January/February 2025 • PharmaTimes Magazine • 32-33
// PHARMACY //
Super pharma?
Pharmacists must update safeguarding as the era of Wegovy and Pharmacy First loom large
The recent report from the MHRA on inappropriate prescriptions of the weight-loss drug Wegovy provided a very troubling read and an indication of future challenges.
As such medicines become more common, the pharmacy sector has a special responsibility to ensure that proper accountability measures, record keeping and safeguarding processes are in place to uphold clinical standards.
Weight of expectations
In my experience, the MHRA’s findings ring true. When I was pregnant about a year ago, I decided to investigate how easy it was to access GLP-1RAs at a number of different online pharmacies.
What I found was deeply concerning. When I logged on to order a dose, there were few, if any, clinical barriers in place to prevent potential misuse or inappropriate prescriptions.
Despite such medications being a known risk to pregnant patients, this was hardly taken into account by any of these online pharmacies.
Weight-loss medications like these are only meant to be taken under strict clinical supervision, so the lack of any real safeguards in this process was hugely concerning.
Medications like Wegovy are meant to support weight loss for patients who meet specific clinical requirements, decided by healthcare professionals.
But drugs like this risk becoming a species of cosmetic medicine; unethically prescribed to any paying customer.
The indiscriminate prescription of such drugs has led to a measurable rise in primary and emergency care admissions. There is now an urgent need to improve clinical standards in order to safeguard patient health as these drugs become more widely used.
One obstacle to a greater level of safeguarding is a lack of peer accountability in the pharmacy sector. Such systems are common among primary care professionals, but have yet to be fully adopted in UK pharmacies.
Pharmacies should establish clear reporting systems that would allow employees to notify the proper medical authorities when they observe instances of inappropriate prescription.
‘When I logged on to order a dose, there were few, if any, clinical barriers in place to prevent potential misuse’
Digital platforms are of course a great convenience for pharmacists, but it is vital that they recognise which services can be safely delivered online and which demand an in-person evaluation.
Any prescription must first and foremost be decided on the basis of patient well-being – not the profit motive. Anything else would be to put patients at risk and compromise the integrity of our profession.
What is Wegovy?
Wegovy is a prescription medication designed to aid weight loss. It contains semaglutide, an active ingredient that mimics a hormone to regulate appetite.
This helps reduce cravings and makes you feel fuller. It is intended for adults with obesity or those who are overweight and have weight-related health issues. Wegovy is administered as a once-weekly injection.
Off script
Greater safeguarding will also require action to address the significant gaps in clinical record keeping in pharmacies.
Again, in primary care settings there are rigorous standards of documentation, but pharmacies seldom keep proper records for assessments and follow-ups when it comes to drugs like Wegovy.
This lack of detailed clinical records not only leads to substandard care for patients, but also exposes pharmacists to legal liability.
If a hospital admission takes place as the result of a Wegovy prescription, then proper documentation will be needed to prove that a pharmacist acted in good faith and according to best practice. In its absence, pharmacists will face lawsuits and disciplinary actions.
Therefore, pharmacists must act now to put in place robust systems that record all medical assessments – even virtual consultations.
When I was a nurse, one old maxim of primary care was: “If it’s not documented, it didn’t happen”. In the era of Wegovy and ‘Pharmacy First’, pharmacists have no excuse.
First aid
Pharmacy First is a service introduced by NHS England in January 2024. It builds on the earlier Community Pharmacist Consultation Service and allows community pharmacies to handle episodes of care for seven common conditions without patients needing to visit a GP. These conditions include earache, sore throat and urinary tract infections.
The goal is to provide quicker and more convenient access to healthcare, freeing up GP appointments for those who need them most.
Adapt and evolve
Digital platforms are increasing pharmacy efficiency by streamlining tasks like consultations.
They enable pharmacy professionals to carry out video consultations with patients, manage prescriptions and create essential medical records and store them digitally.
The ease of documentation that platforms like Charac enable supports clinicians in following up with patients to ensure continuous, informed care; and in maintaining the highest standards in clinical record keeping.
As pharmacists take on a greater role in primary care, there is now an urgent need to update safeguarding and regulatory standards to reflect this.
The issues with Wegovy prescription throw this into sharp relief.
Pharmacists must now act to meet primary care standards in peer accountability and oversight to safeguard the welfare of patients and protect the integrity of the sector.
Katherine Bridges is Head of Brand and Clinical Lead at Charac.
Go to charac.co.uk
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