Filling and refilling prescriptions is often a time-consuming but necessary part of a physician's day. Making sure patients get the medication they need is important for helping them stay healthy. However, there are often restrictions and regulations around certain types of drugs, or even how frequently certain medications can be refilled. Make sure your prescription management plan complies with the appropriate laws and makes the process as accurate and efficient as possible for your patients.
Know Your State's Laws and Limits
Before you implement or update your practice's prescription and refill policies, make sure you know the laws in your state. According to the Centers for Disease Control and Prevention (CDC), 47 states, along with Washington, D.C., have laws that place time or dosage limits on controlled substances. Those time limits can be narrowed down even further to certain drugs, populations, or situations, such as emergency-basis dispensing or a pain-management clinic setting.
Fifteen states (plus D.C.) set dosage limits based on the type of drug schedule. For example, Rhode Island law restricts prescriptions for Schedule III drugs from being written for more than 100 dosage units. Six states set dosage limits for members of certain benefit plans, such as Delaware's Drug Payment Assistance Program.
Certain states may also place restrictions on the use of mail-order pharmacies. In 2011, New York Governor Andrew Cuomo signed a bill into law that barred insurers or employers from forcing patients to use mail-order plans for prescription drugs. A year later, Pennsylvania Governor Tom Corbett signed a bill that requires patients to receive equivalent terms at retail and mail pharmacies, which went into effect March 1, 2013.
Streamline the Refill Process
A 2012 study published in Family Practice Management recommends streamlining the prescription renewal process by bundling prescriptions. By using this approach to prescription management, you would refill all of a patient's chronic medications -- with the exception of narcotics and benzodiazepines such as Valium and Xanax -- at their annual visit and provide enough refills to last until their next visit. If new medications are added during interval appointments, they are renewed and synchronized so that they expire at the same time as previous medications. While bundling prescriptions eliminates waste, it also helps practices save time by taking a more organized approach to the renewal process.
Phoning It In
Filling or refilling a prescription over the phone may be more convenient for patients, but in most cases it's better for them to make the trip to your office. A physical examination will reveal much more information than a phone call or email, ensuring that the patient receives the correct medication based on their symptoms.
Additionally, in a 2013 study published in JAMA Internal Medicine, researchers found that antibiotic prescription rates were higher at e-visits -- when physicians and patients meet virtually instead of in person. The study also found that when physicians do not perform a physical examination, they are more likely to use a "conservative" approach and prescribe antibiotics.
There are some situations, however, in which filling a prescription over the phone may make sense. One prominent scenario is if the doctor saw the patient in person a few days earlier and the symptoms haven't improved; another is for conditions, such as urinary tract infections, that have distinctive symptoms. However, the CDC still recommends writing a prescription that the patient can fill in a couple of days if their symptoms haven't improved.
Above all, you want your practice to handle prescriptions efficiently and consistently. By getting educated on any relevant state regulations and effectively communicating your prescription process to your patient base, you'll be well on your way toward building a strong, clear protocol that works for both your staff and your clientele, leaving you more time to focus on treating your patients.