In Virginia, docs are at least strongly encouraged if not perhaps mandated to prescribe electronically, and have been for several years. And our pharmacy has an only moderately hideous app that lets us see our 'scripts and request refills.
The UK uses the electronic prescription service (EPS) to transmit prescriptions to your nominated pharmacy.
Other pharmacies can dispense most medications to you. In an urgent situation that doesn’t require A&E (ER) help you can phone 111, and they will contact your GP, even out of normal GP hours, and they will use the same system to send a prescription to a pharmacy that is not your regular pharmacy. Useful if you’re on holiday, or are robbed, or have just run out of your medication unexpectedly when your regular pharmacy is closed (i.e. evenings and weekends).
Not entirely relevant to the thread, but you can buy salbutamol inhalers over the counter, and have been able to since 2012.
And then there’s me, rockin’ it old school. 
I either give patients handwritten paper scripts or call them in to the pharmacy’s answering machine. The electronic prescribing software is too expensive to be workable for a solo practitioner like me. When COVID hit and I started working from home, I didn’t have an incoming fax machine, and I have since decided to elevate that to a matter of principle; why should medicine be the only industry in the country that still clings to that 20th century technology? It’s been a huge timesaver for me, since 90% of the refill requests I used to get were for medicines that had been discontinued or the patient had just switched pharmacies. I figure if it’s important, they’ll call me on the phone, and in the last year-plus that system hasn’t caused any problems.
When I travel to the U.K. from the USA, I bring 3 asthma inhalers with me, one on me, one in hand luggage and one in held luggage. I keep them separate. But, yes, I’d assume getting a similar product in a developed country could be done in an emergency with a little time and effort
I’ve wondered why they aren’t for sale OTC in the US. They seem to be used pretty widely and it’s not like they are a new drug with unknown hazards. You can’t abuse them in any way, can you?
By all accounts I’ve heard or read, there isn’t much that can go wrong with salbutamol (known as albuterol in the US). Yet it is still sold by prescription only.
If you have a bad asthma problem, you might also be prescribed a nebulizer and nebulized albuterol. I did the arithmetic once and found that one albuterol nebule is about equivalent to 20 puffs from an inhaler.
ETA: I always thought the name “albuterol” sounded like something you would put into your cigaret lighter.
My doctor’s office FAXes them to the pharmacy. I know this because I asked them, because several times recently the message clearly hadn’t gotten through, and my medicine wasn’t there even after several days. I had to call to find out what happened, and in each case the doctor’s office said that they had sent out the prescription, and the pharmacy said they hadn’t gotten it.
I don’t know if the pharmacy is overworked or if their FAX machine is broken, or what, but it seems yo me that, although a FAX might create a literal paper trail, it’s clearly not a great system, and it looks surprisingly dated.
Both the doctor and the pharmacist should have fax logs, which are generated automatically by an fax machine bought in the last 40 years, and by all server-based fax systems. And your doctor’s office should check their logs and test the phone number if a pharmacist is claiming non-arrival of a fax.
The system allows you to track, report and repair delivery failures. Somebody hasn’t bothered.
I wasn’t aware of that - thanks.
Of course, for me at least, they re free with a scrip.
Yes, I have done that with Walgreens. But be careful-after I filled a script in Pa. my subsequent prescriptions were filled by default in Pa. rather than in my home state. My pharmacy had to explicitly reset my location back to my home. Other than that, it went smoothly.
In Canada, as I mentioned - several provinces use a tracking system. They can see which patients are prescribed by which doctors, along with tracking what the pharmacies are dispensing. Thus they can see if a doctor is outside the norm in terms of prescribing “interesting” medications. All doctors, patients, and pharmacies have registration numbers. (Patients because they are covered by provincial health plans) In some news stories about problem physicians, it has mentioned that they were reprimanded at times for prescribing too many opiates. This applies not just to fraud, drug dealing and doctor-shopping, but also a way to warn doctors who did not exercise care when dealing with people who were using flimsy reasons for asking for pain-killers. So a patient cannot avoid being flagged by spreading his prescriptions around.
(Reminds me too, of the story where the Health Department approached a doctor in the small town many years after motorcycle helmets were made mandatory. The doc was a biker himself, and the health department, presumably on a complaint by the local police, reminded him that medical exemptions for helmet use were only to be issued in actual medical necessity, not simply because the patient asked. If he didn’t smarten up, they said, he would lose his right to provide medical exemptions and all existing ones would be invalidated. When his friends came in for renewals, he had to tell them “no”. )
I wouldn’t be surprised if that was the case here in some states in the US as well, but it may be something that SureScripts or their competitors send to that state, or it may be something that the pharmacies themselves send. It’s not really involved in the basic procedure of getting providers and pharmacies connected via SureScripts for e-prescribing.
From what I can tell, it’s the prescribing pharmacies that transmit that to whatever state level PDMPs that there are; that gets them the most information from the fewest sources- doctor, prescription, pharmacy, amount actually prescribed, form actually prescribed, etc… A lot of that isn’t necessarily present from the prescription itself- for example, a doctor may prescribe 30 800 mg ibuprofen tablets with instructions for the patient to take one tablet twice daily, but that may get turned into 60 400 mg tablets with instructions to take 2 tablets twice daily, if the pharmacy doesn’t have 800 mg tablets. Or maybe that they prescribed 30 of the prescribed 60 in one visit, with instructions to come back when the others are in stock.
Sending that data from the pharmacy captures that, while the prescription would not.
Anyone know how it works with Veterans Administration? Community physician can prescribe to local pharmacy who can fill 14 days, and the VA provides rest by mail order. I hope this all happens automatically, but suspect it will take phone calls to be approved for each prescription to discourage use of this “benefit.”
My doctor’s office and my pharmacy still communicate by FAX. Badly, often. I’ve frequently had to call both when the doctor’s office swears they have sent the prescription but the pharmacy swears they haven’t received it.
Oregon is similar. My doctor sends the script to my pharmacy (I don’t know if it’s done by fax or some method that’s more up to date), and the pharmacy fills it (if it’s available!). Unless I need to see her for some other reason, I go in about once every 90 days and she sends three separate thirty-day prescriptions to be filled at the appropriate intervals. With this system, the patient doesn’t have to see the doctor every 30 days, but it also prevents disreputable people from buying the entire 90 days’ worth of a controlled substance all at once.
When my mom was dying, the “comfort pack” was misplaced by FedEx, and we urgently wanted that morphine. The hospice nurse recommended a pharmacy that usually carried it, my BIL confirmed he could go there, and the rest happened electronically. The nurse called the hospice doctor, he made the prescription happen, and my BIL went to the pharmacy and waited until they could fill it.
The hospice doctor never saw my mother. He talked to me and to the nurse over the phone, and perhaps consulted with my mother’s pcp. (My mom could no longer talk, and i was her proxy.) We certainly didn’t need a piece of paper.
That was for a few days worth of liquid morphine, perhaps not the easiest opiate to fence. Still, I’m sure it was a controlled substance, and when my mom died, there was paperwork and witnesses attesting to the destruction of the leftovers.
According to my daughter, who manages a doctor’s office, there’s software with a giant database of (nearly) all pharmacies. They look up the pharmacy code number and zap the Rx directly to them. Controlled substances require a two-factor authentication which in her case, goes straight to the doctor’s phone.
My daughter also wishes everyone to know that when the pharmacy says “we haven’t received the prescription yet,” they really mean, “we’re backed up and haven’t gotten to it yet.”