges identified by renal physicians and nurse specialists over 35 years of caring for patients with chronic kidney disease in South Auckland.
... Some prescribers made additional software changes to make the process more seamless, a finding previously noted in the local literature. 12 Technology issues, including a lack of funding for information technology (IT) applications and perceptions that vendors were not delivering acceptable products, have been identified as primary barriers to e-health in previous international research. 13 In this study, respondents shared concerns about technology issues undermining benefits and sometimes resulting in e-prescribing being abandoned. ...
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.
... Considering practicelevel policy, Lillis and Lack used a Medical Protection Society structure for assessing risk in repeat prescribing to develop framework for general practices to use when developing their repeat prescribing policies. 3 We also have research signalling policy vacuums, 4,5 successes, failures, 6 and policy revisions. 7,8 In the first category Chatindiara and colleagues report high levels of malnutrition and frailty among patients entering residential aged care facilities. ...
