I VISITED a pharmacy in Kuala Lumpur recently and noticed that many local customers were there to get medication without a doctor’s prescription. I spoke to a few of them and they told me they did not see the need to pay for consulting a doctor when they could just go to a pharmacy to get the medication they required. All they had to do was tell the pharmacist in charge what symptoms they were having and they would get the medication. This is happening not only in one pharmacy but throughout the country as well.
There are specific roles for doctors and pharmacists in healthcare. That is why in first world countries, it is the doctor’s job to prescribe the medication and the pharmacist’s to dispense it. The Malaysia Pharmacy Association is fighting for this now but what they may not realise is that some pharmacists are selling medication over the counter to customers without a prescription.
This is dangerous for a number of reasons. Firstly, the pharmacists are selling medication to a customer without knowing his or her medical history or doing a proper examination. For example, a lame man could go to the pharmacy, say he is having a bad cough and would be prescribed some cough mixture. How sure is the customer that he is just having a common cold and not suffering a more serious illness like upper respiratory tract infection (URTI)? This diagnosis would be missed without a proper medical examination of the patient.
I also noticed that pharmacists tend to prescribe antibiotics when the patient is just having URTI where antibiotics are not indicated. This might cause resistance to bacteria in future.
Another example of the consequences of not doing a proper medical history-taking is that one might not be aware the customer is taking a blood thinner (Warfarin) and prescribe him an analgesic such as NSAIDS. This is one of the contraindications for Warfarin.
I’ve noticed that many of the customers who buy medication from pharmacies are people with chronic illnesses such as diabetes and hypertension who do not go for regular checkups with their respective doctors. Diabetes and hypertension are dynamic diseases which require adjustments in medication throughout the disease. As such, the complication of these chronic illnesses might be missed if the patients just buy their medications over the counter.
There are many other bad outcomes for patients who buy medication over the counter without a doctor’s prescription. I hope the Health Ministry will look into this matter