What to do when presented with a prescription from another European country: insight from a qualitative study of pharmacists in England.

OBJECTIVES: Prescriptions for medicines issued by healthcare professionals in other parts of the European Union are legally valid in the UK. However, it is not known whether this is fully understood by British community pharmacists. In this study we aimed to understand the implementation of UK pharmacy policy on dispensing prescriptions from other parts of the European Union and to investigate pharmacists' knowledge and interpretation of the relevant provisions in a mystery shopping exercise in English pharmacies. METHODS: We reviewed the policy literature on regulations and practices pertaining to the prescribing and dispensation of prescription-only medicines in the UK. We interviewed key English informants in pharmacy. We then conducted a 'mystery shopping' exercise in 60 randomly selected pharmacies in urban, peri-urban and rural areas of England to investigate how community pharmacists manage four different types of prescriptions from another EU country. KEY FINDINGS: From the eight interviews conducted there was broad consensus that existing processes for verifying the authenticity of foreign prescriptions could be improved. Of the 60 pharmacies visited, only 27% (16 out of 60) were willing to dispense the medication. Pharmacists unwilling to dispense were invited to explain their reasons for refusal. The most common were that they believed that English pharmacists are unauthorised to dispense foreign prescriptions, and that prescriptions must be in the English language or issued by a UK-recognised prescriber. CONCLUSION: Existing processes available to English pharmacists for verifying the authenticity of foreign prescriptions seem to be insufficient. Strategies to overcome these problems were proposed by pharmacists and key informants, and include the creation of a database or registry of all authorised European Economic Area/Swiss prescribers, development of EU standards on prescription content and on dosage of medications, consistent international non-proprietary name (INN) prescribing and the use of an agreed common language for key information on prescriptions.