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The consequences can be very sad
According to the director of the Vilnius City Mental Health Center, the psychiatrist Martynas Marcinkevičius, Lithuanians consume statistically more sedatives than other European countries, so it was decided to take measures to reduce their use, as these drugs are for use only In the short term, they only affect the symptoms and not the diseases cause, in addition, a strong habituation to them.
“Three things have been agreed with SAMe since the problem started. The first concerns the methodology to reduce the use of these drugs, since they cannot be abruptly discontinued to avoid severe withdrawal symptoms. The second is the training of physicians. family on how to treat people addicted to drugs. Finally, the third and most important point is the creation of a mental health subsystem in the e-health system, so that doctors from other specialties do not see psychiatric diagnoses of the patient if they do not need it.
Now the diagnosis can be seen even by the pharmacist who reviews the prescription.
Now the diagnosis can be seen even by the pharmacist who reviews the prescription. Naturally, a person feels insecure, this is especially true in the regions. For example, I am a school principal. After getting injured, I go to a local hospital to get an X-ray. Doctors open my account and see that I’m supposed to be depressed. And in a small town, languages can spread very quickly, ”said the interlocutor.
That is why, according to him, it was very important that the new sedative prescription procedure began together with the e-health subsystem, but the development of the latter is postponed for another two years and the new prescription procedure will take effect. 1st of July.
“What are the consequences? Today, a person who is going through a certain difficult stage of life that has caused them sleep problems and is suffering from anxiety can ask a doctor for a paper prescription that does not require writing any diagnosis. In this case, it does not end in the electronic system and the person receives help for that brief episode in life. As of July 1, the doctor will only be able to issue an electronic prescription, and when writing it, it is always necessary to enter the diagnosis , that is to say, the code of the disease.
All codes for mental disorders begin with the letter F. For example, insomnia or post-traumatic stress disorder. This is not a difficult diagnosis, but who will dig deeper, it will be enough to look at the letter F. And because our electronic health system is currently rampant like a scar, a person will suffer symptoms without medication, or search for illegal drugs in the markets or in other places, or she will be treated with an over-the-counter drug available to everyone, namely alcohol. This will create a problem on equal terms, “said the psychiatrist.
E.Blaževič / Photo by LRT / Head of Psychiatrist at Martynas Marcinkevičius Mental Health Center
You may not even know you have an F code
Colleagues are supported by Ramunė Mazaliauskienė, President of the Lithuanian Psychiatric Association.
“Currently, all patient diagnoses are available to any specialist who opens their electronic health record. Everyone knows the codes of mental disorders, although the person who is prescribed sedatives for insomnia does not even believe that they have received a psychiatric diagnosis. After all, we all know our approach to these diseases. It is true that it is improving, but there is still little tolerance. At least in the past, a person could not get a loan due to disease code F. If they requested it, they had to sign a permit so that the bank could access their medical data.
If a subsystem arose, some specialists would be able to see all the diagnostics, while others would only be able to see it within their competencies. Even the police can only access the data that is relevant to them.
Our colleagues looked at examples from other countries. We proposed a compromise: either limit the amount of medicine in the prescription, for example, prescribe only 30 tablets, or use personal medical stickers. Police and pharmacists say there are fake paper prescriptions. As far as I know, there is also counterfeit money, but no one has canceled its use as a result, ”said the interviewee.
SAM offers the so-called pink recipes as a commitment. These are accounted strictly for drug prescriptions, which are issued in Lithuania only at a pharmacy located in Vilnius and are valid for half a year.
“It just came to our knowledge then. Because it is difficult to remember and record these prescriptions, it is difficult to imagine that all doctors have them. Also, only a certain amount of them is released, so even if all medical institutions plan take 10 of them, there will simply be a shortage of prescriptions. Therefore, the possibility of people receiving a prescription on paper is really private, “said M. Marcinkevičius.
Examples have not been taken from other countries.
Therefore, according to psychiatrists, the introduction of a new sedative prescription procedure without an electronic health subsystem will deprive thousands or even tens of thousands of people of the opportunity for anonymous treatment.
“We like to emulate the EU or other countries in the Western world, but we do not believe that in Great Britain, for example, the patient has to decide for himself if he wants to be included in the electronic system or not. France, which relies heavily on its doctors and citizens, has decided to print special and more protected forms for these drugs in order to avoid the simple malicious falsification of such prescriptions, but it has certainly not offered to prescribe them for drug prescriptions ( as morphine, as provided in Lithuania). Why not use best practices from other countries in this case?
Another example is Swedish, which is even simpler than French, with stickers not counted in the recipe. It is technically simple and is already used in Lithuania, ”said psychiatrist Mindaugas Šablevičius.
Such a system violates perhaps the most important human right, the right to human data protection.
To these problems is added another particular problem: the treatment of alcohol dependence. After all, benzodiazepines are often used in this disease, sometimes for long-term treatments, as substitutes for alcohol. Now these people, who are even more stigmatized than those with mental illness or simply psychological problems, also run the risk of the Registry Center keeping a largely public diagnostic record and may even be cared for by a nurse to register an eHealth vaccination.
And since an insecure eHealth system can be used by malicious people to bill or blackmail a public figure, such a system is likely to open the way for these actions. Furthermore, such a system violates perhaps the most important human right, the right to protection of human data.
Photo from Fotolia / Medication
SAM sees no problems
SAM does not undertake to suspend the entry into force of the new regime. According to the ministry, already now, in 2021. in the first quarter, 77 percent. the most popular benzodiazepines and 91% other psychiatric medications are prescribed by electronic prescription.
“The Ministry of Health is taking comprehensive measures to reduce the stigma of mental and behavioral disorders and the fear of losing a job or certain rights when seeking specialized help for mild mental disorders. The main legal acts that regulate health requirements regarding work restrictions and rights (legal professions (lawyers, judges, notaries, prosecutors), doctors, pharmacists, midwives, dentists, right to drive, adopt or care for a child), prevention of mental disorders right to possess a weapon, it is planned to review the health requirements for public officials.
Mild diagnoses of depression, anxiety, and sleep disorders have been removed (or proportionately relaxed) from the above lists of health requirements. Therefore, the preconditions for a person’s diagnosis of injury (loss of employment or rights) to benzodiazepines due to mild mental disorders (for example, mild depression, anxiety, or insomnia) after a person’s diagnosis are routinely eliminated. ”SAM said in response to a request. of the Association of Psychiatry.
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