Pharmacists - repeat prescription refused

[tribpot]

Any pharmacists out there? Help me ensure my dh goes off on one with the right healthcare professional tomorrow! He uses a delivery service which has been very hit-and-miss in the past and today is the last straw. He is on a dose of a very heavy duty painkiller (among many other things) and, reordering the 14-day dose as normal a couple of days ago, has come to take his first dose of the new order tonight to find the box of pills contains a note 'reordered 28/4/11, should have plenty left'. No pills. This is not a painkiller it is safe to come off unexpectedly (although in fairness he's not gonna die before tomorrow or anything).

Is this an error at the pharmacy or was it the duty GP when asked to sign the repeat, who must have misread his daily dose? He's been on this dose for years, and had it prescribed every 14 days for all that time.

Isn't it your job to check your pharmacy order is correct when you receive it? I'm not saying that as a perfect patient who always does, as I don't always open my bag.

I would expect the pharmacist to point out if something was deliberately missing though. Mine always does, and she points out when I need to see the GP before they will authorise more.

I agree, ThingOne, although I think the bag was delivered in the post-school run chaos and DH just grabbed it and got back to business. It was ordered along with another prescription which was filled, so it's not like the bag was obviously empty or anything like that. I'm surprised they didn't phone to question the 'over order' earlier in the day - they know us extremely well.

I think this is probably a problem with the collections service, the pharmacist himself would have mentioned it if we'd gone in to collect, I suspect. The only plus side is it's not the start of a bank holiday weekend, which is when they tend to make their dispensing errors!

Could have been that teh pharmacist who decided not to request Repeat from GP...in which case the pharmacists fault.

Could be that teh GP didn't issue the repeat, in which case I might have expected the GP to call him and explain/ask for a consultation or at teh very least send a letter via pharmacist asking him to book a review appointment.

Personally I would have expected the pharmacst to at least point it out he collected/delivered the "empty medication" so that he knew there would be none there before he went to use it IYSWIm.

Thanks - it all seems very odd to me. This is a painkiller more commonly used as a drug replacement with heroin addicts, if you get what I mean, not exactly something you bugger about with. If they wanted a medications review there's no way they'd just stop it til he could make an appointment.

I hope you get it sorted in the morning as it's really really horrible to just stop taking it (speaking from experience!)

In that case maybe the someone things he is selling it on teh black market?

Pharmacist should not be the one to make any judgement though on whether he is "allowed" a repeat prescription, if that is what has happened.

In my experience it would be very unusual for the pharmacist to decide not to put your request in even if they thought it was early. It is most likely that the receptionist/prescription clerk has misjudged it and referred it back to the pharmacy.

If i were you I would ring the surgery and ask them if they could explain amd arrange a prescription as a matter of urgency.

I've had this and it was the Pharmacist taking it upon themselves NOT to request the refill so I had to make a GP appointment to get the new script. I don't bother with the Pharmacy re-ordering service now.

Interesting, thanks all. Looks like we'll be doing a round trip of the pharmacy and the surgery tomorrow morning, what fun.

Update: apparently "computer said no" when he re-ordered, in theory because he ordered a day or two early. Still not sure how that translates into 'should have plenty left' but hey ho, sorted now.

Thanks for all your advice.

Glad it's all sorted (I'm assuming it is and the script was refilled??)

Yes, thank you! Script was immediately forthcoming, the inhouse pharmacy offered to order the meds in but I said I'd go to the old pharmacy (the practice has just moved premises) as he'd already missed the evening dose and didn't want him waiting on the morning one too. All sorted just in time for my 9:30 conference call, bish bosh!

I shall certainly be encouraging dh to check his meds when they're delivered in future but it seems they've got a bit out of sync, which is part of the problem - so if he ordered them strictly when each one was due he'd be on the phone every other day. Fortunately we can use the meds review next week to re-align them, not to mention get some notes on his file to the effect that if he orders a few days early this is not him turning to a life of crime. Or something!

Blimey. What a palaver. Hope the review sorts it out for the future.

Not much chance of that I'm afraid ThingOne, we just lurch from one problem to another, twas ever thus!

You shouldn't have to go through a meds review to get things into line if he doesn't need advice or extra info on his meds. Your GP surgery should be able to do it for you easily.

Pharmacies get paid for meds reviews and some of them are using simple issues like this as a money-spinner. Try just ringing the surgery and ask them to put all the meds into line. Many GP surgeries now have a pharmacist who works in the surgery and deals with all sorts of medicines issues who should be able to do it for you if they have one.

Thanks Serenity but he was due one anyway (with the GP as he's been repeat prescribing for well over 6 months). I think the GP likes to touch base in general as DH has a complex set of health conditions and these days he's basically prescribing whatever a variety of consultants have requested, it keeps him up-to-date on why, if you see what I mean. We can do it as a phone appointment so it's no biggie.

Getting things back in line could be a bit tricky, although fortunately he's not rotating any painkillers these days, which was very difficult. But he is meant to be working on reducing various drugs so the dosages do vary.

A review at the surgery is always useful when you have complex medical needs and changing medication. I just have issues with some of the reviews done in some pharmacies as they add no value for the patient or surgery (large chemist companies do loads which IMO do little other than cost the NHS money it cannot afford)

Good luck to your DH (and to you too of course!)

Thanks again Serenity. I don't know about pharmacy MURs in general but it certainly wouldn't be for us; I tend to claim (entirely incorrectly) that I walk into the pharmacy and shout "hand me the keys to the controlled drugs locker, I'm helping myself" So far the furthest they've got in questioning the meds is why I don't have the same surname as DH but claim to be married to him! (Not put in quite those terms, I should add).