New questions raised over CMI provision

Consumer group leaders say CMI is still not being provided adequately and changes may be needed    

The provision of CMI by pharmacists is once again being questioned by industry stakeholders, with some suggesting it could better be provided by manufacturers.

Writing in Australian Prescriber, Leanne Wells and mark Metherell from the Consumers Health Forum say that “despite the existence of CMI, uncertainty remains about who should be ensuring it gets to the patient”.

A 2014 study found that fewer than half of participants had received written medicine information, they said, despite payment for provision of CMI by pharmacists being specified as part of the dispensing fee in the Fourth Community Pharmacy Agreement of 2005.

The seeming lack of CMI supply has prompted a campaign to return CMI leaflets to medicine packaging, the CHF leaders said.

“The national CMI guide promulgated under the Quality Use of Medicines strategy in 2000 was meant to ensure medicine information was ‘designed to inform consumers about prescription and pharmacist-only medicines’ in a reader-friendly and standardised way,” they said.

“Seventeen years on, we have an unsafe and less effective situation where CMI leaflets are no longer inserted in packages, and patients are not getting the information they need”.

The authors pointed to comments in 2016 by the late Sally Crossing, convenor of advocacy group Cancer Voicers who said that “most Australians are receiving their medicines…. from hospital and community pharmacies with no information about the drug at all”.

She said there was “real confusion” as to whether the patient should be offered a CMI automatically, or must ask for it. Of course most health consumers will not know what their information options are…. “

Ms Crossing had argued for a greater role for manufacturers in providing this information. Wells and Metherell partially agreed with this in the Australian Prescriber article, but said that while the CMI produced by pharmaceutical companies was “by and large comprehensive and understandable”, CMI can tend to emphasise potential harms rather than benefits and it does not include information about off-label indications.

“While discussion with the prescribing doctor usually takes place, it is not easy for a patient to recall all the details needed for safe and effective use of a medicine. Doctors and pharmacists can help consumers by talking about CMI, especially if a medicine is being used for an off-label indication,” they said.

In a 2016 article for AJP, John Guy, chair of the PDL Victorian Local Advisory Committee said providing CMI whenever a drug is dispensed for the first time was not only good professional practice, but also worked to protect and benefit the dispensing pharmacist

“PDL strongly advocates the provision of CMI because it encourages the pharmacist to discuss the dispensed drug and counsel the consumer appropriately. The process of counselling the consumer is an important final check that the medicine has been dispensed correctly and this procedure has helped prevent many dispensing errors from leaving the pharmacy,” he said.

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