Funny, if it wasn't so stupid.

So I asked about this at my surgery's PPG, and luckily their pharmacist was there. They said that where there's a review element, prescriptions are for 1 month. When they're going to be long term and a static dosage, they can be prescribed to cover longer, up to a legal maximum of 6 months. I guess for Metformin, that could be prescribed for 3 months to match HbA1c test intervals as prescribing's based on those results, give or take side-effects which I presume are most likely to happen when starting on it.

Then for getting multiple forms, apparently that's based on risk and 1 item per form is meant to reduce the chance of the wrong quantity or dosage being dispensed. And I guess for some items, like my pain meds, might prevent possible abuse.

That aside, it was an interesting meeting with an opportunity to find out more about how the practice works, and offer feedback & suggestions.

Same here. My ramipril changed from 56 being 2 months worth to 28 tablets. No warning. And the system online won't let you order more for 2 weeks. Just give me 6 months.

DavidGrahamJones said:

I couldn't understand why my Metformin ran out way ahead of any other prescribed meds. The answer was simple, the prescription amount had been halved, it was still 2 x 2 500mg per day, just one months supply. No warning which is irritating. When I discovered who had halved it I could see where the breakdown in communication was.

So I asked at the surgery I was told that an external pharmacist had audited all the prescriptions and reduced the number of tablets being prescribed, where they thought fit. Supposedly a cost saving exercise, which makes no sense whatsoever. I have to renew the prescription every month, instead of two months (minimal cost to me, just a pain in the neck). The GP has to sign two scripts (significant increase in workload as Metformin is commonly prescribed to type IIs). My local pharmacist has to dispense twice the number of scripts (significant increase as for GP). So, where's the cost saving?

I would be interested in discovering how many people who are prescribed Metformin are experience the same sort of nonsense.

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I wonder if it was the practice manager doing it. These people, whoever they were, obviously have little medical knowledge & one wonders if they should be in the job in the first place. So dangerous.

DavidGrahamJones said:

My pharmacist wouldn't either

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That's good to hear.

first14808 said:

When they're going to be long term and a static dosage, they can be prescribed to cover longer, up to a legal maximum of 6 months.

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I get one Metformin script plus five repeats, the scripts are good for one year.

H

Terrytiddy said:

Does your pharmacy not offer free delivery?

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Hi Terrytiddy. I expect they do but to date I have never had the need to use this service as my pharmacy is not too far from home but I might inquire about it next time I go. Thanks.

Bittern said:

I had the same problem, spoke to the pharmacist at the surgery who immediately adjusted the dates by slightly over and slightly under dispensing for one month. The recollection dates at the commercial pharmacist are now the same. One renewal request, one drug collection.

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Hi Bittern. I may try this next time I go to the GP surgery. Thanks.

There is no saving on changing the amount, it's false economy at it's worse. You haven't got a cat in hells chance of recovering from type 1 diabetes, but I am interrogated everytime I put a prescription request in. Only last week the doctor's pharmacist rang me about 1. GlucoGen injection kit - was asked if I knew that they was very expensive. Informed him how expensive I would be if it wasn't prescribed - emergency ambulance, a bed in A&E plus staff who would be caring for me. 2. Why had I requested a different sized hypodermic needle - the depth size wasn't suitable because Insulin leaked out following injection. I pointed out that after having type 1 for 53 years, I do know the correct injection technique and have never used that size before, why had they changed the size without consulting me? - it was down to cost! Total rubbish! 3. On going trouble for a lot of us, blood testing strips! 4. Insulin - yes you've read it correct. Why did I need so much. After this question I hung up and stomped down to the surgery ready for battle. After much, shall we say, rather difficult conversation, they agreed to send prescription for bigger needles to chemist by late afternoon. On collection, I found they had prescribed lancets! I went back to the surgery and gave 'him' an insulin pen and a new unused lancet and asked if he could please show me how I could inject my insulin using this new cost cutting technique. Ahh, hum, mutter, with what few brain cells he had got slowly turning in his empty head a conclusion was reached ..... you couldn't inject using this, it wasn't a needle!! You couldn't make it up! When I return from my holiday I will be seeing my GP for a very long discussion. I'm absolutely fuming! As I said at the beginning of this rant, it is every time I send in a request.

DavidGrahamJones said:

I frequently feel that we are becoming slaves to technology instead of the other way round. As Bittern suggest, have a word with both pharmacy and surgery to align all the dates. Good luck, let us know how it goes.

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Thanks DavidGraham Jones. I may well have a word with the surgery soon. Recently I ticked 2 items at the same time on my repeat request list and only one was ready to collect at the pharmacy but they kindly allowed me several tablets to tide me over until the prescription arrives electronically from the surgery when they will reduce the amount accordingly.

I have recently had one of my insulins removed from my list of repeatable items, plus my tablets for BP. I always order my prescriptions online, so I can see the list in full, plus date of last prescription for each item. I immediately rang the surgery and explained the problem. The receptionist was very confused and finally got me a telephone appointment to speak to the doctor the following day.

I ws told that my usual 1 mg BP tablets had been removed because there had been a manufacturing problem and the pharmacist had requested a prescription for 2 mg as a substitute. This was not news to me. I had asked the pharmcy to cut them in two, to allow me a 1 mg dose. The doctor said she decided to remove the tablets from my repeatable list in case I ordered the 1mg tablets, once they were again available, and took them in addition to the half tablets I had been using. as a substitute. I decided that was perhaps understandable, but it could have left me without any BP tablets if I had not already developed the habit of ordering a week in advance, to allow time for error corrections. There was no explanation of why my insulin had been removed and it was immediately reinstated.

JohnEGreen said:

.........>>
except for February.

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And that is only correct if year is not exactly divisible by 4, and then it skips once a century too. Think it was due to God saying ' Just a sec '.

Edit; Sorry, you are technically correct, I should have replied to the poster who was complaining about the 28 day cycle not coinciding with a monthly renewal. My wife gets her PIP (ex DLA) paid 4 weekly, but her standing orders and direct debits are all pcm, so we keep getting angry telephone calls. However, the firms doing direct debits seem to be totally unable to use scheduling on a weekly basis, as are the banks at doing standing orders on a sliding scale. Aren't computers wonderful? So clever nowadays.

Oldvatr said:

My wife gets her PIP (ex DLA) paid 4 weekly, but her standing orders and direct debits are all pcm, so we keep getting angry telephone calls.

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My hubby has his state retirement pension paid weekly into the bank to avoid any of this. She could ask for that.

JohnEGreen said:

My repeat prescriptions are monthly or I should say four weekly on all items any way but I do find that on certain meds I always run out a few days before the new prescription is filled never been able to quite understand why I think it may be the discrepancy between the 28 days of tabs prescribed and an actual month of 30 or 31 days except for February.

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Oldvatr said:

And that is only correct if year is not exactly divisible by 4, and then it skips once a century too. Think it was due to God saying ' Just a sec '.

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24 hours per day.
7 days per week.
4 weeks per month, or 28 days.

So 13 pay periods where I used to work, the British gubberment pays my pension this way.

My Insulins and Liraglutide are on a when I need more basis, as are my blood testing strips, as I find them to be unpredictable. All my other stuff is on a two month supply basis.
I don't know how anyone can put up with Metformin. I hated the stuff and the radical mood swings it caused me. The reaction to the stuff lead to me choosing Insulin even though I hate needles. It was far better than being the raging, angry lunatic that Metformin turned me into!

DavidGrahamJones said:

Another reason to mention it to my GP is that as far as I'm concerned she alone is responsible clinically and legally, not some pharmacist that I don't know from Adam.

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I would be going down this track by reporting it to the relevant Ombudsman in Queensland where I live if the need ever occurs.

The UK one here. https://www.ombudsman.org.uk/making-complaint

QPR4Me said:

I don't know how anyone can put up with Metformin. I hated the stuff and the radical mood swings it caused me. The reaction to the stuff lead to me choosing Insulin even though I hate needles. It was far better than being the raging, angry lunatic that Metformin turned me into!

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Sorry but I need to address this comment about Metformin incase anyone just prescribed it reads this. I have been on Metformin for just over a year now and after a week or so stomach upset I am able to take it with no side effects whatsoever. So I don’t have to “put up with it”. Yes some people get side effects but each person prescribed it will need to find out how it affects them as an individual.

Rachox said:

Sorry but I need to address this comment about Metformin incase anyone just prescribed it reads this. I have been on Metformin for just over a year now and after a week or so stomach upset I am able to take it with no side effects whatsoever. So I don’t have to “put up with it”. Yes some people get side effects but each person prescribed it will need to find out how it affects them as an individual.

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I think that goes for any drug. We can all react in different ways to certain drugs. It would be foolish to **** metformin when so many people get on with it and it helps. If you have a bad reaction it’s an individual thing. I hope those effected can find a different medicine to help them