Warfarin - Yellow Book system abandoned in Kent

[evrybuddy]

MiL is on Warfarin in Kent and we took her to clinic for her INR test today.

Apparently the Yellow Book system of getting pills has been changed - now nurse sends electronic prescription to pharmacy/or GP - not sure?

But would only issue prescription for 28 pills not the 56 that are needed to take MiL thought to next warfarin clinic appointment.

Will now have to visit pharmacist 4 days before the 28 pills run out to order another 28.

Feels like more work for everyone (and an extra trip for me) with no obvious purpose.

MiL was in clinic with nurse alone so can't explain the whys and wherefores behind the change - says nurse told her 'just new system for everyone'.

Pharmacist wasn't forthcoming with reason but was busy.

Anyone else come across this?

[NK346f2849X127d8bca260]

www.dorsetccg.nhs.uk/Downloads/aboutus/medicines-management/Useful%20Resources/28%20day%20prescribing%20leaflet.pdf
I don't know if it might be to do with this policy...my mother lives in Dorset and she has been told this is happening at her surgery. She is not on Warfarin, but many other medications.
Hope they don't start it where I live, right pain getting repeats at our surgery is.

[Mysillydog]

My surgery do electronic prescribing and it is really convenient. I am on warfarin too, and when I am running low I just order more. In my case the warfarin dosing and prescribing are entirely separate. The dosing is done by the anticoagulation clinic and the prescribing by the GP. The GP can prescribe 56x1mg, 56x3mg and 56x5mg and I order what I need using the repeat service.

I actually test at home, email my results and get a dose emailed back, which saves me so much time. My prescriptions are also ordered online - but they don't have to be. The way I do it isn't for everyone.

It sounds like a call to the GP to ask if the prescription could be changed to 56 tabs might help? I know some surgeries don't like to issue large quantities of meds at one time, but I don't think 56 is excessive.

[evrybuddy]

Thanks NK... that 28 day policy certainly looks like a possibility.
I wish they'd just tell people when they do this stuff.

Every time MiL goes to DR I get a text message asking how she found the service etc - well, send me a text message when you change the policy!!!

MiL is on electronic prescription service which eventually we managed to get working fine on 56 day roto for all her other meds.

Warfarin is more awkward because of the potential changing levels and unfortunately she couldn't do her own testing (not sure if they offer that here) and because she takes paracetamol and overdoses her warfarin now and again, she's on a constantly changing testing regime.

We collect her meds for her but the pharmacist is not an enthusiastic communicator so things 'just happen' according to them.

The Yellow Book system was working so well.

I'll check with the GP and see if they know what's going on.

The warfarin test and prescription is done by a nurse which seems an alien concept to the pharmacist but generally means the GP is out of the loop.