The evil pharmacist

rissfish

Hello!

I haven't been on in aaages so hello to everyone who welcomed me a long time ago.

Since coming on here about 6 months ago I'm now on a lovely combo of MTX, Plaqnil, steroids, omeprazole, etc...you get the picture.

Anyway, a few weeks ago, the pharmacist at [ Name Deleted] (am I allowed to use names on here, block it out if necessary and put 'a London hospital') has decided to stop dispensing all my meds for longer than 28 days (I never used to have a problem before).

Now apparently, according to him, I am supposed to be seeing my GP for top ups of my medications (anything that I need for more than 28 days which is, well everything) because "if the lines of communication are broken you become an at risk patient".

What on earth does this mean?! And why is this guy going against my rheumy prescribed 8 weeks dispensing?

Anyone else got this issue? According to my blood monitoring nurse, it's happening to many other patients. I can't understand this. Anyone got an explanation as to why the pharmacist wants to go against the explicit wishes of my rheumy?

Thanks!

The name of the hospital has been removed because it contravened the Forums Terms & Conditions Rule 2.7
Moderator EH

tillytop

Hi Rissfish

Sorry you are having prescription hassle. You really don't need that!

My experience is that once the initial prescribing request has gone to my GP, he does all the prescribing and I only ever get a month's work of anything. I don't have to see him when I need a repeat (he's not iinterested basically :roll: ) but I do have to put in a repeat every month (or actually several times a month because things run out at different times). Being the cynic I am when it comes to medical stuff I wonder if the underlying factor is actually cost? If you are prescribed only 28 days at a time, you pay more frequently than if you are prescribed 2 months at a time. Hopefully you have a prescription pre-payment card so that this change is inconvenient rather than costly.

Hope you do get to the bottom of it sooner rather than later.

Tilly xxx

keith1971

Hi Rissfish,

I actually go to the rheumatology dept. in 'that' hospital. I've had pretty poor care up 'til now & been very misinformed regarding the potential severity of my condition.

Luckily I have health insurance so am going for a 2nd opinion & when I do eventually go back on the NHS it'll most definitely be at a different hospital!!

rissfish

Hi Tilly,

I see the rheumy once every two months, so they fill my prescription to say 8 weeks supply, which now, isn't getting filled by the hospital pharmacy. All very well and good if it's a funding issue or just a normal rule (the pharmacist categorically denied that it was a funding issue), but why have they dispensed the 8 weeks every time up until recently? Besides that, my GP knows nothing (I mean nothing) about RA, even to the extent that she wasnt' sure if I could take ibuprofen with steroids. What is the use of having the rest of my meds prescribed by her (particularly MTX which I'm sure she won't write for anyway). And thanks - I finally got a PPC two weeks' ago, after the pharmacist blatantly lied to me about their existence!

Keith...oh my, how I could go on about the treatment at the hospital. In the four visits I've had there, I have seen three different rheumys! And oh how I wish I had private insurance. Did you sign up after you were diagnosed? What's the deal with chronic illness and private health cover in this country? (Excuse my ignorance, I'm Aussie)!

Thanks

keith1971

My favourite thing about that place is having to wait over an hour every time I have an appointment there as they always seem to run late!

I guess I've been lucky (!) and only seen two rheumys in my 3 visits. I should've had four but they kept me waiting over an hour and a half once so I walked out.

As far as health insurance goes, the problem has to arise after you've taken out the cover otherwise you're not covered. This is actually the first time I've used the policy so am keen to see how the treatment differs from the standard NHS service.

Have you thought about trying The Whittington at all if you're in the North London area.

rissfish

Yes...EVERY SINGLE TIME!!! Haha, glad someone else has the same experience.

My favourite day was this...
My rheumy was out (on holidays) so she had someone filling in for her. Fill-in was so slow all the nurses were even whinging about her. Then they rolled in a completely immobile poor older guy who needed an emergency appointment. At the end of it all, the other doctors there started taking on her patients. I waited 2.5 hrs to be seen. Blood room on LG was closed that day as well and when I went to the pharmacy, their system had broken down so had to wait another hour to get dispensed meds! Seriously, then when I complained to the rheumy that I have a job and this can't happen every single time I go in, he had the gall to say 'well your workplace needs to recognise you are sick and you need time for your appointment'. Well yes, great, if the appointments stuck to the schedule and I spent two hours out of the office, not half a day!

Sorry...rant over...

Anyone else with pharmacy issues???

dreamdaisy

These are powerful and dangerous meds. I think the 28 days at a time is a safety thing more than anything else. Yes it's a pain, yes it's a nuisance, but so are many other things in life. I do receive a reasonable amount of omep, cocos and steroids from the GP, but the meth I have to collect from the hospital every four weeks. I get it from the rheumatology department. I avoid hospital pharmacies like the plague - everything takes an age! DD

jenniet

Hello there.

I'm on lots of drugs including triple combination therapy for my RA and I order all my drugs on line from my GP, although the rheummy prescribed them initially. The only one I have to order 4 weekly is the mtx. all the rest I can get 2 monthly. I'm lucky I guess, I just have to go to the chemist by the doctors to pick them up and as an added bonus the drugs appear to be working!
Jenniet.

Lisaa

Hi

Far from having pharmacist problems, i have major GP problems.

I recive all my prescriptions from my GP who are informed what im on and what i need etc from my rhumy. I have to order everything every 4 weeks aswell as get my bloods done once a month. Everything was going great up untill the last 4 or 5 months, everytime i order my medications they always seem to get it wrong, only giving me one or two items out of the 8 that i am on, clearly they think that i dont acctually NEED to take methotrexate.

The latest and most infuriating development was after seeing my rhumy she said she would fax a letter to my GP saying that i was to start immediatly and i was instructed to pick up the prescription in 2 days time.
It took me going into the GP twice (and arguing my case with a particularly arsey receptionist), two phonecalls from my pharmacist, a phonecall from me and a very angry phone call from my mum to get these two drugs two weeks later,which i had been told to start IMMEDIATLY!!

The pharmacist told me (perhaps i think because i used to work there) that said receptionist who thinks she is the be all and end all, had told him that "the letter from the hospital is in the doctors workload, but it is 7 pages long so... you know"

Anychance something that takes 7 pages to explain might acctaully be pretty important and require more immediate attention than "Mrs Smith would like some paracetamol"

The receptionist in question also told me that i should leave atleast two weeks between ordering my medications and acctually running out, more if possible. Unrealistic much??

Its a right pain having arthritis :P
Hope everyone elses problems are getting sorted
Lisa

tkachev

My consultant and nurse write to my GP when new meds are subscribed or unsubscribed. I have a repeat prescription at B**ts. I phone them once every 4 weeks to re-order the meds I need off the list and they send my prescripion request to my GP on my behalf. A few days later I collect my meds.They can deliver but not sure if there is any criteria about who they will deliver too.It is a free scheme,with no joining fee.

I only ever use hospital pharmacy if I have to.
Ask at B**ts about their repeat prescription scheme. I live in West London area.

Regards
Elizabeth

tillytop

Hi again Rissfish

I can understand your frustration with the hospital pharmcy - and clearly you are also hugely frustrated wth your treatment in general. From Keith's post it sounds as if you are not alone in your experiences. I wonder if, instead of using the hospital pharmacy you could take your prescription to another pharmacy - who hopefully would prescribe what's been ordered by the rheumatologist.

Re private healthcare - as has already been said, you would, I reckon, struggle to get healthcare cover for an existing condition but it is possible to pay yourself to see a rheumatologist to get consistency. Be aware though that you can find yourself caught between the NHS and the private heallthare cos the NHS can be a bit funny about "mixing and matching". Although my experiences were some years ago, I found myself being charged for routine procedures (eg blood tests) carried out at my GP because they had been ordered by a private consultant and it can get frighteningly expensive very quickly.

Good luck with it all.

Tilly xxx

rissfish

Hi all...

Thanks very much for the responses and it seems everyone has their own different issues with dispensing of meds.

I may not have explained myself properly though at the start. Basically, my rheumatology department have taken my care well into their hands and I really don't see the GP at all. The rheumy department do my blood monitoring (once every two weeks up until recently and now once a month) so they know everything is going ok with the MTX and everything else. My rheumy (who I see once every two months) will then write my 8 week prescription and I get blood tests at the same time. So, I am being monitored at least once every month and my issue was, that up until a couple of weeks ago, the hospital pharmacy was dispensing the 8 weeks as prescribed by my rheumy. This has recently changed and the pharmacist has taken it upon himself to dispute this with me (making me very upset and angry) rather than with the doctor dispensing my medication.

I work full time and a very busy job at that, so making time to see the GP to get a prescription is just that extra hassle that I really can't be bothered with. If my rheumy is happy enough to prescribe 8 weeks, what I don't understand is why the pharmacist would have an issue with this and go to the extent of claiming that I will become 'at risk'. To me, that is alarmist and purely unnecessarily upsetting to someone who is young and sick!

Other issue is that MTX (according to my blood monitoring nurse) is considered a 'red line' drug by Camden trust. GPs in my area apparently won't even dispense it.

Thanks again for all the comments and support. Much appreciated!!

Marissa xxx

frogmorton

Nightmare Marissa

28 days here that's all and the rheumatologist writes to the Gp who then has to prescribe it. It is a dreadful system, none of use have time to go to the GP then 48 hours later go back for the actual prescription, go to the pharmacist then wait there to collect them :roll:

System just doesn't really work.

Love

Toni xx

rissfish

frogmorton wrote:

Nightmare Marissa

28 days here that's all and the rheumatologist writes to the Gp who then has to prescribe it. It is a dreadful system, none of use have time to go to the GP then 48 hours later go back for the actual prescription, go to the pharmacist then wait there to collect them :roll:

System just doesn't really work.

Love

Toni xx

Dead right Toni!

Sorry for sounding like a whinger when I know you all have to deal with the same rubbish.

Thanks for understanding

rugbygirl

I have a very good local pharmacist who orders all my meds on a 4 weekly basis and ensures that I have sufficient to get me through the month. I asked my GP if there was anyway I could have more of the co-codomal than the 100 I get every time and he told me that he couldnt prescribe more than that as there were guidelines on how many could be prescribed. I wouldnt mind but at the moment I am taking 56 a week and obviously 100 doesnt last me a week. I have taken to going to the GP every other week to get a prescription as I am not allowed to put in a repeat more than once a month for them.

I have now built up a little stock pile of them. My pharamcist always checks that I have enough and I have no problem getting the necessary drugs. If anything he would prefer to give me more than less and he makes sure everything is working for me.

I feel that he has more interest in my health than the actual GP and if he didnt have to rely on the prescription I would be able to get what I want when I need it.

I dont have to pay for my prescriptions so I dont think it actually matters about that. If anything I think it might be down to the NICE guidelines or the good old GOvernment

tillytop

Hi again Rissfish!

Interesting what you say about mtx being "redlined" in your area. My GP prescribed my mtx totally on my say-so, well before he had the letter from the rheumatologist and when I increase the dose (which I do every 4 weeks without any input or support from GP or rheumatologist) I just tell the GP what the new dose is so he can prescribe accordingly. From my point of view that's alot easier than faffing around with appointments but it's just a good job I've been at this stuff for many years and know what I am doing - ie how far it's ok to increase the mtx without input from the consultant. And reading the posts from everyone else it sounds as if there is no standard procedure and, as Toni says, the system doesn't really work.

Hope you do manage to get your issue sorted.

Tilly xxx

need me bed

Hi All,

Don't even mention the hospital pharmacy to me....Last time i had to use it i got my script from the rheumy, got down to the pharmacy put script in, come back in 1/2 hour they said, so i poddled off to the coffee stand and waited my turn. bang on the 30 mins i got back to pharmacy to see it had actually shut 15 mins before... AAArrrgggghhhh Why didn't they just tell me to come back the next day??? Is that just to hard to comprehend?? talk about annoyed.... they are all evil! :evil as for the rheumy i usually take a days holiday for the appt, that way i'm not worried about having to rush back to work if they're (as they usually are) late. longest i've waited was around 3hrs, coz my rheumy 'forgets' to cancel a clinic when he's teaching... yet if im late.. im told to go back another time.... my worst has been over xmas. Appt came for tues 21st dec but i couldn't remember the time... called the dept the day before to check the time only to be told my appt was that monday 20th and i had missed it... they had apparently sent me a letter which i never received to change the appt could they not have phoned?? or at least confirm i could make it?? I am still waiting to see the rheumy where i shall kick off in style about this my appt is 4th April as there was nothing sooner.... so all in all i have waited 10 months for an appt to see the rheumy about which i am not at all happy. I asked my GP to call and see if there was anything sooner as i am desperate to see him. got letter from GP say all I had to do was call them and they'd fit me in??!! Having tried that several times i didn't bother and shall make GP aware of this next time i see him. They also have a 'helpline' for patients but either no-one answers or you get the machine and they don't call you back anyway so whats the point?? All i'm doing is stressing myself out for other peoples lack of communication.... so i have given up and shall just await my appt in april...(only about another 3 weeks)

I now get a PPC at £104 per year, and get as much as i need. I get my repeat prescription through my local B**ts and then i go every 2 months to collect.... i'm still trying to figure out the Meth as doc puts 2 month course on the script but I only get 1 month from the chemist. I'm sure i'll get there...

My chemist/ helpers are great, if i wasn't for them i would never have known about the PPC. Its saved me a fortune!! i get 8 items every 2 months and 1 item is around £7.20. For my regular meds that about £350 (ish) a year and then there all the in between things like anti-biotics, occasionally morphine ....i just couldn't afford it otherwise... I would urge anyone with lots of meds etc to get a PPC it's soooo worth every penny.


Sorry didn't mean to have a rant but i just get so frustrated with the system.... :x

Thanks

NMB xx

Cez

I work in a hospital pharmacy but thankfully don't provide a service like the one you've experienced!! Each department has it's own specialist pharmacist and the pharmacist will rotate in the pharmacy when they're not on clinic/wards. If the pharmacist on duty isn't a rheumatology specialist, it can be hard for them to understand how well the rheumatology team monitor ppl on Methotrexate and other cytotoxic drugs. Although there will be guidelines on how many the doctors can be prescribed at any time, the pharmacist has a say at the end of the day on how many he things are clinically appropriate. Whether that be a good or bad thing!

I'm lucky that i don't have any problems getting the quantity i need, i've just been travelling for a month and had no problems getting a 7 week supply to cover me between appts, but i always attend my appts and blood monitoring so i guess they've got no reason not to trust me in that respect.

If only some of the ppl we encounter in hospitals understood the struggle to obtain when you have a potentially debilitating disease!