A pharmacy delivery service allows medication dispensed in a community pharmacy to be directly delivered to the patient, their carer, or another authorised person. Pharmacists and pharmacy owners must not interpret this as a postal delivery service — medications should never be left in any location for later collection by the patient.

Before providing a home delivery service to a patient, pharmacists must assess the risks and benefits of the service based on the individual patient’s care needs. Although in-person collection is generally preferred, certain circumstances may necessitate delivery. Engaging and listening to patients helps the pharmacist conduct the risk-benefit assessment and ensures shared decision-making. Patients must sign a consent form authorising the pharmacist to provide the delivery service. Pharmacists considering implementing a home delivery service for medicines must ensure that policies, procedures and training are in place before offering this service. At a minimum, all the policies and standard operating procedures (SOPs) outlined below (including the following sections) should be in place:

• Patient consent documentation;
• Delivery process;
  • Proper storage and security of medications during transit;
  • Verifying patient identify and proper handover of medications;
  • Managing of delivery failures or delays; and
  • Record-keeping for all deliveries;
• Recording all delivery errors in an error log;
• Delivery driver guidance/training;
• Confidentiality agreement between pharmacist and delivery driver; and
• Audit and risk assessment.

For pharmacies that are already providing deliveries, it is essential to regularly audit the service to ensure compliance with regulations, patient safety and service efficiency.

Pre-delivery protocols

Before supplying medications via delivery, pharmacists must:

• Evaluate whether direct face-to-face contact is necessary on every occasion that supply is made via delivery system;
• Obtain consent from the patient to provide the service, and this consent should be noted in the patient’s medication record;

• Contact patient or their carer to advise on the safest way to take medication, side effects, storage, disposal and to answer any questions they may have; and
• Inform patients about whom to contact if they have any questions regarding their medicines.

Method of delivery

Pharmacists must ensure that the delivery system used is suitable for the type of medicine being delivered. The delivery system must adhere to the following standards:

• Medications must be securely transported in sealed, tamper-evident containers which have been clearly labelled with the patient’s name, address and phone number;
• Deliveries should be timely to ensure patients receive their medications when needed;
• Deliveries containing medicines that require refrigeration should be identified to the delivery driver and prioritised for delivery in validated storage containers that maintain the cold chain (2°C – 8°C) and the integrity of the medications; and
• The delivery process must include a verifiable audit trail, tracking the medication from the moment it leaves the pharmacy to when it is received and signed by the patient.

“For pharmacies that are already providing deliveries, it is essential to regularly audit the service to ensure compliance with regulations, patient safety and service efficiency.”

Complications during delivery

In the event of complications during the delivery process, such as adverse weather conditions or vehicle breakdowns, pharmacies and delivery personnel must adhere to the pharmacy protocols and should:

• Inform patients promptly about any delays or issues affecting their delivery;
• Implement contingency plans, such as rerouting deliveries or offering in-store pickups, to ensure patients have timely access to medications;
• Leave a note for patients who were not home during delivery attempt, to inform them of the missed delivery and provide instructions for rescheduling or arranging an alternative method to receive their medication; and
• If the patient is unable to receive their medication, for example, due to a medical appointment, an authorised individual at an alternative address may accept the delivery on their behalf:
  • Patient consent must be obtained, and pharmacies should document this to ensure safe delivery.

Record keeping

Pharmacies must maintain accurate records for each delivery, including:

• Prescription details;
• Consent forms;
• Confidentiality agreements; and
• Delivery logs with delivery times and name, address and recipient signature.

Conclusion

It is essential that all the above factors are considered and implemented when using a delivery system to get medications to patients in a safe and timely manner. Patients are entitled to the same quality of care whether they are collecting their medications face-to-face from the pharmacist in a pharmacy or if they are receiving their medications via a delivery system.

Additional information regarding delivery of medicines from a retail pharmacy business is available on the PSI website, psi.ie.

References available on request.