Is this pharmacy dispensing prescription drugs?

mnalis commented 1 year ago

General

Affected tag(s) to be modified/added: dispensing=yes/no Question asked: Is this pharmacy dispensing prescription drugs?

Checklist

Checklist for quest suggestions (see guidelines):

[x] 🚧 To be added tag is established and has a useful purpose. Yes, over 140k uses, and it is useful to know where you can get your prescription drugs.
[x] 🤔 Any answer the user can give must have an equivalent tagging (Quest should not reappear to other users when solved by one)
[x] 🐿️ Easily answerable by any pedestrian from the outside but a survey is necessary. Yes. At least in Croatia, pharmacies that are authorized to sell prescription drugs announce that on the outside doors (along with opening hours etc.)
[x] 💤 Not an overwhelming percentage of quests have the same answer (No spam). According to taginfo , about 6% are no, but in reality many that should be no do not have this tag at all. Judging by personal experience, I'd say about 30% are no in Croatia .
[x] 🕓 Applies to a reasonable number of map data (Worth the effort). Yes, over 360k amenity=pharmacy

Ideas for implementation

Element selection: amenity=pharmacy or healthcare=pharmacy without dispensing=*.

Metadata needed: Taginfo map shows pretty wide distribution of the key, so I'd guess wordwide would be fine.

Proposed UI: simple yes/no quest.

Should be a good and simple choice for new wannabe-quest writers wanting to try writing a new quest. It's easy and straightforward, and can be done by copy/pasting from similar quests even if you don't know Kotlin (and even if don't program at all).

(Otherwise, if nobody else wants to try it, I can write it.)

matkoniecz commented 1 year ago

In which countries this distinction exists? AFAIK it does not in Poland.

westnordost commented 1 year ago

I don't understand the wiki description. Dispensing prescription drugs? Like, automatically? Or is it about that they offer prescription drugs at all? If the latter, what pharmacy does not offer prescription drugs? (Isn't that the very definition of pharmacy?) Would that not rather be a shop=chemist then?

HolgerJeromin commented 1 year ago

ref https://wiki.openstreetmap.org/wiki/Talk:Key:dispensing for more people (for example a well known Mateusz) confused by this tag.

rhhsm commented 1 year ago

I guess the number of countries where the distinction between dispensing and non-dispensing pharmacies exist and where this can be surveyed from the outside is very limited (I had also never heard of it). So far only Croatia? It should not be asked in Germany, the Netherlands, Denmark, Bulgaria, ...

Cj-Malone commented 1 year ago

I seem to think this has come up on talk GB before, IIRC, if it dispenses it's a pharmacy, if it doesn't it's a pharmacy. This tag doesn't matter.

mnalis commented 1 year ago

In which countries this distinction exists? AFAIK it does not in Poland.

Well, taginfo for dispensing=no does seem to show it all around Europe :shrug: perhaps people can take a look into their own countries and make a sense of where/why it is mapped as such if it was not possible/intended?

Or is it about that they offer prescription drugs at all? If the latter, what pharmacy does not offer prescription drugs? (Isn't that the very definition of pharmacy?) Would that not rather be a shop=chemist then?

Yes, it's about selling them at all (not about vending machines). I dunno, for me shop=chemist would be things like dm-DrogerieMarkt, herbal medicine shops etc. If the naming "Apoteka" and offering between two pharmacies is 95% the same, I would not mark one as shop=chemist and another as amenity=pharmacy (maybe I should? Those wiki definitions seem to keep changing every time I look at them...)

To clarify, the difference in Croatia is:

while any pharmacy will sell you popular stuff like cold remedies or painkillers based on ibuprofen and the like without any prescription (so say 95+% of the stuff they sell?), only those pharmacies with contracts with national health ministry are allowed to sell certain groups of drugs (say, heavy-opioid-based or other addictive/dangerous drugs), and then only on government-approved prescription (i.e. dispensing=yes) after you identify yourself.
those that are dispensing=yes (i.e. only ones that will sell you any and all stuff on digitally signed / approved prescription) also give the customer heavy discounts or even free on those prescriptions (e.g. 50-100% off; the rest of the bill being payed transparently by the health ministry, which is digitally connected to such pharmacies, in order to allow digitally issued prescriptions and handle that price reductions. That also happens to mean that you can't get your prescription if the system is down :smiling_face_with_tear: - luckily happens very rarely though)

Helium314 commented 1 year ago

Well, taginfo for dispensing=no does seem to show it all around Europe

Interestingly, in some random checks it looks like that dispensing=no was mostly added a long time ago (most recent I found in ca 30-40 pharmacies: 5 years ago), while dispensing=yes was also tagged much more recently.

matkoniecz commented 1 year ago

heavy-opioid-based or other addictive/dangerous drugs

OK, these are not appearing in all pharmacies - but I they appear independently from each other and any pharmacy can order them, but only some deal with extra paperwork and special procedures which can be is annoying (I confirmed it by asking pharmacist).

It also mismatches "whether a pharmacy dispenses prescription drugs or not" wiki definition, this kind of drugs are subset of prescription drugs

I added results of that research to https://wiki.openstreetmap.org/wiki/Key:dispensing

Well, taginfo for dispensing=no does seem to show it all around Europe

I raised some questions to people using it in Poland: https://wiki.openstreetmap.org/wiki/User:Mateusz_Konieczny/dispensing

mnalis commented 1 year ago

heavy-opioid-based or other addictive/dangerous drugs

OK, these are not appearing in all pharmacies - but I they appear independently from each other and any pharmacy can order them, but only some deal with extra paperwork and legality is annoying (I confirmed it by asking pharmacist).

The list might also include things like antibiotics (it does here, AFAIK). But yes, the point of dispensing=yes as I see it is about what pharmacy is allowed (i.e. paperwork) to sell (or give out for free, as in some cases here; i.e. "dispense") all that is prescribed by authorized medical personnel.

It also mismatches "whether a pharmacy dispenses prescription drugs or not" wiki definition, this kind of drugs are subset of prescription drugs

Perhaps "whether a pharmacy can dispense any/all prescription drugs or not" would be clearer? :man_shrugging:

https://en.wikipedia.org/wiki/Over-the-counter_drug#United_Kingdom for example have some useful explanations (open the link for more details, I'm trying to extract only most important bits here):

"Prescription Only Medication (POM), which are legally available only with a valid prescription from a prescriber"

This would be IMHO available only in amenity=pharmacy + dispensing=yes

"General Sales List (GSL), available off the shelf with no pharmacy training required to sell (so they can be sold anywhere, such as supermarkets)"

this would be available in any shop=chemist (as well as any amenity=pharmacy of course)

"Pharmacy Medicines (P) are medicines that are legally neither a POM or GSL medication. These can be sold from a registered pharmacy but should not be available for self-selection (although directions to discuss a 'P' product may be allocated shelf space with associated GSL items). 'P' medications are reserved from the GSL list as they are either associated with a need for advice on use, or used in conditions which may require referral to a medical prescriber. Suitable trained counter assistants may sell a 'P' medication under the supervision of a pharmacist and will ask questions to determine if the customer needs to be referred for a discussion with a pharmacist"

this would be available only in amenity=pharmacy (even dispensing=no ones). Because, you still cannot buy that in regular shop=chemist, supermarket or whatever, but only in pharmacies.

westnordost commented 1 year ago

In any case:

This needs a list of countries in which 1. "non-dispensing" pharmacies exist and 2. it is signed clearly from the outside, best with a photo of evidence. One country is enough for this quest to be accepted (label: new quest), however the more countries there are, the more it makes sense to invest time implement it.

mnalis commented 1 year ago

This needs a list of countries in which 1. "non-dispensing" pharmacies exist and 2. it is signed clearly from the outside, best with a photo of evidence

Here (circled in red by myself) is picture for Croatia (HR) ("HZZO" is "Hrvatski Zavod za Zdravstveno Osiguranje", and whole phrase means "contractual partner of Croatian Ministry of Health" that is to be shown on dispensing=yes pharmacies, and must not be shown for non-dispensing ones; with meanings as I've described before). hzzo_small

One country is enough for this quest to be accepted (label: new quest), however the more countries there are, the more it makes sense to invest time implement it.

Wiki pages I've read: https://en.wikipedia.org/wiki/Over-the-counter_drug https://en.wikipedia.org/wiki/Prescription_drug

seem to indicate similar distinction should exist at least in Netherlands, Canada, UK, some states of USA, and Australia (and I guess at least few ex-Yugoslavian countries beside Croatia). Unfortunately, I do not know about signing practices in other countries at all, so if there are any users informed about the subject from those (or other!) countries that would like to provide pictures or explanations for dispensing=* use there, it would be great.

One country is enough for this quest to be accepted (label: new quest), however the more countries there are, the more it makes sense to invest time implement it.

I have no problem with investing time myself to write SC quest (and would probably do it for my & EE fork anyway), so that at least should not be a blocker. (of course, if someone new wants to try their hands at simple yes/no quest instead, just say so and I can help guide you).

matkoniecz commented 1 year ago

Here (circled in red by myself) is picture for Croatia (HR) ("HZZO" is "Hrvatski Zavod za Zdravstveno Osiguranje", and whole phrase means "contractual partner of Croatian Ministry of Health" that is to be shown on dispensing=yes pharmacies, and must not be shown for non-dispensing ones; with meanings as I've described before).

Can you consider uploading such photo to Wikimedia Commons? Do you want to mention this Croatia situation on https://wiki.openstreetmap.org/wiki/Key:dispensing ? That may help to reduce future confusion.

westnordost commented 1 year ago

So at least for Croatia, this could be implemented.

rhhsm commented 1 year ago

Here (circled in red by myself) is picture for Croatia (HR) ("HZZO" is "Hrvatski Zavod za Zdravstveno Osiguranje", and whole phrase means "contractual partner of Croatian Ministry of Health" that is to be shown on dispensing=yes pharmacies, and must not be shown for non-dispensing ones; with meanings as I've described before).

Such labels also occur on the windows of Bulgarian pharmacies (it say something like "this pharmacy works with the national health fund НЗК"), but this means that such pharmacies cooperate with the national health insurance fund so that if you buy prescription drugs there that are partially or wholly covered by the health insurance, they do the paperwork for you and you only pay them the part of the price that isn't covered (if any). At a pharmacy without such a label, you can buy such prescription drugs too, but you pay the full price and you have to claim the part that is covered by insurance yourself at the fund. Could this be the meaning in Croatia too?

Wiki pages I've read: https://en.wikipedia.org/wiki/Over-the-counter_drug https://en.wikipedia.org/wiki/Prescription_drug

seem to indicate similar distinction should exist at least in Netherlands, Canada, UK, some states of USA, and Australia (and I guess at least few ex-Yugoslavian countries beside Croatia).

As described on Wikipedia, there are 4 classes of drugs in the Netherlands. Prescription drugs can only be sold by pharmacies, but afaik all pharmacies in NL sell prescription drugs. Like @westnordost I always thought that a pharmacy is defined by the fact that it sells prescription drugs.

westnordost commented 1 year ago

Phew, okay. Back to "feedback" then...

HolgerJeromin commented 1 year ago

Just as a datapoint. This node got added dispensing=no by the wheelmap app. https://www.openstreetmap.org/node/361083029/history

ivanbranco commented 1 year ago

We have the same distinction in Italy, a "farmacia" is tagged with dispensing=yes and a "parafarmacia" with dispensing=no.

rhhsm commented 1 year ago

They have "parafarmacia" in Spain too: https://www.farma-amparo.es/blog/que-es-una-parafarmacia/ From what I understand from the Google translation, they can be tagged with shop=chemist (chemists also can sell over-the-counter drugs, so their product range is larger than that of a Spanish parafarmacia)

westnordost commented 1 year ago

If it is a different kind of place, it sounds like something that should be added to the iD presets as a country-specific preset then.

mnalis commented 1 year ago

Such labels also occur on the windows of Bulgarian pharmacies (it say something like "this pharmacy works with the national health fund НЗК"), but this means that such pharmacies cooperate with the national health insurance fund so that if you buy prescription drugs there that are partially or wholly covered by the health insurance, they do the paperwork for you and you only pay them the part of the price that isn't covered (if any).

While the reduced/waived price is indeed a part of the HZZO National healthcare system in Croatia, I would not think that it is necessary condition for dispensing=yes (it depends on the country). If you look at my pictures at bottom there are additional two labels (red which is probably "Wiener osiguranje" a blue which is "Croatia osiguranje") which are two additional money reduction / coverage operators/schemes available at that pharmacy. But that payments/refundations are orthogonal to whether they are filling prescriptions.

At a pharmacy without such a label, you can buy such prescription drugs too, but you pay the full price and you have to claim the part that is covered by insurance yourself at the fund. Could this be the meaning in Croatia too?

Not really. Firstly, prescriptions here have been purely digital for some time now here, so dispensing=no pharmacy wouldn't even know what is your prescription (you'd have to remember / write down yourself if it is unrestricted drug and you prefer to buy it in dispensing=no pharmacy). Secondly, they wouldn't be able to sell you certain drugs which are prescribed by your doctor to yourself only (like antibiotics, heavy opiods, etc.)

Like @westnordost I always thought that a pharmacy is defined by the fact that it sells prescription drugs.

Hm, not in my mind (where pharmacy is defined as having pharmacist on duty):

amenity=pharmacy is where there is employed pharmacist (i.e. licensed person with degree in pharmaceutical science). So even when buying over-the-counter drug, you can ask on advice which one to use, how much should you take for your symptoms, what they recommend for children of certain age and weight, will that drug interact with other medicines you're using etc.
In shop=chemist, they don't have such persons, but regular (e.g. like in a supermarket) cashiers only. They might be able to tell from experience which one is dishwasher salt and which one is an Aspirin (or not, depending on your luck :smile:), but they certainly aren't educated nor licensed in pharmaceutical sciences, so they can't provide advice, only sell you whatever box you picked up from the shelves yourself (or you named it to them - if they themselves give drugs, usually in order to prevent thefts). Of course, they can thus only sell "over-the-counter" (e.g. unrestricted) drugs.
Now, if it has a pharmacist (i.e. it is amenity=pharmacy) it can be:
- dispensing=yes (meaning they can sell you any prescription you have) or
- dispensing=no e.g. so while they'll be able to advice you what is the best cough syrup or painkiller or antipyretic to give to your kid of certain age, and how often to give it, and when to get them to the hospital if it doesn't help; they won't be able to sell you for example antibiotics (or heavy opiods, or other restricted drugs depending on the country) that the doctor have prescribed to the kid.

(note that terms pharmacist / chemist / druggist might mean the same or similar things in different English dialects, but in OSM we should stick to meanings as defined in OSM wiki pages, which is often at odds with layman language usage)

As to why would an amenity=pharmacy choose NOT to be dispensing=yes (given that they have to employ the pharmacist anyway to be an amenity=pharmacy, which is the biggest hurdle probably), I can only guess (but few guesses for Croatia are: for a defined big list of popular drugs you must have fixed country-wide price, and for reduced-price drugs they'll have to wait months [or worse] to be refunded by HZZO, which is not a speed-champion when it comes to payments).

I think that is in line with what dispensing=* says:

dispensing=yes - A pharmacy with a dispensing pharmacist able to sell prescription drugs as well as over the counter drugs.
dispensing=no - A pharmacy with a pharmacist that does not fill prescriptions, but does sell pharmacist-only drugs (e.g., pseudoephedrine in the US).

matkoniecz commented 1 year ago

dispensing=no e.g. so while they'll be able to advice you what is the best cough syrup or painkiller or antipyretic to give to your kid of certain age, and how often to give it, and when to get them to the hospital if it doesn't help; they won't be able to sell you for example antibiotics (or heavy opiods, or other restricted drugs depending on the country) that the doctor have prescribed to the kid.

Would they be able to sell none of medicines requiring prescription? Or would they be restricted only from extreme ones like opioids?

westnordost commented 1 year ago

Anyway, looking at the example photos provided so far, it is an information that is not really surveyable for non-experts. I certainly wouldn't know what an "uvigorni partner hzzo-a" is and that blue-red icon in the second photo is also not something anyone would recognize. Remember, StreetComplete quests ought to be solveable by anyone, not only locals. So, I'll close this as not planned.

streetcomplete / StreetComplete