Ndhb prescriptions and dispensing frequency 2012.pub

Close control rule is no longer relevant — replaced by dispensing frequency rule The Pharmaceutical Schedule specifies for each medicine a default dispensing frequency - one or three months (six months for OCs). It is recommended prescribers write each medicine using: generic medicine name (not brand name), route of administration and/or formulation, dose and frequency of administration or other appropriate instruction, and quantity or period of supply, leaving the dispensing frequency for the pharmacist to decide. The patient will be dispensed their medicine usually at the default dispensing frequency. Persons in residential care facilities funded by the MoH or a DHB wil be dispensed medicines in quantities of not less than 28 days except in the case of a “trial period”. Prescribers may request MORE frequent dispensing in the following circumstances: i) Trial Periods: The medicine has been prescribed for a patient who requires close monitoring fol owing initiation or dose change (applicable to the patient’s first changed prescription only); and al of the fol owing − endorsed the medicine being trial ed clearly with the words “Trial Period”, or “Trial”; and − the maximum quantity or period of supply to be dispensed at any one time is specified. ii) Safety medicines: Medicines on the safety list: www.pharmac.govt.nz/ccc are usual y dispensed at a Dispense 30 days “trial “+ remainder frequency of 30 days + 2 repeats or for Class B CDs 10 days + 2 repeats. The prescriber can request more frequent dispensing, i.e. fortnightly, weekly, twice weekly or daily, provided: − clinical risk has been assessed and it is determined the patient requires a more frequent period of dispensing than specified in the Pharmaceutical Schedule; and − the maximum quantity or period of supply to be dispensed at any one time is specified. Medicines co-prescribed with a safety medicine(s): The pharmacist wil determine dispensing frequency. This may be aligned with the dispensing frequency of the co-prescribed safety medicine or dispensed at the default dispensing frequency for that medicine. Prescribers may request LESS frequent dispensing in the following circumstances: iii) Certified exemption to monthly dispensing: A prescriber may choose a less frequent dispensing than monthly for any medicine identified in the Pharmaceutical Schedule with “certified exemption”. See section F in the Pharmaceutical Schedule for a list of medicines. In doing so “Certified exemption—dispense stat” the prescriber is certifying that the patient wishes to have the medicine dispensed for a period greater than one month, the patient has been stabilised on the medicine for a reasonable period of time, and the prescriber has reason to believe that the patient wil continue to be compliant. The pharmacist might contact you if they have a different view to seek clarification. Close control rule is no longer relevant — replaced by dispensing frequency rule The Pharmaceutical Schedule specifies for each medicine a default dispensing frequency - one or three months ( 10 days for Class B CDs; six months for OCs). In most cases pharmacists wil dispense medicines at their default dispensing frequency. Persons in residential care facilities funded by the MoH or a DHB must be dispensed medicines in quantities of not less than 28 days except in the case of a “trial period” as defined by the prescriber. A pharmacist may decide MORE frequent dispensing is required. This can occur as fol ows: − For LTC patients dispensing frequency can occur as often as the dispensing pharmacist deems appropriate to meet the patients compliance and adherence needs − For non-LTC patients dispensing frequency should be no more often than monthly. If more frequent dispensings than monthly are necessary for non-LTC patients, prescriber approval is required. Verbal approval is acceptable, provided that this is annotated and dated by the pharmacist on the − Co-prescribed with safety medicine(s): The pharmacist wil determine dispensing frequency. This may be aligned with the dispensing frequency of the co-prescribed safety medicine or dispensed at the default dispensing frequency for that medicine, e.g. lorazepam is a safety medicine dispensed monthly therefore the pharmacist wil decide if the other medcines should be dispensed stat or monthly. A pharmacist may decide LESS frequent dispensing is required. This can occur as fol ows: Certified exemption to monthly dispensing: A pharmacist may choose a less frequent dispensing than monthly for any medicine identified in the Pharmaceutical Schedule with “certified exemption”. See section F in the Pharmaceutical Schedule for a list of medicines. In doing so the pharmacist is certifying that the patient wishes to have the medicine dispensed for a period greater than one month, the patient has been stabilised on the medicine for a reasonable period of time, and the prescriber has reason to believe that the patient wil continue to be compliant. Access exemption to monthly dispensing: A patient may have their medicines dispensed less frequently than monthly if they have difficulty getting to and from a pharmacy and they sign the back of the prescription certifying which of the following criteria they meet: i) have limited physical mobility Ii) live and work more than 30 minutes from the nearest pharmacy by their normal form of transport Ii ) are relocating to another area Iv) are travel ing extensively and wil be out of town when the repeats are due.

Source: http://www.aucklandpho.co.nz/sites/default/files/NDHB%20Prescriptions%20and%20dispensing%20frequency%202012.pdf