Repeat prescribing: a role for community pharmacists in controlling and monitoring repeat prescriptions

Background. Traditional systems of managing repeat prescribing have been cr iticised for their lack of clinical and administrative controls. Aim. To compare a community pharmacist-managed repeat prescribing system wi th established methods of managing repeat prescribing. Method, A randomised controlled intervention study (19 general medical prac tices, 3074 patients, 62 community pharmacists). Patients on repeat medicat ion were given sufficient three-monthly scripts, endorsed for monthly dispe nsing, to last until their next clinical review consultation with their gen eral practitioner (GP). The scripts were stored by a pharmacist of the pati ent's choice, Each monthly dispensing was authorised by the pharmacist, usi ng a standard protocol. The cost of the drugs prescribed and dispensed was calculated. Data on patient outcomes were obtained from pharmacist-generate d patient records and GP notes. Results. A total of 12.4% of patients had compliance problems, side-effects , adverse drug reactions, or drug interactions identified by the pharmacist There were significantly more problems identified in total in the interven tion group. The total number of consultations, deaths, and non-elective hos pital admissions was the same in both groups. Sixty-six per cent of the stu dy patients did not require their full quota of prescribed drugs, represent ing 18% of the total prescribed costs (estimated annual drug cost avoidance of pound 43 per patient). Conclusion. This system of managing repeat prescribing has been demonstrate d to be logistically feasible, to identify clinical problems, and to make s avings in the drugs bill.