Pharmacists severely limited without patient record access

 

In response to the following article:

 

“Tramadol overdose death raises questions over repeat prescriptions.”

 

Dear PIP Editor,

 

Patients are being put at risk due to how repeat prescription services are being managed in my view. The excessive accumulation of prescription medication is a common occurrence and I have seen this in practice.

 

Patients keep ordering but stop taking their meds either through active choice or self-neglect. I think they fear being told off if they admit it or they will be somehow forced into compliance.

 

I think that the supervision of repeat supply of prescription medicines is acceptable at the moment if we use the tools at our disposal. Using tools available such as stricter dispensing. For example, daily and weekly dispensing can help.

 

The real issue to be tackled is what happens after the patient leaves the pharmacy. This really needs to be addressed. Perhaps a multi-disciplinary team regularly visiting the patient might help.

 

We are careful about how we manage ‘when required’ prescriptions like the tramadol in this case. We try and ensure that the quantity is appropriate for the usual daily dose.

 

In terms of making sure this type of case never happens again, we simply cannot achieve this by ourselves. We can try and adopt a culture where talking about pain levels is normal within the pharmacy. Unless we get a fuller picture of the patient’s history we are severely limited.

 

Your etc.

 

Anon.

 

This pharmacist wished to remain anonymous.

 

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PIP editor

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