Repeat Prescribing and Medicines Safety training

At every stage of the repeat prescribing process there are specific safety checks. When processing, check the request is due, not too early or too late, and the item, dose and quantity match what is prescribed. Check if a medication review is overdue. Check if blood test monitoring has lapsed. Look for interactions, allergies, duplications or dosing concerns. Check if the patient is over ordering or under ordering. These checks catch errors before they reach the patient. If anything looks wrong, flag it. Never process a request that raises doubt. Querying a concern is part of safe practice.

Some medicines are high risk and demand particular care. These include anticoagulants like warfarin, methotrexate, lithium, disease modifying drugs, insulin, opioids and medicines affecting kidney function. They require specific blood tests and monitoring. Never reauthorise these without checking monitoring is current. Use recalls and the clinical system to hold the line. For example, methotrexate needs regular blood tests for liver and bone marrow. Lithium needs lithium levels checked. ACE inhibitors and other kidney affecting drugs need kidney function tests. Missing monitoring with these medicines can cause serious harm including bleeding, toxicity, organ damage or death.

When a Drug Safety Update or National Patient Safety Alert arrives, we must act. Run searches to identify affected patients and take action. Use prescribing safety searches and indicators to find people at risk, such as those with monitoring overdue or on risky combinations. Controlled drugs like opioids, benzodiazepines and gabapentinoids need particularly careful handling. Check for dependence, escalating doses and overuse. After a hospital discharge, reconcile medicines carefully because changes can be missed. Use electronic repeat dispensing safely, ensuring batches are managed with the pharmacy. All of this is part of our shared responsibility for medicines safety across the whole team.