Errors can happen with pharmacy’s automatic refill service


People who take medicines to treat chronic diseases, such as high blood pressure, asthma, or diabetes, need to fill their prescriptions regularly. Many pharmacies allow people to sign up for an automatic refill service so they don't run out of their medicines because they forget to call for refills. Once you sign up for this service, all your prescriptions for ongoing medicines are automatically refilled until there are no more refills left on the prescription. Each month, the pharmacy then notifies you when they are ready to be picked up.

This service offers some great benefits beyond eliminating the need for you to remember to request refills for your prescriptions. It can help make sure you don't miss taking doses while waiting to refill your prescriptions. It also allows pharmacy staff to prioritize and pace their work. They can prepare the prescription when time permits, without the pressure of feeling rushed if you are waiting for your last-minute refill. Rushing can lead to errors.

Still, there are some potential problems with this service. First, you may receive an automatic refill of a medicine that has been stopped. Or, your pharmacist may not know that your doctor has changed the dose of your medicine or how often you take it. So, you may receive a refilled medication in the wrong dose or with the wrong directions on the label. Consider the following examples of actual errors that have happened.

A pharmacy called a man to pick up his prescriptions that had been automatically refilled. After he picked up the medicines and drove home, he remembered that his doctor told him to stop taking one of the medicines, amlodipine, which was used to treat high blood pressure. His blood pressure was very low during his recent physical exam, so his doctor wanted him to stop taking the medicine until his next office visit. The pharmacist did not know the medicine had been stopped, so the prescription was automatically refilled. Fortunately, the man remembered not to take the medicine and called the pharmacy to let the pharmacist know. Had he taken the medicine, he could have experienced dizziness and fallen or been involved in an accident from a dangerously low blood pressure.

Another elderly man taking diltiazem to treat his angina (chest pain) received a new prescription from his doctor. The doctor increased the dose of diltiazem from 240 mg to 360 mg. The man went to the pharmacy to fill the new prescription. He also picked up other prescriptions that were refilled using the automatic refill service. One of those prescriptions was for diltiazem 240 mg, which was his old prescription that still had refills on it. When the man got home, he fortunately noticed that he had two prescriptions for the same medicine. He called the pharmacy to see if there was a mistake. The pharmacist contacted the doctor to determine which dose the man should take. The man was told to take the higher dose and to return the other prescription to the pharmacy. Had the man taken both doses of the diltiazem, he could have experienced serious heart irregularities.

Automatic refill services are also offered through mail-order pharmacies and new medicine dispensing machines (similar to vending machines). Like the examples above, refills of discontinued or changed prescriptions can happen when using these services. In these cases, though, it is harder to reach a pharmacist for advice or to return the unneeded prescription.

Here are ways to stay safe when using automatic refill services:

√ Keep your pharmacist informed. Notify your pharmacist of any changes made to the prescription medicines you take. This includes medicines that are stopped, doses that are increased or decreased, and changes in how often you take the medicine.

√ Discard old medicines. If your doctor tells you to stop taking a prescription medicine, dispose of it properly to lessen the risk of confusion. √ Bring in your old medicine with a new prescription. If you have a new prescription because your doctor changed the dose or directions for taking the medicine, bring the old medicine back to the pharmacy when you drop off the prescription or when you pick up the medicine. If the medicine change is related to the dose or how often you take the medicine, your pharmacist may be able to provide you with new directions to use up the older supply.

√ Talk to a pharmacist. Each time you pick up a prescription medicine, ask to talk to your pharmacist to review the medicine and how to take it. Tell your pharmacist if the instructions don't match what your doctor said. If you receive medicines by mail, look at each prescription medicine you receive and make sure you understand how to take it and why you are taking it. Call the mail order pharmacy's 800 number, your local pharmacist, or your doctor if you have any questions.

√ Check for duplicate medicines. When you get home with your medicine (or when medicine is delivered to your home), look at all your prescription medicines together to make sure you do not have duplicates. Remaining supplies of refilled medicines are expected; to avoid double dosing, set aside the new medicine until you finish the old. Make sure the newly purchased medicine is not the same as another medicine on hand in a different dose or with different directions. If you have brand name medicines, check the generic name of the medicine on the prescription label to make sure you do not have duplicate medicines.

√ Use the same pharmacy. Try to fill all your prescriptions at the same pharmacy. This way, all of your prescription information will be available to the pharmacist.

Created on January 9, 2012

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