To find this stockpiling of medications really annoying?

[MindSweeper]

'This medicine was returned by a patient today. Once medicine has left a pharmacy it cannot be reused for safety reasons. All of the inhalers are full. The purple ones alone (all 42 of them) are worth £60 each. That is £2520 worth of medicines that the NHS could be using for something useful'

Medication wastage currently costs the NHS £300,000,000 per year.

It's shocking how much we have to waste in hospitals too, I see how much is destroyed and it makes me think how much good that could do for people in countries who don't have access to meds.

What solutions can you think of?

People are shifting the blame on pharmacists and doctors, but a lot of the time this stockpiling is people just not telling their doctors they're not taking medications, and still ticking the box to receive the med.

Personally I wish there was a way mis/over prescribed meds could be used in poorer countries.
Lurking - I've posted about one - Intercare - up thread.

Tbh I want to know how the people selling glucose monitoring strips manage to get so much. I have to practically beg to get 100 a month (which isn't enough given I need to test a min of 4 X a day) and when I was pregnant And needing to test 10+ times a day or took 4 letters and a phone call from my consultant to get enough!!

Bloody hell.

I suspect this person was getting their prescriptions on a scheduled repeat, whether they used them, or not.

We had that issue too initially iccle and had to get a consultants letter for the bg strips and also to get the GP to prescribe glucose tablets

Here in Ireland, unless you are on social welfare benefits, you usually have to pay for medication. It's capped at €144 a month though so no matter what you are prescribed, that's the most you should have to pay a month. It cuts down on a lot of stockpiling.

Bloody hell - it's capped at less than that per year in England - if you know about it:
www.nhsbsa.nhs.uk/1127.aspx

We have a 3-6 month supply for many reasons
I can see someone would keep an extra month's worth I still think that 3-6 month's worth is wasteful

What happens if a medicine is changed or if someone dies?

Can you honestly say that you would still stockpile like this if you were paying £8.40 per item?

Lurking - I've posted about one - Intercare - up thread
Intercare do not accept patient returned medications as their website states - "unfortunately, we are unable to accept patient returned medicines".

intercare.org.uk/how-to-help/donate-medicines/

There's only one medication for type 1 diabetes so it's not likely to change....same with the other conditions currently the medications are the only treatments and two need significant weaning times so even if they did change it would not be wasted.

Yes, I'd still stockpile. Actually some of dd2's medical equipment we used to have to self fund at a cost of £250 a month and I stockpiled them too. Luckily she now has nhs funding for it but it doesn't change the need for a supply

As for someone dying....no, id rather not even think about that

To be fair, people do sometimes have to change the insulin they have.

We've had no issues so far and whilst I appreciate some may need to I don't anticipate that happening-only change we've ever had to make was from pens to vials yet still have to get the pencils as always have to have one new each month in case pump fails so we ended up adding to the prescription

It's just how we manage the dcs disabilities and medical conditions. We need to be organised and part of that with a large family and multiple conditions is having a stock of things. Nothing has ever been wasted

Penfills not pencils

I have a medical condition that flares up and over the last 4/5 years would receive the same prescription for each flare regardless of need. The last few times I have gone to my doctor to be signed off work, I've refused the prescription on the basis that I have sufficienct meds in my cupboard at home.

At one point, I had 6 boxes of amytriptiline, 5 of diazepam, 3 codrydamol and 3 cocodamol. As well as the variety of pregabalin and naproxen I've been given over the years. I hate to think I'm wasting my money, and NHS money when I've got the supply at home. Luckily they've been fine with me using what I have and offering to replenish if I run out.

Hedgehog80
But would you still stockpile in this way if you had to pay £8.40 for each item?

Yes absolutely

It's not about the cost to the nhs/potential cost to me it's about need

Luckily for us the dcs obviously get free prescriptions, as do all children. Like I said previously when some items were self funded we stockpiled and had the bus not granted funding we would have continued to do so

I do object to our GP reminding us how much our items cost though. I'm aware it's expensive but dcs did not ask to be unwell so I don't feel there should be any guilt placed on us or us made to feel we are burdening the nhs in any way. Quite to the contrary we save the nhs money by managing the conditions and avoiding unnecessary hospital admissions wherever possible

His medication was very complicated so I set up a spreadsheet of what he should take and how soon before/after food - the nurses had never seen anything like it & asked if they could copy the idea for other patients - I thought that was heartbreaking - what a basic thing someone with cancer needs

Yet this is surprisingly common. I'm only on 4 medications, to control pain, usually at night. I take 2 of one thing on waking, then one each of one or two other things, once I've had my breakfast. I used to take a version of one of those that needed to be eaten at least an hour before or after food and that simply didn't work for me, because I forgot and then ended up with an upset stomach. The other, I take one, or maybe two, of, just before bedtime. I can take the first thing drug at a few points through the day, if I want, or i can take paracetamol, in its place (it's 30/500 co-codamol, so don't take it more than I really need or else I can't shit for a week!) and one of the after breakfast tablets can be repeated after dinner, if I need it. Or I might leave that one out, if I'm feeling good with no painful injuries or pinched nerves.

Way beyond the usefulness of a dosette box and that's just 4 drugs to balance! Some people are on 2 or 3 times as many drugs with before or after or nowhere near food, rules, or 1, 2, 3 or 4 doses a day, some regular, some as needed, and so on. While a good pharmacist and GP can work together, in some cases, cost limitations, side effects and interactions permitting, to find drugs and dosages which simplify the daily route, very often maintaining compliance is so much more complicated than dispensing everything into a weekly compartmentalised box. it's not just the subject of speculation on the Internet, there are researchers scratching their heads over exactly these sorts of issues because they're not easily solvable, within the resources available.

Ime it is the elderly, yes
They have this "I'm entitled to it" mentality that means that even if they don't need it they will still re order it

In my grandparents case I think it was just that people were collecting their meds and they didn't realise they could be cancelled . I doubt they are unique,I imagine lots of people are the same.

Why on earth do people want glucose testing strips?

The frustrating thing is, it would cost money to sort this out, but would save so much.

Actually, I bet we have enough collective knowledge on MN (doctors, nurses, pharmacists, people working with elderly or other groups with a lot of medication) to figure out a workable solution...

It seems based on people's suggestions and opinions that:

we need better medication reviews, from both GP and pharmacist.

HCP's who go into people's homes need to flag up to GP that medication is being stockpiled.

There needs to be more patient education, including actual costs of meds included on the packets

Better services for those who are rural so they can have their medications delivered properly instead of having to stockpile

People to take more responsibility themselves and let GPs know when they no longer need a medication and/or do not request it

I'm in Scotland - so no prescription charges -but I'm not sure that the prescribing matches that.
I think we get prescribed 'value for money' - if you were paying prescription charges of £8 getting 2 weeks supply of something and then needing to pay again we would be annoyed -but getting 2 months of something 'to try' with free prescriptions is madness.
I got prescribed a massive bottle of oral morphine - I tried to split the prescription but it was a choice between a tiny bottle (2 days worth) or 1lt or something. Obviously off my head on morphine and in pain I didn't want to have to go out just to pick up medication but if I still needed it long enough to use the big bottle I'd be back in hospital...(if I hadn't been on morphine I guess I would have thought and got two/three small bottles - the pharmacist didn't suggest that though...maybe several small bottle were more than a big one?) Anyway I ended up returning 75% of the massive bottle ...
Also a few years ago I hurt my back - was given strong painkillers and told to go back in 3 days if no improvement - I got a months supply! Again 90% went back (out of date).
Also I agree with a small amount of new medication to try -
I was told to try some stomach medicine (omeprazole) - took 2 weeks to work -I got 2 months supply - after 2 weeks no improvement so changed to another medicine -again another 2 months worth... 6 weeks of the first lot went back eventually...
I share meds with my family though - DM was on 75mg aspirin on prescription - I was too (bought it for years -cheaper than prescription charge, when prescription charge was abolished they kept telling me when I bought it I didn't need to pay any more - £2 a month I could afford - then the GP told me I SHOULD get it on prescription so they knew I was still taking it and how often...). Anyway when DM stopped taking it I used hers up...
Same with lansoprazole -I get it on prescription and she was given it to try, didn't like it so I used her 'left overs'. (later found out my dad has omeprazole to take with certain painkillers when he has a flare - so I could have given him mine!)
I was on warfarin for a while - DM has warfarin - when I stopped taking it I gave it to her to use up...

And I agree with checking what is in the bag and sometimes I think the GPs don't help.
I've had cellulitis for over a month now - been on various antibiotics. The second GP visit I mentioned I'd bumped the other leg - looking redder and more inflamed than I'd expect. (And I have had several different infections over the last few months -tonsilitis etc) I showed it to them in a 'this isn't related is it way'.. they said nothing to worry about - put a pain killing/anti-inflammatory gel on it. I got my prescription for antibiotics -when I got home and looked in the bag I had two big tubes of ibuprofen gel I wasn't expecting. I didn't need it - DP stock piles the stuff (buys it) for various aches and pains - I offered it to him and he said he had too much anyway ... (I did use it once or twice but when it dried and it made it itch like mad - seeing as itching had set my cellulitis off...). I have remembered my dad does use it (buys it) so I'll give it to him to save it from the bin...

I worked for a PCT that did try addressing non compliance. They employed pharmacists on a variety of hours to work in practices doing medication reviews. They concentrated on patients with lots of items and repeats, invited them in and went through their meds with them. They also did home visits where stockpiling was often identified. They had some very good results, especially where patients were taking "contradictory" medicines which might have been happening for years. The GP practices thought it was great, it was something they wanted to do but is extremely time consuming. It improved the standard of care and It made a difference to the overall bill. Sadly the funding disappeared in one or other of the reorganisations and the next PCT I worked for had nothing of the sort.
Someone up thread suggested this sort of scheme, so just wanted to say they are effective and could easily be self funding from savings. Just needs the political will. If Hunt paid as much attention as he does to terrible contracts...

I think my GP has the right idea ( even if it fucks me off) that every 6 months a med review is done.

It's just so fucking ironic

That all I can say

My friend while having terminal cancer struggled to get her morphine

It's does seem to be an issue with repeat prescriptions / but nowadays my surgery just send me painkillers - I don't have to see anyone

I do pay for them though - and certainlly I have enough to not stress about 4 week GP waiting

It shocks me officer that people like yourself don't glance at their prescription to see what they're getting before ordering I suspect this happens less when people have to pay the fee, maybe there's an air of complacency? I don't mean to offend by the way

sorry that was supposed to be to unluck

officer to you I meant to say that that seems like such a good idea, I wish it had been continued across the board