Repeat prescriptions

[hoops120]

My mother in law has severe Alzheimer's and is cared for at home by F-I-L. By and large he is doing a great job under very difficult circumstances.

For years he has continued to accumulate a vast collection of M-I-L's medicines, for fear that the GP will cease to prescribe some of them. We are desperately trying to persuade him only to keep a small supply in the house, both for safety's sake, and on account of the cost to the NHS.


Today OH brought home literally hundreds of packets of surplus drugs which F-I-L wants him to safely dispose of. I guess that is progress in a very small way, at least he is not keeping them in the house!


The next step is to persuade him not to accept and “cash in " the repeat prescriptions if they do not actually need them. He is worried that if the GP notices that the prescription has not been “cashed in” then he will not re- prescribe. I have little experience of this, other than the occasional prescription for myself. I may be naive, but I am assuming that even if the system is sophisticated enough to notice that you have not cashed in a prescription, it is unlikely to come to the attention of a busy GP. Or even if it does, the GP will re-prescribe a drug if appropriate.


Can anyone with any relevant knowledge (a GP , pharmacist or surgery staff perhaps?) please give me some advice re this. I really do need a convincing answer, as years of trying to persuade FIL have so far been unsuccesful.

[calleyw]

Well as far as I know they do know how often you cash in a repeat prescription because if you do it to many times they can stop the prescription.

My husband has had this before. But as far as I am aware they don't just take things off your repeat. My husband still has stuff on his that he has not used for nearly 3 years.

He needs to stop doing this as it is costs in his own time as well as others peoples times and resources.

Yours

Calley

[BallandChain]

How can a person accrue so much medicine? My GP limits me to one pack of tablets a month. It's a real pain having to keep going back for more when the month is nearly up.

[f10na]

why dont you get him to ask the pharmacy for a dosette box which they make up weekly and then he would only have enough medication for a week at a time and pharmacy would order then he would not need to worry about not getting scripts

The dr does not know if the script has been dispensed after he hands it out

[VfM4meplse]

This is an interesting OP. Medicines wastage puts patients at risk and costs the NHS millions every year. Drugs for AD are particularly expensive and many peple don't realise that by accruing unused medication, or not urning up to appointments means that the NHS can't afford to fund other areas of care, such as specialist treatments.

If your FIL doesn't want to talk to your MILs GP then a chat with your MIL's community phamacist / MUR will help. Don't think your GP will be annoyed, he will be please to finally learn why clinical progress has not been made!!

[hoops120]

Thanks for your advice so far. I agree that it is a gross waste of time and money to hoard medicines, the cost to the NHS grieves me. I am also concerned about the risk that whilst unsupervised MIL may accidentally take some tablets


FIL is a very awkward, stubborn man and illogical man. We have tried all the suggestions so far made, sadly with no success.


He does have a very great challenge on in caring for MIL, and by and large does this extremely well so we don't want to make his life any more complicated or stressful than it already is.


The unused medication is for conditions for which mother in law was being prescribed over many years (eg constipation, migraine,,, and much more) and which she does not appear to need at the moment, but which he fears she may need at some time in the future. He does use the drugs for her Alzheimer's appropriately (I think) but sadly she has deteriorated too far for these to have any real benefit, as far as we can see. However, he is convinced that she would deteriorate further without them and is prepared to pay privately if the GP is no longer willing to prescribe them. I think it is this fear that a review of her prescribed medicines would lead to the withdrawal of her Aricept which is partly behind this situation.


I think the only thing that will convince him to cut back on the wasted prescriptions is if we can reassure him that the GP will not know if he does not “cash in” the prescription at the pharmacy, and to do so only when he actually needs the items.


F10na has stated that this is the case, so we will chip away at this with him. Once this has been achieved, we may be able to get him to have a more honest relationship with the GP

[LondonDiva]

When was the last time your MIL has a medication review? It sounds well overdue & I would contact the practice to arrange one asap.

It also sounds as though your FIL could do with soem support. Has he has a carer's assessment & has he also informally had a word with the community nurses / matrons or the practice manager?

Could you look online & give him a ££ figure for the drugs so work out whether each packet that's unused is £80-150 for the NHS. If it's not used it will be treated as waste and essentially means that he's flushing someone else's chances of getting medication down the drain.

The practice will have a drugs budget and I'm sure would be happy to work with him.