Repeat Dispensing Flashcards
What is repeat dispensing? (1)
For patients who are on regular medications and are stable with their condition. Batch Rx is given depending on tx duration (can range from 1 month - 12 months).
What are the benefits of repeat dispensing? (7)
Px: Convenient, flexibility and easier access to medicines.
Pharmacist: Reduced workload and time, enhances the role of pharmacist.
Gov: Reduced medicinal waste, encourages drug safety (regular monitoring and safe Rx).
What are the 2 main types of paper Rx? (2)
Repeatable Rx: Legal/clinical authority to medicine supply. 1/batch. RX on Rx - Repeatable Authorisation. ‘Master’ Rx.
Batch Rx: Dispensing Rx, >1, RD on Rx - Repeat dispensing. ‘Invoice’ for payment.
Only.amended electronically!
Which patients are suitable for repeat dispensing? (2)
Stable on condition.
Patient using the same pharmacy.
Which patients are unsuitable for repeat dispensing? (3)
Newly diagnosed
Acute Medicines
Unstable medical conditions.
Are there any medicines that can/can’t be included in repeat dispensing? (4)
CAN’T:
- CD’s Schedule 2-3.
CAN:
- PRN medication
- Non-oral meds (inhalers, creams, drops)
- As long as it can be in-sync with other medications.
How does repeat dispensing work in GP? (3)
Surgery staff makes a batch of repeat Rx.
Max of 12 months medicine supply.
Rx Date included.
How does RD work in pharmacies? (4)
Repeatable Rx is dispensed for the 1st time within 6 months (POM) / 28 days (Sch. 4 CDs).
Repeatable paper Rx left in the pharmacy. To dispense batch Rx, the repeatable Rx must always be seen. Px are encouraged to leave the batch paper Rx at the pharmacy.
Batches only dispensed at pharmacy holding the repeatable authorisation.
Expiry date of all batches = 12 months from issue date.
Explain the process of dispensing a repeat Rx. (6)
Secure storage/legality/validity/clinically appropriate (changes to conditions)
Inform Rxer of any issues.
Intervention records.
What questions must the patient be asked before each batch is dispensed? (6)
Are they taking the medicines appropriately? (Do they have any issues taking/using their medicines?)
Do they have any s/e from the medication?
Has there been any change in their condition?
Are they takng any new medicines - OTC/Rx?
Is there anything they don’t need or if applicable, whether they need any ‘prn’ medicines?
Inform them the date they should collect their next medicine supply.
What should happen when the last batch is dispensed? (4)
Inform px on last issue.
Contact surgery for clinical check.
Give written reminder that it’s their last batch.
If Rx is 1 month supply, inform px of their penultimate issue to allow time for review.
What are the common problems for PRN medicines? (3)
Issued on acute Rx
Issued on separate batch Rx
Not added on regular RD as it limits flexibility when dispensing.
What are the common problems for new medicines? (1)
Need fitting in into current batches.
What are the common problems for discontinued medicines? (1)
Pharmacy is notified if discontinued mid-batch.
What does changes in medicines usually involve? (1)
Hospital admissions/changes to medicines since last batch was issued.
Explain the importance of good communication between surgery and pharmacy. (6)
Especially regarding any changes in medication or concerns about compliance:
- When Rxer starts/stops a medication.
- Changes in medicine(s) strength.
- Px is hospital admitted/changed by a secondary care.
- When a px isn’t collecting medicines regularly.
- When px consistently doesn’t request an item/refuses item which should be used/taken regularly.
Why is keeping good records of dispensing important? (4)
Audit trail
Date and quantity of each item should be recorded.
Intervention records kept in px’s record.
Pharmacy informs Rx any issues.
What about Rx charges in repeat dispensing? (3)
Px exemption must sign each batch Rx.
No charge is payable on paper RA.
Briefly outline the process of using electronic repeat dispensing. (6)
GP decides to issue Rx (repeated x times)
EPS repeat dispensing used to Rx.
X repeat Rx for medication added to spine. (7 day before medication is needed)
Spine sends Rx to patient’s nominated pharmacy/pulled from spine from pharmacy.
Pharmacy dispenses repeat Rx.
Px collection.
