-----Original Message-----
From: GP-UK [mailto:[log in to unmask]] On Behalf Of Roger Gardiner
Sent: 26 May 2004 16:07
To: [log in to unmask]
Subject: Re: Significant events
In an email dated Wed, 26 May 2004 9:46:30 am GMT, Colin Brown
<[log in to unmask]> writes:
snipped
>
>The chairman's view would result in a much longer interruption to a
>regime where stability is of the essence, and a wholly unnecessary
>encounter with the practice. The users's lateness does not require
>further punishment of him, nor any of the doctors.
>
>Prescriptions have a start date, but no end date, I believe.
Endsnip
Methadone/subutex scripts written to be dispensed daily usually have a
start date.
If an addict misses a couple of days then their drug tolerance falls and
the previously OK dose may cause severe/fatal effects.
I don't know how long the patient failed to pick-up but I reckon
referring back to the prescriber if he missed a couple of days (by the
pharmacist at least) is good practice.
--
Roger Gardiner
--
Yes to "referral back to prescriber" after several days - and locally a
phone discussion is usually OK to restart an interrupted dispense,
considering the previous stability, dose, length of interruption, other
info.
But in this case, firstly - the interruption was only overnight.
Secondly - it seems that a disciplinary hearing has gone beyond its
powers of governance of the MDA, to officiate over a debatable point of
good practice. It is the carefree mixing of legal process and matters
of clinical judgment that adds hassle to this already complex work.
Colin Brown
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