The medicines cycle continued
Step 4: Pharmacy dispenses medicine
Pharmacy teams should:
- Ensure they have processes in place to manage repeat prescriptions
- As part of the clinical check of prescriptions, pharmacists should intervene to support medicines safety and appropriateness based on the information available. An important point to consider is that there may be a difference between the intended timing of the dose and the time when it is given, because of the way it is placed in the monitored dosage system. Examples include lansoprazole, which needs to be given 20-30 minutes before food, as this may be in the same blister as aspirin, which should be taken after food
- Supply patient information leaflets with all medicines so residents can read and refer to them. These can also help care home staff with medicine queries and identifying potential adverse effects
- Provide advice to care homes to ensure that medicines are stored correctly. This includes checking fridge temperature, advising on what to do if the fridge temperature goes out of normal range and keeping the care home informed of any medicines that may have manufacturing supply issues
- Provide advice about whether medicines can be crushed, dispersed in water or mixed with thickened food
- Refer to the prescriber for clarification for 'as directed' dose instructions, as well as when doses exceed the BNF guidance or appear unusual
- Communicate with the GP surgery and care home team to resolve any problems
- Consider what actions need to be taken regarding returned medicines from care homes, including completing appropriate paperwork, taking steps to prevent medicines wastage and disposing of waste medicines.
Step 5: Arrival of medicines at the care home
On receipt of the medicines, care home staff should sign the paperwork and contact the GP and/or pharmacy immediately if there are any discrepancies or changes to prescriptions since the order was made. It is good practice for pharmacies to document any discrepancies so that they can be followed up.