https://www.theguardian.com/austral...ng-consultation-for-vaping-scripts-in-minutes
www.theguardian.com
GPs caution against telehealth websites promising consultation for vaping scripts ‘in minutes’
Melissa Davey
6 - 8 minutes
The peak body representing general practitioners has warned against using “pop up”, telehealth websites that promise to deliver consultations for “vaping scripts in minutes” because they can disrupt continuity of care for patients.
On Friday laws came into effect that prevent nicotine-containing vaping products from being obtained without a prescription from a doctor. Doctors are only supposed to prescribe nicotine-containing vaping products as a last resort when other smoking treatments and methods have failed. There is no strong evidence vaping is an effective quit-aid.
In response to the laws, websites have emerged offering to link those who vape to a health practitioner authorised to prescribe the product. But there are concerns that many Australians who vape are not doing so to quit smoking, and they use the products in conjunction with cigarettes, or vape despite having never smoked before. The law changes were prompted by concerns about the health impacts of vaping, and data showing that children are increasingly using the products.
One vaping shop website, PodVapes, says it has “teamed up with telehealth provider VapingScripts to provide a telehealth consultation”. The government has introduced a new telehealth medicare item number for smoking cessation consults, to obtain scripts for nicotine-replacement products, including vaping products.
<strong>Sign up to receive the top stories from Guardian Australia every morning</strong>
“Prescriptions can only be used exclusively at PodVapes,” the PodVapes website says, although the VapingScripts site says it will forward scripts to a “participating pharmacy” or a “preferred supplier” (one of which is PodVapes). The VapingScripts website it links to says that it offers consultations for “vaping scripts in minutes”. Although the homepage does not expressly say that vaping products will only be prescribed as a second-line treatment for tobacco smokers wishing to quit, the “about us” section does say it is a service “to enable the safe use of e-cigarette nicotine for the purpose of smoking cessation”.
A spokeswoman for Australia’s drugs regulator, the Therapeutic Goods Administration [TGA], said “The TGA will review the website for compliance with the requirements of the nicotine advertising permission and the Act”.
“Should it be found to be non-compliant, the TGA will take appropriate action,” she said.
“The [laws] allows pharmacies and pharmacy marketing groups to advertise nicotine vaping products in a certain, very limited way. Non-pharmacy websites which advertise nicotine vaping products, or advertise links to online nicotine vaping suppliers, are likely to be non-compliant with the nicotine advertising permission.”
The website is owned by the CEO of an online telehealth service called Phenix Health, which describes itself as “Australia’s virtual superclinic”. CEO of Phenix Health, Gillian Alexis, says the Telehealth provider has not partnered with any vaping websites associated with big tobacco, and that neither VapingScripts nor Phenix Health receive any financial or other incentives in partnering with vaping websites.
Alexis said the website follows all government regulatory guidelines.
Asked why the website promises a consultation for a vaping script in minutes, given health practitioners are required to take a patient history and only prescribe vaping products as a last resort, Alexis said she would; “take that on board”. She confirmed a lengthy consult was required.
“Of course they have a consultation with a doctor, so it’s up to the doctor and the nurse practitioner … who do a full patient history,” Alexis said. “And this is a second line treatment, so isn’t for all patients, they’re not necessarily going to get a script given to them. It is up to the doctor and the nurse practitioner’s discretion.
“They actually do take about 45 minutes for a patient to be assessed as appropriate [to receive a vaping script], and they will go through a plan for that patient.”
Asked if it was unethical to partner with pro-vaping websites promoting particular products, Alexis said there were only 71 approved prescribers in Australia, and that it was important for those who do rely on vaping as a smoking cessation tool to have clear information about where to get a prescription.
“We do not send our scripts to a patient directly”,” Alexis said. “We can only send it [an electronic script] to an approved, compliant organisation or pharmacy, and the pharmacies are very slow in taking this up. That’s the reason that we want to make sure that we send our script to the right companies. We don’t care what company that is, as long as they are compliant, and we are now working with a number of vaping providers.”
The president of the Royal Australian College of General Practitioners, Dr Karen Price, said smoking cessation prescriptions should ideally be issued via a patient’s usual GP.
“GPs know their patients and are well-placed to provide advice on how to quit smoking, including pharmacotherapy and behavioural treatments,” she said.
“A GP may prescribe nicotine replacement therapy in the form of a patch, spray, gum or lozenge as well as drugs such as varenicline, which blocks the pleasure and reward response to smoking, or bupropion hydrochloride, which reduces the urge to smoke.
“GPs may also prescribe nicotine vaping products as a second-line treatment option if all else has failed.”
Price said the problem with telehealth vaping script “pop up” clinics is that they can disrupt continuity of care.
“Instead of seeking out a telehealth clinic to obtain a nicotine vaping product script, I strongly urge patients to instead book a consult their usual GP to discuss smoking cessations options,” she said.
It was important that those seeking a script from Vaping Scripts, or other seemingly on-demand telehealth clinics, be aware that prescriptions for nicotine vaping products were not simply provided on request, Price said.
“Rather, it is a second-line treatment option to be used when other measures, such as nicotine replacement therapy with behavioural support, have failed,” she said. “It is the job of GPs in communities across Australia, including those at telehealth clinics, to apply discretion and judgment when considering the patient’s individual circumstances and whether a prescription for nicotine vaping products is warranted.
“We will always support patients who want to undergo smoking cessation therapy.”
www.theguardian.com
GPs caution against telehealth websites promising consultation for vaping scripts ‘in minutes’
Melissa Davey
6 - 8 minutes
The peak body representing general practitioners has warned against using “pop up”, telehealth websites that promise to deliver consultations for “vaping scripts in minutes” because they can disrupt continuity of care for patients.
On Friday laws came into effect that prevent nicotine-containing vaping products from being obtained without a prescription from a doctor. Doctors are only supposed to prescribe nicotine-containing vaping products as a last resort when other smoking treatments and methods have failed. There is no strong evidence vaping is an effective quit-aid.
In response to the laws, websites have emerged offering to link those who vape to a health practitioner authorised to prescribe the product. But there are concerns that many Australians who vape are not doing so to quit smoking, and they use the products in conjunction with cigarettes, or vape despite having never smoked before. The law changes were prompted by concerns about the health impacts of vaping, and data showing that children are increasingly using the products.
One vaping shop website, PodVapes, says it has “teamed up with telehealth provider VapingScripts to provide a telehealth consultation”. The government has introduced a new telehealth medicare item number for smoking cessation consults, to obtain scripts for nicotine-replacement products, including vaping products.
<strong>Sign up to receive the top stories from Guardian Australia every morning</strong>
“Prescriptions can only be used exclusively at PodVapes,” the PodVapes website says, although the VapingScripts site says it will forward scripts to a “participating pharmacy” or a “preferred supplier” (one of which is PodVapes). The VapingScripts website it links to says that it offers consultations for “vaping scripts in minutes”. Although the homepage does not expressly say that vaping products will only be prescribed as a second-line treatment for tobacco smokers wishing to quit, the “about us” section does say it is a service “to enable the safe use of e-cigarette nicotine for the purpose of smoking cessation”.
A spokeswoman for Australia’s drugs regulator, the Therapeutic Goods Administration [TGA], said “The TGA will review the website for compliance with the requirements of the nicotine advertising permission and the Act”.
“Should it be found to be non-compliant, the TGA will take appropriate action,” she said.
“The [laws] allows pharmacies and pharmacy marketing groups to advertise nicotine vaping products in a certain, very limited way. Non-pharmacy websites which advertise nicotine vaping products, or advertise links to online nicotine vaping suppliers, are likely to be non-compliant with the nicotine advertising permission.”
The website is owned by the CEO of an online telehealth service called Phenix Health, which describes itself as “Australia’s virtual superclinic”. CEO of Phenix Health, Gillian Alexis, says the Telehealth provider has not partnered with any vaping websites associated with big tobacco, and that neither VapingScripts nor Phenix Health receive any financial or other incentives in partnering with vaping websites.
Alexis said the website follows all government regulatory guidelines.
Asked why the website promises a consultation for a vaping script in minutes, given health practitioners are required to take a patient history and only prescribe vaping products as a last resort, Alexis said she would; “take that on board”. She confirmed a lengthy consult was required.
“Of course they have a consultation with a doctor, so it’s up to the doctor and the nurse practitioner … who do a full patient history,” Alexis said. “And this is a second line treatment, so isn’t for all patients, they’re not necessarily going to get a script given to them. It is up to the doctor and the nurse practitioner’s discretion.
“They actually do take about 45 minutes for a patient to be assessed as appropriate [to receive a vaping script], and they will go through a plan for that patient.”
Asked if it was unethical to partner with pro-vaping websites promoting particular products, Alexis said there were only 71 approved prescribers in Australia, and that it was important for those who do rely on vaping as a smoking cessation tool to have clear information about where to get a prescription.
“We do not send our scripts to a patient directly”,” Alexis said. “We can only send it [an electronic script] to an approved, compliant organisation or pharmacy, and the pharmacies are very slow in taking this up. That’s the reason that we want to make sure that we send our script to the right companies. We don’t care what company that is, as long as they are compliant, and we are now working with a number of vaping providers.”
The president of the Royal Australian College of General Practitioners, Dr Karen Price, said smoking cessation prescriptions should ideally be issued via a patient’s usual GP.
“GPs know their patients and are well-placed to provide advice on how to quit smoking, including pharmacotherapy and behavioural treatments,” she said.
“A GP may prescribe nicotine replacement therapy in the form of a patch, spray, gum or lozenge as well as drugs such as varenicline, which blocks the pleasure and reward response to smoking, or bupropion hydrochloride, which reduces the urge to smoke.
“GPs may also prescribe nicotine vaping products as a second-line treatment option if all else has failed.”
Price said the problem with telehealth vaping script “pop up” clinics is that they can disrupt continuity of care.
“Instead of seeking out a telehealth clinic to obtain a nicotine vaping product script, I strongly urge patients to instead book a consult their usual GP to discuss smoking cessations options,” she said.
It was important that those seeking a script from Vaping Scripts, or other seemingly on-demand telehealth clinics, be aware that prescriptions for nicotine vaping products were not simply provided on request, Price said.
“Rather, it is a second-line treatment option to be used when other measures, such as nicotine replacement therapy with behavioural support, have failed,” she said. “It is the job of GPs in communities across Australia, including those at telehealth clinics, to apply discretion and judgment when considering the patient’s individual circumstances and whether a prescription for nicotine vaping products is warranted.
“We will always support patients who want to undergo smoking cessation therapy.”
