We can click and collect our groceries, have dinner delivered to our door, and access a world of knowledge through the phones in our hands...convenience is at the heart of modern life - so why not prescriptions?

Direct-to-consumer prescription services are on the rise in Australia, but questions remain about whether these services are a help or a hindrance to both consumers and medical professionals.

Associate Professor Chris Freeman from UQ’s School of Pharmacy and Pharmaceutical Sciences led a study investigating the benefits and risks of using direct-to-consumer electronic prescription services.

How do online prescriptions work?

In 2020, electronic prescriptions were rolled out nationally to support the telehealth service, allowing consumers to access prescriptions virtually.

Since then, 80,000 prescribers have issued over 189 million electronic prescriptions indicating a high uptake of the service.

People in Australia can access electronic scripts through two main pathways; via consultation with their regular prescriber who is usually their GP, or by a direct-to-consumer electronic prescription service (DTC EPS).

Through the DTC EPS process, consumers complete a brief medical questionnaire and submit an online prescription request. This is then reviewed by a prescriber and if accepted, an electronic prescription is issued.

Recruiting participants from community Facebook groups from both metro and regional Queensland, Associate Professor Freeman’s research explored the perceptions of how this model of care supports consumers and if it delivers the best care.

“The study involved three focus groups that discussed online prescription services and if they had used them before,” Associate Professor Freeman said.

“Discussions focused on their experiences with or perceptions of DTC EPS, the perceived advantages and disadvantages of the service and their understanding of how this could impact continuity of care in relation to normal GP medical care.”

What are the benefits of online prescription services?

Convenience was the main benefit that stood out for the participants.

Associate Professor Freeman said the participants could clearly see the value in online prescription services for people who are time poor.

“Some people highlighted the difficulty of scheduling a traditional appointment, referring to the lack of availability for last-minute appointments with the increase in demands on the healthcare system,” Associate Professor Freeman explains.

“Booking an in-person appointment often means taking time off work or losing half of your day between wait times and travel, and that is not feasible for everyone.

“For people who have long-term or stable medications, using an online prescription service can be extremely convenient.

“It could also be an effective service for people living in rural and remote areas, who have fewer options or more limited access to healthcare.

“Everyone should have equitable access to healthcare, and online prescription services are one way to help improve this.”

‘… if [the medication] is something that you take regularly, and you know that you don’t have any side effects to it, or you are happy with that medicine, then I think it's a great way to access your repeat prescription because it makes it an easier way to get a hold of them… especially if you can’t get in [to see your GP] and you have to see somebody different’. (Focus group 2)

What are the limitations of online prescription services?

While access and convenience were highlighted as great benefits of digital prescription services, participants also noted these could be potential red flags.

Associate Professor Freeman said misuse of the service, an assumed level of health literacy and lack of communication with GPs were identified as potential risks.

“With DTC EPS services, the consumer is expected to have a certain level of health literacy to complete the application process and this places a lot of responsibility on the consumer,” Associate Professor Freeman said.

“This can be a barrier for cohorts who don’t know what medications they are on or why, as they could potentially answer questions incorrectly when submitting a request.

“Participants also highlighted concerns around misuse of the service and urged for a process which includes the GPs in the conversation.

“This could include automated notifications sent to GPs to ensure they have an accurate medical record for consumers, or required check in periods to ensure people have opportunities to discuss any potential side effects or changes needed in the medications they are taking.”

‘I think that [DTC EPS] assume  a high level of health literacy and understanding, and a lot of older people may not even know what they’re on and why they’re on it. So, like, giving people this and just trusting them to answer things properly, I don’t think that's necessarily safe…’ (Focus group 1)

‘Without that same follow-up from a GP, for example, and having that communication as to what side effects they’re having or that it may not work right away so it's a bit of, like, a breakup in the continuity of care for the patient – like, there's no line [i.e. process] for someone to go down if they use this service’. (Focus group 3)

What’s the bottom line?

Overall, the study found people believed that DTC EPS was a valuable addition to the Australian healthcare landscape increasing convenient and timely access to medicines for consumers.

However, more work is needed to develop system processes to ensure that consumers can safely and confidently access medication.

The full research paper is published in Digital Health.