Old refills vs. new prescriptions

November 29, 2011

Q: Where is the document that says I have to discontinue all previous refills when a patient brings in a new prescription for the same med?

A: That statement was a council policy. When the Standards for Pharmacist Practice came into effect in 2007, that policy was no longer needed since Standard 5 put the responsibility for dispensing refills (new or old) with the pharmacist, not with council policy.

This standard, now Standard 6, still exists in the current Standards of Practice for Pharmacists and Pharmacy Technicians.

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Standard 6 and an example:
 

STANDARD 6 (excerpt)

Each time a pharmacist or a pharmacy technician dispenses a Schedule 1 drug or blood product pursuant to a prescription:

a) the pharmacist must determine that the prescription is appropriate.

Example
Your patient, Carl, presents a new prescription for a medication for which he still has refills. You, the pharmacist, must determine whether it is appropriate to keep the existing refills and add the new prescription and any refills, or whether it is appropriate to cancel the ‘old’ refills and dispense the new prescription.

Some factors you will want to consider include:

  • What was the prescriber’s intent when writing the new prescription? (The prescriber may have intended to add more refills to last until the patient is re-assessed.)
  • When should/will the patient be re-assessed by the prescriber?
  • What monitoring should occur with this patient and this medication?
  • Will that monitoring be occurring throughout the ‘life’ of the refills?

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