Dr Martin Duerden – online
• When you ask about over-the-counter and herbal remedies (an important point in medication review, particularly in the context of polypharmacy) now add the question: ‘Are you taking anything obtained online?’
• Certain conditions are more likely to result in online medication use. In patients with sexual problems and erectile dysfunction, always consider and ask about online purchase of drugs. Some sites provide medicines that the NHS might not support, or for conditions GPs feel should be managed differently. Drugs for hair loss, obesity, and loss of libido are examples of these. Highlight that, as
the GP, you are best placed to provide evidence-based care and assess safety.
• Emphasise to patients the pitfalls of online prescribing, as well as the importance of past history, the value
of face-to-face consultation and examination, and the importance of record keeping and continuity of care.
• One concern about drugs obtained online is that they may be seen as relatively harmless or used for recreational purposes. Always advise patients not to share medicines with others, however obtained, as this is unsafe.
• The key message for patients is that obtaining medicines online is not like online shopping and may be unsafe if the process is oversimplified. If a patient is sourcing drugs online,
request that they ask the online prescriber to inform the GP (as recommended by the GMC).
Dr Martin Duerden is a retired GP and medical adviser to the Diploma in Therapeutics, Cardiff University
