More support needed for rural communities

In a recent press release, network chair Dr Fiona Bolden said that it was an important step forward as New Zealand comes into the next surge of Covid-19, including the emergence of subvariant BA.5.

In rural areas, many people have antiviral medications like Paxlovid prescribed from many kilometres away and then couriered from urban pharmacies, which tend to be better supplied. However, the distances and individual pharmacies' policies involved can cause delays.

Bolden says the decision to allow community pharmacists to supply this medication without a prescription has raised some serious questions regarding patient safety. This concern relates to "back pocket" prescriptions - prescriptions which do not need to be used immediately.

She adds that Paxlovid is a complex medication, with many interactions, and can't be used without a person having adequate kidney or liver function. It can cause side effects, which need explanation and management and for Paxlovid to be safely supplied, access to this information is a necessity.

Bolden claims this information is currently not available in a universal way across the country.

"Pharmacists are an essential part of our rural healthcare team who have already had a very positive role in helping with the care of Covid in the community," she explains.

"Supplying this medication without adequate training and proper support will place additional unnecessary pressure on them. Rural pharmacies shouldn't be prescribing Paxlovid at all, but some rural pharmacists who have had appropriate training, and up-to-date medical records of the patient and the means to provide feedback to the main prescriber, may be able to do so."

Bolden adds that clinical assessment is always going to be an essential part of managing illnesses no matter where people live.

"Outcomes to changes in care need to be monitored carefully for unintended consequences."