Peter Kelly
LET’S talk about a pharmacy taboo. Let’s talk about hoarding.
My dad once told me a story about a man in Ireland, who collected and stored jars of coffee and boxes of cigarettes. The man in question vividly remembered the scarcity of the war years and post-war years he experienced as a child.
His two vices in life were coffee and cigarettes, and he believed war could strike at any time. So, he decided every time he bought a jar of coffee or cigarettes, he would buy an additional jar or box for storage. When he died his house was full of unopened coffee jars and cigarette boxes.
Most of us have never experienced years of scarcity in the supply chain of everyday products, but some of the older generation have. When the Greek economy collapsed, there were stories emerging of insulin and other necessary medicines not being available in pharmacies for patients.
The threat of war and society collapse is real and always lurking in the background. Hopefully, none of us experience it in our lifetime but the possibility is always there. Could depression make someone pessimistic enough to believe that the threat of war or society breakdown is imminent? If you believed society was on the verge of collapsing, would you try and stock up on medicines?
Most patients only fill prescriptions for medicines they need now, this week, or this month. But, do some patients fill prescriptions to stock up their house in the belief, deluded or real, that they may somehow be of value to them in a future crisis scenario
The NHS choices website states that 2-5% of UK adults are affected by some sort of hoarding disorder. It goes on to list examples of items people might hoard:
- Newspapers and magazines.
- Books.
- Clothes.
- Leaflets and letters including junk mail.
- Bills and receipts.
- Containers, plastic bags and cardboard boxes.
- Household supplies.
There is no mention of medicines. Although maybe household supplies could include medicines.
Have you ever dispensed a monthly prescription for someone and thought, ‘how do they take all this?’ If so, what course of action did you take?
When I encounter this scenario, I usually do an MUR.
You have to tread carefully, as you cannot be accusatory. I usually open with: “there is a lot of medication here, do you ever have any trouble remembering to take it all?” I then go through each one, checking they know what it is for and when and how to take it. Nobody has ever confessed that they are collecting, hoarding or storing the medication.
So, 2-5% of adults have some sort of hoarding disorder, millions of people get free prescriptions. Are some patients hoarding medication? If yes, is it a significant financial burden on the NHS or a negligible one?
Should the NHS have a dedicated team investigating such matters? Could such matters be investigated in a suitable manner, that is not overly intrusive? Would pharmacy want to help? Pharmacy could lose money, alienate or offend their customers?
Peter Kelly is a community pharmacist based in London