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(This was initially written as a response to a thread on AnonDoc's blog.)
I often got calls at the pharmacy from people who said, "Gimme all my refills."
"Which ones?" "Duh, I dunno, all of them?"
People have no idea what they're taking, they just want me to refill everything. Then we get calls back. "Why did you refill this? I'm not taking this anymore!" (Um, like we would know that if nobody thought to tell us.) Or conversely, "I'm missing that, why didn't you fill it?" (Maybe because you didn't have any refills on it. Or because you haven't gotten it in months and we had no idea you were still taking it. Or perhaps because you never got it from us to begin with.)
I had one episode about 7 years back. I was working the overnight shift in what at the time was the busiest pharmacy in the state. Someone had called in wanting "all his refills". Rather than just faxing the whole list to the doctor for approval, I decided to look through them first to see what was what. There were a buncha blood pressure meds . . . and one vasopressor. [drug which increases blood pressure] (Can't remember which one at this point, maybe dobutamine or midodrine.)
Going back through the patient's history to see what was up with that, I found it had initially been prescribed for a seven day period with no refills, then renewed by a doctor for 30 days... every month for the next three months. Meanwhile, some of his BP meds had been increased in dose over that three month period.
I called the patient back and asked him if he knew why he was taking that particular med. He had no idea.
I told him this drug was intended to *increase* blood pressure. Then he remembered that he'd had an episode of hypotension [abnormally low blood pressure], several months back, and this might have been given him to raise it back up. I told him that taking this together with beta blockers and other BP meds would have the same effect as putting an engine at both ends of a train and pulling in opposite directions, and maybe this is why his BP meds had needed to be increased so much.
Then he wanted to know, if this was the case, why did we keep renewing it? Uhm, maybe because you kept calling in and telling us to? Following which, some overworked pharmacist on his way to filling a couple thousand scripts in a day hit the button to automagically send in the refill request, and some equally overworked doctor (or more likely, someone in his office) clicked on the Approve button, and nobody actually ever looked at the damn script to see if it was reasonable. And they did this for three months running.
This is one reason why I now refuse to fill "all my refills". No sir/ma'am. You tell me which ones you need, and then I won't be getting yelled at for filling something you didn't want or aren't taking anymore.
I often got calls at the pharmacy from people who said, "Gimme all my refills."
"Which ones?" "Duh, I dunno, all of them?"
People have no idea what they're taking, they just want me to refill everything. Then we get calls back. "Why did you refill this? I'm not taking this anymore!" (Um, like we would know that if nobody thought to tell us.) Or conversely, "I'm missing that, why didn't you fill it?" (Maybe because you didn't have any refills on it. Or because you haven't gotten it in months and we had no idea you were still taking it. Or perhaps because you never got it from us to begin with.)
I had one episode about 7 years back. I was working the overnight shift in what at the time was the busiest pharmacy in the state. Someone had called in wanting "all his refills". Rather than just faxing the whole list to the doctor for approval, I decided to look through them first to see what was what. There were a buncha blood pressure meds . . . and one vasopressor. [drug which increases blood pressure] (Can't remember which one at this point, maybe dobutamine or midodrine.)
Going back through the patient's history to see what was up with that, I found it had initially been prescribed for a seven day period with no refills, then renewed by a doctor for 30 days... every month for the next three months. Meanwhile, some of his BP meds had been increased in dose over that three month period.
I called the patient back and asked him if he knew why he was taking that particular med. He had no idea.
I told him this drug was intended to *increase* blood pressure. Then he remembered that he'd had an episode of hypotension [abnormally low blood pressure], several months back, and this might have been given him to raise it back up. I told him that taking this together with beta blockers and other BP meds would have the same effect as putting an engine at both ends of a train and pulling in opposite directions, and maybe this is why his BP meds had needed to be increased so much.
Then he wanted to know, if this was the case, why did we keep renewing it? Uhm, maybe because you kept calling in and telling us to? Following which, some overworked pharmacist on his way to filling a couple thousand scripts in a day hit the button to automagically send in the refill request, and some equally overworked doctor (or more likely, someone in his office) clicked on the Approve button, and nobody actually ever looked at the damn script to see if it was reasonable. And they did this for three months running.
This is one reason why I now refuse to fill "all my refills". No sir/ma'am. You tell me which ones you need, and then I won't be getting yelled at for filling something you didn't want or aren't taking anymore.
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