In response to the following article:
“Tramadol overdose death raises questions over repeat prescriptions.”
Dear PIP Editor,
I believe patients being put at risk due to how repeat prescription services are being managed. I agree with the experienced specialist mental health nurse in this case when she said that excessive accumulation of prescription medication is a common occurrence.
I have seen this in practice. This ranges from patients ordering their own repeats and also batch prescriptions. With batches, we ask the patient each time if each prescription item is needed at each supply. If the patient is unsure, I ask them to call us and we make a note on their batch auditable paperwork.
When patients order their own medicines, we probably don’t ask as often as we should. I would say we don’t check every time if the prescription they are receiving is the one they are expecting.
There is an assumption that if a patient has control over their prescription then they must need it and it is correct.
I don’t think there is an easy solution to this.
A point to note is that a patient’s regular pharmacist cannot go into a patient’s home to talk to them about their meds. I think this would help with those patients that we do not see on a regular basis.
If stockpiling is an issue then other healthcare professionals need to contact the pharmacist as their duty of care. They need to check if they are taking their medicines, check compliance, check health outcomes and also check who is ordering the repeat medicines.
This is where batches come in.
We don’t manage prescriptions for our patients. This would be up to the patient or the carers or the carers to prompt the pt to re-order.
PRN medicines should also never be placed on repeat. For example, I think painkillers should never be on repeat slips.
I believe to prevent such case as this happening again there should be no ordering of prescriptions without the prior informed consent of the patient. This may mean having to contact them month after month!
Yours etc.
Anon.
