HIV drug reforms needed
A Federal Government bid to lighten patient load is unlikely to affect the nation’s HIV patients.
Health Minister Nicola Roxon announced last week the Government would set aside $126 million over four years to allow nurses to prescribe medication on the Pharmaceutical Benefits Scheme (PBS) and bill their services to Medicare to speed up patient care when doctors are unavailable.
However, it is unlikely this will impact people with HIV as their drugs can only be prescribed by GPs and specialists with written approval to dispense them.
Australasian Society for HIV Medicine (ASHM) CEO Levinia Crooks agreed the funding would not help people with HIV.
I don’t think the budget makes a significant change as things stand at the moment, she said.
As far as getting nursing more involved in HIV care, this is something that’s going to take some time … it’s a matter of making sure nurses are well-versed and well-trained in the HIV area.
ASHM released a report earlier this month calling on the HIV sector to broaden its approach to patient care.
Crooks said one of the key problems was the lack of a safety net if doctors moved away from service areas.
The strain in HIV mirrors, in many respects, the strain on the health system generally. Where you have more doctors, you have more doctors who can do HIV medicine. Where you have fewer doctors, you have doctors who have competing demands on their time, she said.
We’re seeing a shortage in the medical profession. We’re seeing a shortage in lots of different doctors and, yes, we are also seeing a shortage in the HIV area.
Positive Life spokesman Rob Lake said people with HIV often use the same drug for up to three years.
If nurse practitioners could repeat scripts it would free up the time of GPs. One of the issues for us is there aren’t that many GPs who work in HIV and they’re all very busy, he said.
If you could spend that 10 minutes talking about your broader general health, instead of having another script filled out, then that would be good.
Being able to talk to a nurse about other health issues would also benefit the patient, he said.
Meanwhile, the NSW Government is considering a reform to the dispensing of HIV medication. Currently most antiretroviral prescriptions can only be collected from hospitals during business hours and only in quantities up to one month’s supply.
HIV groups have been lobbying Health Minister John Della Bosca to ease the burdens on HIV patients by allowing three-month prescriptions, but SSO understands he is yet to make a decision.
For working people. it’s a serious issue. For people who aren’t out about their HIV status, they have to tell their boss they’ll be away from work for two and a half hours and can’t tell them why, Lake said.
People in the country can travel for up to several hours to a community health centre.
Della Bosca’s office said it did not have an announcement at this time.
– Additional reporting by Andie Noonan
There are aspects of managing HIV outpatient care that could be improved to the benefit of the patient, staff and the health system as a whole. The key is greater flexibility and greater emphasis on the needs of the patient.
Nowadays, because of good health, I have clinic checkups every 4 months. I live in a different health area to where I attend clinic, so I travel a 2 hour round trip for checkups and prescription fulfilment. My doc writes a 4 month script — but hospital pharmacy can rarely fill it all in one hit because of supply limits. They can usually do 2 months. If a script could be filled in one go, that’d save extra visits (which is good for medication adherence, good for pharmacy efficiency, saves me lost work time and petrol).
Apparently the script must be filled by the hospital pharmacy within the same health area as the prescribing doc. If this restriction was eased, patients like me would be able fill their script closer to home. Together with getting bloods done locally — which I do, at a local collection centre in advance of my next clinic appointment, so that by my appointment, my doc has recent results to go by *before* writing a new prescription — I would be able to get my face-to-face clinic appointments down to, say, once a year or even *none* unless an adverse event occurs. This way, my doc would simply confirm my latest blood results are ok (ie. no med change needed and blood workup looking normal) and post me the next script and blood collection form for the next 4 months (saving a 2-hour round trip to mainly collect and fill a prescription, freeing up clinic time to deal with people who actually need face-to-face and urgent attention, and meaning the money I save in petrol can go towards meds in the future).
Here’s hoping.
This is great news from the Federal Health Minister Nicola Roxon to allow nurses to prescribe ‘repeat prescriptions’ to HIV patients. I have to sit for up to 3 hours at my clinic & wait to see a doctor to write a new prescription , after I have been told that my viral load is undetectable & T-Cell count is steady. This has been going on for 3 years, so I will be glad to be seen by a nurse & have my repeat prescription issued in a quicker manner. This will free up a lot of time for doctors to look after patients who have developed problems & need further care.
Good Health to everyone !