x Abu Dhabi, UAESaturday 22 July 2017

UAE plans to cut down on hospital visits for repeat prescriptions

Many patients whose condition is stable will have to see a doctor for a repeat prescription only once a year under plans to eliminate time-consuming and costly hospital visits.

Many patients whose conditions are stable will be required to make fewer visits to hospitals to collect repeat prescriptions under new rules expected to be in place by next year.
Many patients whose conditions are stable will be required to make fewer visits to hospitals to collect repeat prescriptions under new rules expected to be in place by next year.

ABU DHABI // Many patients whose condition is stable will have to see a doctor for a repeat prescription only once a year under plans to eliminate time-consuming and costly hospital visits.

At the moment the maximum time allowed between prescriptions is six months. Health officials hope the new rules will be in place by the end of the year.

"We're pushing each other to make sure we achieve it as soon as possible because we understand the need for it," said Dr Mahmoud Ramadan Abu Raddaha, head of the government prices and product benefits section at the Health Authority-Abu Dhabi (Haad). "Regulations take a long path of review, but the deadline is the end of the year."

Among those who may benefit is CZ, an Australian expatriate who has been receiving treatment for more than 20 years for a condition that causes high cholesterol.

"When I visit my doctors in Australia, they take into account my whole health and they notice I am fit and active and that I have a good diet," she said. "Because of this they say I need monitor my cholesterol only on a biannual or yearly basis."

But since moving to Abu Dhabi, CZ has had to go to hospital every two months to refill her prescription, and laboratory tests must be conducted each time to justify the need for the medication to the insurance company.

A visit to the consultant cardiologist at her private hospital costs about Dh1,000 and laboratory tests from Dh600 to Dh1,000, all paid by her insurance company and adding to the overall cost of premiums.

Thousands of patients in the capital with long-term but manageable conditions are forced to make unnecessary trips to hospital - 17 per cent of the emirate's population has hypertension; 21 per cent diabetes; 36 per cent high lipids. It is not known how many cases are stable.

Repeat prescriptions were introduced in public hospitals seven years ago and in private hospitals three years ago. Patients still collect their medication monthly, but are given postdated prescriptions.

"If the case is extremely stable and the visit is just for rewriting the prescription, then that visit should not take place," said Dr Abu Raddaha.

The standardised pharmacy computer system can note and monitor refill prescriptions, said Dr Mohammed Abuelkhair, the head of the drugs and medical products regulation department at Haad. "What we think is happening is some of the physicians are not used to this system, because we get physicians from all over the globe, not only the United States or the United Kingdom where doctors are used to writing a repeat prescription."

The authority is now placing the onus on doctors to determine the number of visits required. "But we will also mandate that the patient is seen at the proper frequency to make sure people are not getting a drug without being checked for the progression of the medical condition," said Dr Abu Raddaha.

Insurance companies are hesitant to extend repeat prescriptions because the UAE has no tradition of family doctors - the system in which one doctor tends to a patient's medical needs for an extended period of time.

"Unfortunately our context here is different. Very few patients know how to link their disease with one doctor, so basically they change doctors," said Dr Jad Aoun, chief medical officer at Daman, the national insurance company.

The transient nature of the expatriate community means both patients and doctors come and go, making it difficult to form a medical relationship.

"People go to the hospital because they feel they need to see a doctor, but they don't have a name in mind or a particular person to interact with."

The insurance law of 2005 does provide scope for insurance companies to require general practitioners or family doctors to act as "gatekeepers". "We are currently reviewing that model and we're looking at a way to promote it further without causing any constraint or adding any more pressure to the market," Dr Abu Raddaha said.

mismail@thenational.ae