Iniative to monitor sale of codeine-containing meds

This follows the formation of the Codeine Care Initiative by the Community Pharmacy Sector (CPS) and Pharmaceutical Society of South Africa (PSSA) to monitor and audit the sale and supply of codeine-containing medicines. The initiative was introduced to delegates attending the recent inaugural National Pharmacy Conference, hosted by the South African Pharmacy Council (SACP). Rollout will begin from 1 July 2013, with final implementation and "switch-on" scheduled for January 2014.

The Initiative will use a 2D-barcode called a TrustaTAG on the packs of all codeine-containing medicines and linked to a secure central database to monitor the national purchase of these medicines. This barcode is scanned prior to purchase and will immediately show when and where a patient had last purchased codeine-containing medicines. Pharmacies may also use their existing dispensing systems, into which the Codeine Care offering has been integrated. This will help prevent accumulative buying and misuse of the drug.

This increased control - and user education - comes courtesy of a computerised system for monitoring sales of codeine-containing medicines that will be implemented by SA's biggest pharmacy groups, including Dis-Chem, Clicks, Pick n Pay, and MediRite.

Alison Vienings, the Executive Director of SMASA, says that when healthcare professionals dispense potentially addictive or misused medicines, their responsibility increases dramatically as the custodians of medicines and knowledge of those medicines.

Advice and education

"The onus rests almost entirely on the shoulders of the healthcare professional to ensure that the consumer is given the correct advice, the most suitable over-the-counter medication and recommended dosage.

"Usage is especially difficult to regulate as up to now, no national database has existed and as such could lead to the abuse and misuse of codeine-containing medicines," says Vienings.

"We agree with the on-going safety concerns around the misuse of non-prescription medicinal products containing codeine. However the pharmaceutical industry does not believe that classifying codeine as a higher scheduled medicine, available by prescription only, will appropriately control the problem of misuse. If these medicines were only available through a prescription, they would soon be out of reach of many South Africans. Instead, we support the Initiative's efforts to rather self-regulate the supply of codeine-containing medicines by ensuring that there are appropriate controls and mechanisms in place for pharmacists to use their professional skills and competence and specialised knowledge to encourage the rational and proper use of medicines," she says.

The Initiative however also has an important educational role to play, Vienings says. "Because the system will enable your pharmacist to see your codeine medicine purchase history, potential misuse will immediately be flagged. As such, the system will help us address and ultimately prevent codeine medication misuse."

Whilst the focus is on OTC codeine-containing medicines, higher scheduled products obtained via a prescription will also be included in the central database as will those prescribed in a hospital for in-patients and out-patients. The plan for the Initiative is in time to roll it out to dispensing doctors and to State institutions. In addition, once the Codeine Care Initiative proves successful, the industry may well decide to roll out this project to include other misused substances.

Product information

The system will also provide patients with a mechanism whereby they are able to discreetly access information about the codeine-containing product they are taking through scanning the TrustaTAG on packs with a basic feature phone or smart phone. They may then seek help through direct links to telephone numbers and email addresses of either the manufacturer involved, or that of the likes of Drugwise - and in time, Lifeline. Whilst the same TAG is used, the system is able to differentiate between a pharmacist and a consumer accessing the system, and will display different information to the two users.

Drugwise will also make available training for pharmacists to help them assist customers or patients who are potentially misusing codeine-containing medicines and to handle an instance where the sale of these medicines is declined by the pharmacist due to potential misuse occurring.

To find out more about the Codeine Care Initiative and effective, responsible self-care and self-medication, visit www.selfcare247.co.za.