The Pharmaceutical Journal
Vol 270 No 7250 p719
24 May 2003

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Letters to the Editor

Patient packs

There is better practice carried out in breweries

From Mr J. Sharp, HonMRPharmS

The advantages of patient pack dispensing are too obvious to need restating. It should have been fully in place long ago, and, but for (on all sides) a considerable deal of stupidity and not a little intransigence, would have been. However, the three articles which you published last week (PJ, 17 May, pp683–687) all, directly or by implication, perpetuate a fallacy.

For example, Kailas Mahadevaiah and Trevor Jones, respectively, state that patient packs "allow patients to recognise their medicines more easily" and "clearly identify the name of the medicine, where and by whom it was made". This is just not so.

In current practice, the use of patient packs only serves further to confuse patients as to the nature and origins of their medicines, thus:

• The doctor prescribes using a generic name

• The pharmacist dispenses a patient pack, which in all probability has, printed on the manufacturer's pack, a different (and quite possibly not English) name for the medicine (indeed, if the dispensing pharmacy uses a variety of sources of parallel-imported products, the name on the pack could well differ with each repeat prescription)

• The pharmacist then sticks the (generic) dispensing label on the pack, usually over the manufacturer's name for the product, for all the world as if the object is to obscure it

This does nothing to clarify things for the patient; rather, the reverse. But it does not end there. On opening the carton, the patient is likely to find strips printed in a language other than English, over which yet another not entirely comprehensible label has been affixed — quite possibly with yet another name for the product, and giving a different manufacturer's name.

Good manufacturing and dispensing practice? They do it better in breweries.

John Sharp
Woodley, Berkshire

Snipping is dangerous and should stop

From Mr C. Anton

You asked for pharmacists' views on patient packs (PJ, 17 May, p670), but here are my views as a patient.

I recently collected some doxycycline capsules from the pharmacy attached to my general practitioner's surgery. They came in a box and there was one complete strip of 25 capsules and a part strip of three capsules of a different brand. The part strip of three had no expiry date and the box only contained the patient information leaflet for the strip of 25 and not the part strip of three. Such practice is profoundly dangerous, illegal and should stop.

Christopher Anton
Administrative Co-ordinator,
West Midlands Centre for Adverse Drug Reactions

Packs should be labelled in English

From Mr R. M. Hall, MRPharmS

It was with interest that I read the article on patient packs, in particular the patient pack principles and the four key benefits (PJ, 17 May, p684).

Now that I have reached the stage in my life where I am a consumer rather than a dispenser of medicines, I find it interesting to be made aware of the problems of compliance. I can just about cope with patient packs with the days of the week printed in Spanish but my latest prescription has completely floored me — the days of the week were abbreviated in Greek.

I have pursued this problem, arising from the dispensing of parallel imports, with the Medicines Control Agency as was, to no avail because it is simply not interested. I would therefore suggest that the requirement that the packs be labelled in English be added to the patient pack principles.

This whole subject is a good example of how we can spend thousands of pounds on bureaucracy without managing to implement what is generally agreed to be a desirable policy.

Richard Hall
Market Drayton, Shropshire

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