As a result of using local remote monitoring and control technology, Pick ‘n Pay has improved the visibility and control of the temperature in its pharmacy fridges, ensuring that temperature-sensitive drugs are safely managed at all times.
Certain drugs, including some vaccines and manufactured insulin, are very temperature sensitive, which is why pharmacy fridges are supposed to keep them within a range of
2–8°C. If the drugs are exposed to temperatures outside of this range for a period of time, their effectiveness cannot be guaranteed.
“The ethical considerations around temperature-sensitive drugs are enormous,” says Ian Lester, CEO of Beyond Wireless, a local specialist wireless machine to machine (M2M) communication solutions provider that has been working with Pick ‘n Pay’s pharmacy operations. “The shelf-life of many medications is entirely dependent on proper temperature control. The importance of accurate cold chain management in the pharmaceutical sector cannot be understated.”
Beyond Wireless has experience in temperature monitoring and control solutions for operators at every level of the cold chain. Lester notes that often, suppliers and distributors manage the cold chain well, only to hand the medication over to retailers that unknowingly break the cold chain in-store.
“The South African Pharmacy Council’s Code of Good Pharmacy Practice requires retail pharmacists to manually check and record the temperature of their fridges twice daily and to have the fridge linked to an alarm system,” says Lester. “Sometimes, however, the manual logging method and traditional security alarm systems fall short of the mark. For example, if a pharmacist relies solely on the manual logging method they might experience a power failure during the night, and when the pharmacist checks the fridge the next morning, the power may have been restored and the temperature would have returned to within the allowed range. They will never know that the drugs were out of range, how far they went out of range and for how long , all of which is crucial in deciding in what to do with the drugs.”
Similarly if a pharmacy uses both the manual logging method and a traditional security alarm system, the alarm system is generally disabled during normal trading hours. This means the pharmacist may check the temperature at 09h00 and again before going home at 18h00, but will have no visibility of what the fridge’s temperature profile was between the two readings. The temperature may have fluctuated radically and no alarm would have been detected.
The most serious and often overlooked problem is fridges in which the temperatures go too low. A fridge that goes below 0°C does more harm to insulin and vaccines than a fridge that goes above 8°C. Going above 8°C reduces the drugs’ shelf life, but going below 0°C can destroy the live cultures of some vaccines and alters the molecular structure of most insulin. In extreme cases, drugs may freeze and thaw repeatedly, which is the worst case scenario in terms of maintaining efficacy.
Strict storage specifications within the industry mean that once insulin, vaccines and other temperature-sensitive drugs have been outside of the allowed temperature range for certain periods of time, they must be disposed of. In fact, the World Health Organization reports over 50% vaccine wastage around the world, part of which is attributed to poor cold chain management.
Thankfully there are now tools available for minimising this wastage. Pick ‘n Pay has made use of the remote monitoring and control technology from Beyond Wireless to improve its in-pharmacy temperature management of medication.
Sue Jarvis, Head of Pick ‘n Pay’s Pharmacy Division, explains that the Beyond Wireless solution addresses a wide range of possible temperature problems, from power outages to current surges, faulty fridges and even a potential lack of responsibility taken by the resident pharmacist.
“The Beyond Wireless solution is an automated web interface that constantly monitors the temperatures both within the pharmacy and the fridges 24/7 and sends alarm signals when temperatures are out of the specified ranges,” she says. “It keeps a history and the parameters given can allow for creation of tables and graphs. This remote monitoring allows for all parties involved to be kept in the loop, so if a particular pharmacist is not heeding the alarms, there can still be an intervention from a second or third party.”
As a result, Pick ‘n Pay’s thermolabile medication (medicine subject to destruction, decomposition, or great change by moderate heating or over-cooling) is now always kept under controlled conditions. “This means that the quality of the medicine can be guaranteed and it ensures the safety of the medicines to our patients,” says Jarvis. “It also prevents large stock write-offs thanks to proper control and adds to our professionalism.”
The Beyond Wireless solution requires minimal training and because the secure web interface can be accessed remotely from any computer, tablet or smart phone with an Internet connection, it is convenient for pharmacists, who are able to see the temperature of their fridges at any time, from anywhere.
The seamless installation, maintenance and web-based access are the features Jarvis cites as most useful to Pick ‘n Pay. The company now boasts full visibility of the temperature in every fridge in each of its pharmacies, with access to both real-time and historical data. Response times to problems that arise have improved drastically, stock write-offs have decreased and Pick ‘n Pay believes it is adding value for its customers by going the extra mile in ensuring its medication is safe and responsibly controlled.
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