Ontario "pill pack" cuts increase risk of drug error, says pharmacist

I guess pill packs are just not a sexy issue. Not unless you're elderly, living on a fixed income and tied to taking several medications a day — but what kind of political clout do you have then?

Evidently not very much.

Since the Ontario government cut funding for pill packs under its drug plan a couple of weeks ago, there's been little public reaction. Pill packs are those handy plastic containers that keep different medications in clearly marked compartments. They are particularly important for seniors who are trying to live on their own. Under new regulations effective Aug. 1, Ontario will pay the $8 dispensing fee for only twice monthly (with limited exceptions) — a decision critics argue will help push seniors into nursing homes. Health ministry official Helen Stevenson told the Toronto Star the new policy was carefully studied before implementation.

But problems with the new policy are deeper, according to Kichener pharmacist Scott Hannay, who wrote to me after a recent story on the policy change:

 

"Thank you for writing your article (July 30/08) bringing the issue to the public's attention. I share the frustrations with some of the readers who have commented on the article. Our pharmacies supply a large number of retirement home residents with a version of a weekly pill pack. The new regulations will have a huge impact for those seniors who have a nurse administer their medications in a retirement facility (which unlike nursing homes are unregulated by the government and are not exempt from the laws). By eliminating compensation for preparing medications on a weekly basis pharmacies will stop offering this service. This will shift the task of organizing and preparing medications to the nursing staff and will result in less time to spend with the residents and much higher chance of errors in dispensing. There's also the issue of community psychiatric patients who are dispensed their medications in limited supply to monitor their compliance and reduce risk of overdose. By having some medications exempted from the regulations (like antipsychotics) Helen Stevenson has given the impression that she has put some thought and political posturing into this but the fact is that it is far easier to have a lethal overdose on blood pressure medication than it is on sleeping pills. Ironically drugs to treat Alzheimer's Disease are not on the exempt list (those who need compliance packaging the most to keep up their independence before the eventual placement in an LTC facility).

If it is decided that a person needs help organizing and monitoring their medications (by the doctor, patient and pharmacist together) I feel the taxpayers of Ontario would support the government continuing to pay for this service (which I have figured out based on our pharmacy's patient population works out to about $250/yr).

Scott Hannay
Medical Centre Dispensary/Williamsburg Pharmacy
Kitchener, ON.

Mr. Hanny had no objection to my publishing his views. Such concerns apparently weren't top of mind for the health ministry making the changes.