repeat dispensing Flashcards
what is repeat dispensing?
- Essential service in the community pharmacy contract
- Most prescriptions issued in the UK are for the management of
long-term conditions
what are the benefits of repeat dispensing?
- Flexibility and easier access to medicines for patients
- Reduces workload and time for the prescriber and their staff
- A single authorising repeatable prescription for review and
signature - Enhances the role of the pharmacist - more than dispensing
the Rx – also a compliance check with the patient - Pharmacist essentially ‘manages’ the repeat Rx
- Helps to reduce waste of medicines
- Drug safety - should encourage regular clinical reviews at
surgery – monitoring of drug therapy and safe prescribing - Uses standard FP10s – no new prescription forms needed (but
Rx are printed in two slightly different formats)
what are the two different types of paper prescription?
repeatable prescription
batch prescription
what is the repeatable prescription?
- Legal authority and clinical authority to supply medication
- Only 1 is needed per batch
- Has letters ‘RA’ on the Rx – Repeat Authorisation
- Think of it as the ‘master’ prescription
what is the batch part of the prescription?
- The dispensing prescription
- Usually have more than one
- Has letters ‘RD’ on the Rx – Repeat Dispensing
- Think of it as the ‘invoice for payment’
which paper prescription is the dispensing prescription?
batch
what are rx printed on?
FP10 form
can prescriptions be ammended by hand?
no
which patients are suitable for repeat dispensing?
- Patients with long-term conditions who are stabilised on
medication (i.e. no changes for a while) - Patients who use one regular pharmacy
- Newly diagnosed patients, those on acute medicines (for
short term treatment) or those who have an unstable
medical conditions are not suitable - GP has the final decision of the suitability of the patient
- Note that the patient must give initial consent to the
sharing of information between the GP and pharmacist. If
they are unwilling to do this they cannot utilise the service
what medicines cannot be repeated?
- Controlled drugs in schedules 2 and 3 are not legally allowed to be prescribed in this way – ordinary FP10s should be issued in the normal way
can prn medicines be included on a repeat?
‘When required’ (‘prn’) medication and non-oral
medication (e.g. inhalers, creams, drops etc) CAN be included but they should be issued on separate RD prescriptions because these are more difficult to ‘fit in’ with the ‘regular’ items
how does repeat dispensing work in GP practice?
Surgery staff generate a ‘batch’ of repeat prescriptions for a patient
* Up to 12 month’s worth of medicines can be issued
* All the issues are dated with the date when the Rx was generated
* One repeatable prescription is issued (RA) and signed by the GP
* Batch prescriptions are produced next (RD), these do not have to be signed by the GP
what are the checks needed to be done when dispensing a repeat prescription?
secure storage
check legality
if its safe to dispense
is it still valid to dispense
to inform the prescriber of any signifigant changes
records of interventions
what questions must the patient be asked before each batch is dispensed?
- Are they taking/using the medicine appropriately (i.e. do they have any problems taking/using their medication)?
- Do they have any side-effects from the medication?
- Has there been any change in their condition?
- Are they are taking any new medicines – OTC or on Rx?
- Is there anything they do not need or, if applicable, whether they need any ‘prn’ meds?
- Also inform them of the date they should collect their next supply of medicine
what should happen when the last batch is dispensed?
- In addition to the usual questions you also need to inform them that this is their last issue
- They will need to contact the surgery and may be required to attend for some clinical check
- It is good practice to give then a written reminder that this is their last batch
- If their prescription is only for 1 months supply, it may be advisable to inform them of their penultimate issue to allow time for them to arrange a review
