Greg Hunt warns pharmacists and doctors on medicine information
Federal Health Minister Greg Hunt will write to pharmacists and doctors to remind them of their responsibilities, after consumer advocates raised concerns that patients were not being given vital information about medicine interactions and side effects.
The Consumers Health Forum of Australia called on Mr Hunt to step in after receiving complaints that patients were not always being given consumer medicine information documents (CMIs), which pharmaceutical companies are required by law to make available.
In the past CMIs were provided as a leaflet inside prescription medicine boxes but most products now direct patients to read the information online, leaving it to doctors or pharmacists to print off the documents for patients starting new medications.
But consumer advocates say this makes the information inaccessible to many, particularly if busy GPs and pharmacists fail to provide the documents – which experts say are far too difficult to read and understand.
Leanne Wells, chief executive of the CHFA, said that CMIs should “ideally” be placed inside prescription medicine packets and that directing patients to a website was “not of any use to those consumers, particularly older patients who may not use the internet”.
“It should be standard practice for pharmacies to give printed CMIs when dispensing prescription medicine,” Ms Wells said.
“Both doctors and pharmacists should ensure patients receive simple, clear and accurate advice, preferably on paper.”
One patient who spoke to the Sydney Morning Herald and The Age reported unforewarned side effects from a common prostate medicine that caused him severe constipation, interfering with a medical procedure.
The man complained that he was not told of the side effect by either his doctor or pharmacist, or that the medicine could be harmful to patients with liver damage.
The CHFA has previously called for warning labels to be mandated on the package of asthma medicine Singulair, after dozens of families reported side effects including suicidal thoughts in children who had taken the drug.
Sydney University pharmacy professor Parisa Aslani, who specialises in medicine use optimisation, said patients must be given information they could understand, whether inside the box, printed out or online.
“My biggest push is can we make this document user friendly and understandable, that people want to access,” Professor Aslani said, citing Australian Bureau of Statistics data showing that 60 per cent of Australians had poor to low health literacy.
“There’s no point trying to force health professionals to give out the current document – it’s not going to be understood.”
She said many CMIs, which could run into seven pages, were too long and complicated, making patients unlikely to read them even if they were provided in paper form.
Communication Research Institute chief executive David Sless agreed, saying the documents did not “invite reading”.
Professor Sless, who worked on the design of CMIs in the 1990s, said Australia had once led the world in medicine communications but had “gone to the back of the class”, with the documents “designed for something that is basically one up from a typewriter”.
“It’s a bit of a national disgrace,” he said.
Australian Medical Association president Tony Bartone said CMIs were “too dense, too confusing, too non-user-friendly”.
“It’s hard to find the information you’re looking for, unless you read the whole lot,” Dr Bartone said.
“The information should be available, but it’s got to be in a much more manageable and concise framework.”
He said high-tech solutions should be explored, such as a barcode on packets that could be scanned using a mobile phone app.
Pharmacy Guild of Australia spokesman Greg Turnbull said the organisation supported “maximum patient empowerment and health literacy” but that making the issuing of a CMI mandatory “for every one of the 300 million-plus PBS scripts per year might not be the best solution”.
“One size does not fit all,” Mr Turnbull said.
“Pharmacists exercise their professional judgement and clinical discretion in determining the best way to inform patients of what they need to know, always in the patients’ best interest.”
A spokeswoman for Mr Hunt said written information to help patients taking prescription medicines “should be readily available when the medication is bought from the chemist”.
“This is a TGA requirement,” the spokeswoman said.
“The minister encourages patients to talk to their health care professional about their prescription medication.
“[He] will also be writing to the Pharmacy Guild and the AMA to reaffirm existing responsibilities.”
Wentworth MP Kerryn Phelps, who is a Sydney GP, said patients should ask their doctor for information about any new medications, as well as revisiting the CMI for any medications they are already taking to check for drug interactions.
The Therapeutic Goods Administration requires written information to assist patients in the use of prescription medicines to be “available to be provided when these medicines are supplied”.
“In practice, a CMI may not be offered for repeat prescriptions but it should be available on request from a pharmacist,” a TGA spokesman said.
CMIs for prescription medicines on the market in Australia can be found on the TGA website.