The Kentucky Board of Pharmacy is requiring prescribers to send new prescriptions for every hydroxychloroquine patient. It must have the diagnosis attached, and it can only be dispensed for a 30-day supply. It’s meant to keep patients from hoarding, but it also means a lot more work to send over 1,000 new prescriptions this month.
Many patients call seeking advice for dealing with their increased infection risk. The changing landscape of the pandemic is making us re-evaluate our recommendations. Right now, we aim to keep patients’ disease under control and opt to continue most regimens unless symptoms of COVID-19 surface. Next week, we may be telling them something else. We have reiterated to patients that they have an increased infection risk, so they won’t keep taking their immune-modulating regimens during bacterial infections. [By doing so,] we have unintentionally created an increased fear of this pandemic. It does give us a chance to educate patients on how scientists believe the COVID-19 viral infection progresses and why and how they need to be concerned.
Another problem is getting lab results when we cancel live appointments and reschedule them for a later date or conduct them through telemedicine. Patients either can’t find a lab open near their home, or they’re justifiably afraid to have labs drawn. Because many conventional treatments for rheumatic diseases, a few biologics and all JAK inhibitors can cause serious systemic side effects, we are pondering how to safely prescribe and manage these medications blindly.
Q: How is the current crisis affecting you or your family? Can you share any coping tips?
My husband and I are both working from home. He’s always had some flexibility because he’s an outside sales representative, but it’s new to me. I’m busier at home than I was on most days in the clinic. There are more patient problems, more provider collaborations and new processes to create. I miss people and hands-on education. I enjoy my new commute and comfy work wardrobe, but I’m fearful for my patients and co-workers. I stress when I think about this going on for months and months.
In the evenings, our family watches new movies and TV series to unwind and take our mind off the pandemic. We’re cooking more together and sitting outside to enjoy the fresh air.
Susan Bernstein is a freelance journalist based in Atlanta.
