Terry Maguire ponders what may become a permanent fixture — virtual CPD meetings for pharmacists

News that RoI’s medicines regulator has granted an OTC licence for Viagra Connect was music to my ears. Normally, when I have been directly involved with a UK OTC switch, it is highly likely that when it then launches in RoI, the company seeks my services in their push to educate and inform pharmacists when it is due to hit pharmacy shelves.

And so it happened with Viagra Connect, but this time it was different; a webinar from my front room on a Monday evening, which made me somewhat deflated. Covid put paid to those leisurely and sumptuous educational evenings in five-star hotels, a meal before, a lively, friendly educational talk with peers, a few drinks at the bar after, and then off to bed.

With the OTC launch of a product some years ago, I toured Ireland with a product manager and a professor of behavioural science. We spoke on a number of consecutive evenings and the daily format was soothingly the same; breakfast at the venue we had spoken in the evening before, transport to the next venue (train or taxi), arrival early afternoon, a nap, early dinner, educational talk from 7.30-9.00, a few drinks at the bar before falling into a very comfortable five-star bed and then waking late to do it all over again.

When I started to speak, there were, according to the webinar dashboard, 150 in the virtual audience, many perhaps sitting at home in their pyjamas and sipping chardonnay

It was most agreeable. The professor was a commensurate academic and he admirably covered his topic in a highly commanding manner. Despite his considerable lecturing skills, he was taciturn and indifferent during our travels and group meals and by day three, his relationship with the marketing manager was in terminal decline. On day four, it came to a head. Over a night-cap, I was told that the pharma company had agreed to send the Prof by taxi to stay overnight with a friend in another county.

What I didn’t know was that in his spare time, this professor was an amateur escapologist and the visit was to a friend with a similar passion. The friend, the product manager informed me, had invented a coffin into which the professor intended to be incarcerated and given 24 hours to emerge from, which, by my calculation, was roughly the time we should be speaking to the good pharmacists in the next county we visited.

Should he achieve this feat, he would receive a coveted award from the escapology fraternity; should he fail, I would be embarrassing myself by trying to deliver a lecture on a topic I knew precious little about. And so it happened. On that Friday evening, the product manager and I stood on the stage at the venue as the audience streamed in to take their seats, unable to make phone contact.

I did surprisingly well in giving his lecture. I suppose having been in the audience for the previous nights, some osmosis had occurred and of course I had his impressive slides. I did avoid his corny jokes, as they required his unique method of delivery.

The Viagra Connect Covid educational experience this November was very different indeed. I signed in at 7.05pm. Following some chit-chat with my co-presenter and the technician, both at considerable geographical distance, the technician noticed an audio problem on my end. Then the sound went down with 15 minutes to go and there was a desperate scramble to get a solution, known as a ‘wrap-around’, essentially connecting my iPhone though the technician’s computer microphone.

When I started to speak, there were, according to the webinar dashboard, 150 in the virtual audience, many perhaps sitting at home in their pyjamas and sipping chardonnay. I sat at my dining table and looked at my computer screen, on which I could view my PowerPoint presentation and I just spoke to the slides.

It was a strange, lonely and worrying experience. I thought halfway through that perhaps it had all gone pear-shaped again and I was speaking to no-one as I had been cut off, but I quickly dismissed that possibility as I more than likely had 150 pharmacists and pharmacy support staff looking and listening. I got through the WWHAM for supply of Viagra Comment:

‘Who is it for?’ Men (and men only) aged over 18. ‘What for?’ For failure to achieve and sustain an erection for satisfactory sex, self-diagnosed. ‘How long?’ The longer the greater, the need to see GP, as erectile dysfunction (ED) is a strong predictor of CHD. ‘Action taken?’ ‘What have they done and how did it work?’ Sixty-six per cent of men with ED do nothing and ignore the issue. ‘Medicines?’ Some drug-drug interactions; CYP3AD inhibitors, so grapefruit juice is out and so is concomitant use with erythromycin, itraconazole.

I was mainly there to reassure pharmacists that supply of Viagra Connect OTC may be a new category and may seem daunting, but they should be relaxed and use the company support; a helpful check-list which is optional to support the intervention and great in-store advertising. We have been doing this up North for nearly three years and once you master the consultation, it’s easy.

At the end of my 30-minute slot, I handed back to my co-presenter, who thankfully was still there, and we discussed a number of selected questions submitted online during the talks. Mostly, these were sensible; you can supply Viagra Connect to someone with high blood pressure, as you can to someone who has suffered a heart attack last year.

There was, perhaps spurred on by the anonymity of the virtual space, the classroom clown who wanted to know if you needed to be married to get a supply. I was relieved; we delivered, and our audience seemed to appreciate it.

This, I feel, will be the future of continuing pharmacy education, even after Covid is vaccinated into obscurity. Certainly, a webinar is convenient for all and I suppose for the company involved, it is less expensive, but I regret the lack of human contact, the chats after the talks that bring so much more to the educational experience and of course, the possibility to escape (or not) from a modified coffin.

And no, I never discovered if he got out or had to be let out.

Terry Maguire
Terry Maguire

Terry Maguire owns two pharmacies in Belfast. He is an honorary senior lecturer at the School of Pharmacy, Queen’s University of Belfast. His research interests include the contribution of community pharmacy to improving public health