To be annoyed at this pharmacist

[Sandsnake]

I'm pretty new here so sorry if this has been done before!

I went into Boots today to buy some aspirin. I am taking an aspirin a day on the advice of my consultant due to a placental problem and am 33 weeks pregnant. The cashier asked me if they were for myself and when I confirmed they were said that he would just have to check with the pharmacist. I said this was fine and added that he should tell her that I was taking them under advice from my consultant.

He came back and said the pharmacist wouldn't sell them to me as aspirin is not recommended during pregnancy. I argued that they were actually vital for my pregnancy as ordered by the consultant - he said the pharmacist said I would need to bring in a note from the doctor to prove this. Apparently this was 'policy', which I pointed out wasn't true as I had bought aspirin from other Boots branches without issue.

I argued quite a lot and in the end left as I had to get my train to work. I was so angry. I was annoyed at the inference that I could not be trusted with my own health - and that I somehow needed to 'prove' what my doctor had told me. I'm still pretty cross about it now tbh as I think the refusal to sell it to me is indicative of the way that some people feel they have the right to infantilise pregnant women. I can't imagine any other group of competent adults being treated this way.

Do you think AIBU?

Spot on Mary - pharmacists are professionals bound by pesky rules and regulations - generally to protect people

If you want something that is generally not sold to people with your codition get a prescription! I find it hard to understand a consultant telling you you must take a certain medication but not prescribing it to be honest
I remember being on boards for multiple mc (I had 5) where women where self diagnosing left right and centre and insisting aspirin was a miricle drug

smellyoulateralligator the medicine you linked to is actually prescription-only (note the "POM" next to the legal category subheading near the bottom).

The licensing restrictions on the sale of OTC aspirin are pretty strict, and, as PPs have said, a sensible course of action would have been for the OP to take a note from her consultant to the pharmacy if she wanted to buy the tablets. Without this, the pharmacist would have been completely liable for anything going wrong if it had done as s/he would have breached the product license. With the letter, the liability would have been shared, but the pharmacist would have been better equipped to make a professional judgement on whether the medicine was appropriate.

An even more sensible approach would have been to have them prescribed.
Whoever said that the pharmacy would be paid £7 for dispensing a prescription for the aspirin is wrong and may be confusing it with the current £8.20 prescription fee that currently applies to non-exempt patients in England. The dispensing fee is actually 90p per item (again, in England) plus the cost of the drug (in this case, pennies).

Pharmacists are the most visited and most accessible health professionals in the UK. There is nobody else the public can see without an appointment pretty much all hours of the day. They are highly trained, but are bound by many many laws, standards set by the regulator and a professional code of ethics. They do not make snap decisions, but are constantly weighing up complex information on an individualised basis, frequently attending to several people at a time while overseeing a busy retail business and being not very well paid. They do a good job and don't get the recognition they deserve.

I am a pharmacist and I am going to try and clear up this issue.

Aspirin IS used in pregnancy for women at risk of pre-eclampsia as per the NICE guidelines at a dose of 75mg per day.

HOWEVER over the counter baby aspirin is only licensed for the prevention of cardiovascular events in patients deemed to be at risk. That means if the pharmacist sells it for any other use they are breaking the law. Therefore is MUST be given on prescription only.

All women who are pregnant are entitled to free prescriptions and as the pharmacy is paid for the they supply, you are only costing the NHS a few pence as aspirin are dirt cheap to acquire.

It's not enough to say "my consultant said it was fine" have you any idea the number of people who consult "doctor Google" and diagnose then treat themselves completely inappropriately?!

I was prescribed aspirin during my pregnancy and I obtained it via prescription because I didn't want to leave my colleagues open to scrutiny if something went wrong and they had sold it to me.

The law is an ass as they say, it's incredibly frustrating. For instance we can't sell thrush treatment for pregnant women either. The people who say "can't I just have it anyway" are generally the ones who will then jump on the litigation bandwagon and say "but you shouldn't have sold it to me" if something then goes wrong.

Aspirin IS used in pregnancy for women at risk of pre-eclampsia as per the NICE guidelines at a dose of 75mg per day.

I agree but it is still an unlicensed use whether or not it is on prescription. Informed consent should be obtained and documented before using it.

Mary where did I say that informed consent shouldn't be sought and documented?!

That's a conversation for the prescriber to have with the patient. It's not a conversation for the pharmacist to have with the patient.

"There is nobody else the public can see without an appointment pretty much all hours of the day."

A doctor? There were doctors in A&E in the night last time I checked!

Mary where did I say that informed consent shouldn't be sought and documented?!

You didn't but I think you gave the impression that aspiring is licensed for use in pre-eclampsia if it is on prescription vs. OTC which is not the case.

That's a conversation for the prescriber to have with the patient. It's not a conversation for the pharmacist to have with the patient.

I didn't suggest otherwise.

aspiring aspirin

Yabu op.
Why would the pharamacist just take your word for it that the consultant has told you to take it?
They not infantilising you.
I wouldn't risk my job either!
Just get the prescription filled.
I have to take 8 paracetamols a day, this is the reason i have to get them on prescription.
2 boxes wouldn't last me long, but i wouldn't expect someone to bend the rules for me.
This is why if i need things from the pharamacy i always say i have nothing wrong with me

And lets not forget doctors are not always right.
My doc yest prescribed me a med that I discovered since reading a bit more about the side effects this morning should NOT be used in pregnancy. If a pharmacist had told me this and refused to dispense it I wouldnt be worried sick now this medicine could have affected the baby.

And in Boots on Sunday this rotund gobshite was shouting at the top of his voice for asking if he had taken this medication before and if he realised the risks and contraindications. Gobshite started mouthing off 'well ive had this from my doctor. I dont appreciate you patronising me' and he was looking around as if he wanted people to join in bashing this poor pharmacist doing his job. Im afraid i'd have been tempted to say here you fucking go then twat, die if you want.

"some pharmacist are sometimes unnecessarily cautious ... I believe it stems from a lack of knowledge and professional confidence in many cases."

Agreed - there's case to be made for not selling aspirin OTC (I similarly had to get a prescription for OTC Zantac when preg) but I once had a pharmacist in Boots refuse to sell me (regular, not decongestant) Lemsip when I was visibly pregnant. I pointed out that it only contained paracetamol and vitamin C, neither of which were contraindicated in pregnancy, no other active ingredients on the packet, and she still wouldn't budge.

Also don't get my started on pharmacists (and indeed doctors) who think that the restrictions on medication for breastfeeding are exactly the same as in pregnancy and refuse to sell breastfeeding mothers, eg, ibuprofen for mastitis pain.

In addition to other responses on how overdoses have fallen since the introduction of the legislation limiting purchases, and that it is often an impulsive act, I want to add:

what the oh-fuck-rucksack do you think depression means?

At its worst, it can leave the sufferer feeling unable to get up out of bed. Having a shower, never mind walking to the corner shop, seems like an insurmountable challenge. People feeling so bad they want to kill themselves just don't trot round ten supermarkets in a 5 mile radius. They try to buy paracetamol in one supermarket, get turned away, and give up on that plan.

I appreciate it seems easy to say, 'I'd just visit as many shops as possible' but that's because you are not suicidally depressed.

DinoSnores of course doctors are in A&E departments, but you can't just walk up to them and ask what you want. You have to go in, see the boking clerk, wait a bit, then see a healthcare assistant, wait a bit more, then see a triage nurse, wait a bit more and then see a doctor. In a pharmacy, it's as simple as saying "is the pharmacist in?" and they s/he will see you pretty much straightaway. And that's if they weren't the first person you saw anyway.

Pharmacists are health professionals on the high street. No appointment needed and no time constraints set. Increasingly they are back filling GPs by doing health checks, disease monitoring, vaccinations, common conditions consultations etc. And as others have said, they also pick up on a lot of the mistakes that doctors make when prescribing, something that will only go up as they get access to medical records.

Pharmacists know a hell of a lot! They don't just dispense drugs
And you can read a lot about drugs on the net that shouldn't be used in pregnancy/ breastfeeding etc ( because trials won't be done because of ethical reasons) but doctors will know whether or not it will be dangerous for you too take.
If i read up on the net about all the medication i'm on i most likely wouldnt be able to take half of it.

I trust my pharmacist a helluva lot more than my GP. I take 15 different medications and my pharmacist frequently refuse certain prescriptions, phone my surgery and ask for them to use a different medication due to interactions. I'm not sure why people don't use their pharmacy more for general advice.

"And you can read a lot about drugs on the net that shouldn't be used in pregnancy/ breastfeeding etc ( because trials won't be done because of ethical reasons) but doctors will know whether or not it will be dangerous for you too take."

Sadly, often they won't. I speak as someone who was told to wean DS1 to take a particular medication by an idiot locum, fortunately got a second opinion from someone who had done something other than read the package insert and told me it was perfectly safe to take when breastfeeding.

Obviously not all pharmacists and doctors are like this at all, but after that particular incident I'm a lot less inclined to just blindly believe that "they know best".

I think you had two issues here. One is that the pharmacist wasn't aware of the use of aspirin in pregnancy, but also it's not a POM product, so you could have easily just left the store on good terms, popped round to Superdrug or Tesco and bought it off the shelf.
On the other hand, either your GP or your consultant was in the wrong because surely in all their years on the job they have come across problems like yours and ought to know that a prescription is required as pharmacists are only doing their job. And- showing my ignorance- I didn't know that a woman who was pregnant could not purchase aspirin. It's not a controlled drug or sold in a controlled way.

There's always going to be good and bad people in jobs yes your locum sounds shit, but most gps are not like that.
I never even read the inserts now.
Most of them say i shouldn't be on what i'm on, however i do trust my gp when she tells me about the risks, the overall risk they put on the inserts etc
10 years i'm still here
Mind you my gp is very good. If she isn't 100% sure she'll say it and send me too a specialist.
I've only just felt better since i've seen her regulary.

yanbu
I had a my first and only so far hissy fit at the chemist when trying to pick up medicines for dh who had swine flu. I was visibly pregnant.
took lots of arguing until finally they allowed me to buy a pack of paracetamol, ibuprofen and throad sweets.

I had an issue with a pharmacist once who didn't want to dispense my (prescribed) ibuprofen and ventolin inhaler together. Apparently everyone's asthma is set off by NSAIDs.

I went to a different pharmacy

Everstrong, I've had to take baby aspirin for several rounds of IVF and then until week 12 of the pregnancy, and have never been asked for a prescription in the UK. DH and I went to Dublin for a weekend and I forgot the tablets, and they wouldn't sell me a pack without a prescription though, nor would they sell me a normal pack to allow me to take a quarter of a tablet.

I've also had a pharmacist refuse to sell me OTC ferrus sulphate because I hadn't had a blood test in the last year. Her reasoning was that I might overdose on it. I asked her what the harmful dose of iron was, and she didn't know. When I googled it later, I would have had to take 2 packs to reach a harmful dose...

Op I had the exact same problem in boots last week with aspirin. I was cross too so I think yanbu!
I went straight next door and brought some off the shelf in Tesco.

I am a pharmacist but don't work for Boots. Legally the pharmacist takes all responsibility for the sale of any over the counter medicines. So if there was a problem related to the medicine, you could sue the pharmacist for negligence. If you choose to go into a pharmacy and withhold vital information (eg by saying that they are for someone else), that is your choice but you need to accept the consequences.

Unfortunately consumer 'choice' has been eroded by those who want to sue everyone (eg McDonald's for not stating that their coffee is hot) therefore blanket rules are put in place for everything nowadays. Not to mention the Which? report that comes out every few years where reporters go into pharmacies and take great glee in reporting anyone who makes sales such as this.

The General Pharmaceutical Council (the profession's regulator) takes a very tough line and tends to strike people off who breach the law.

Um point of order here.

The McDonald Hot Coffee, durr case did not centre around mere hot coffee. It was coffee hotter than it should ever be: coffee that was so hot it caused third degree burns and meant the customer had to have skin grafts. In the US, where they ain't got no NHS.

McDonalds had already had complaints about the heat of the coffee but had declined to act on it, which was taken into account in the award.

I'd sue for that, and the NHS would do that surgery and all the painful treatment for free.