Medication monitoring and reviews

Posted by: philipwilliams - Posted on:

We have made several changes to our annual review and medication monitoring systems over the last few years so we thought it would be helpful to provide an update now that everything is up and running.

What changes have been made?

With the disruption caused by the COVID pandemic, we took the opportunity to move to a “month of birth” recall system. This means that for annual checks you should be called in for your review around the month of your birth each year. A lot of other surgeries use this system, so not only will it help us all remember when your review is due, but it should help if you need to register at another practice, or move to us from another practice.

Our previous recall system was very much dependent upon our reception team phoning you to book the appointments, and you being available to take the call when they rang. This was a very inefficient system, so last year we took the decision to move to a commercial product which is much more efficient. It lets you know you’re due your monitoring either by text message or by postal letter. You can then either respond via the link in the text message, or by phoning the practice when it suits you. The new “callback” feature on our phone system has been a great success, meaning that when call waits are longer, you don’t need to hold but rather you get a call back from the surgery when you reach the front of the queue.

I’ve been called in twice within a few months! Why?

Unfortunately the roll out of the new system means that we’ve got behind with some patients’ reviews. Our “review year” runs from April to March each year. This means you may be invited in for a “catch up review” then again for your actual annual review.

We realise this can be frustrating but we would encourage all our patients to come back for the second review for two reasons. Firstly, your “catch up” review may not have included everything which becomes “due” in the year 2024/25. Secondly, your next review won’t be until later in 2025/26, which would mean you’d go over the 12 months between reviews. We believe it’s safer to have too many reviews than not enough!

What’s the need for this monitoring? Do I have to have it?

Annual reviews and drug monitoring serve two purposes.

Firstly, sometimes we can pick up your longterm conditions getting worse before you notice it, or what symptoms you experience regularly but think is “normal for you” actually needs intervention to ensure you stay fit and well in the future. Treatment guidelines change regularly with new studies and evidence coming through, so what was right for you last year, may not be right for you this year.

Secondly, many drugs do need regular ongoing monitoring. If these checks aren’t done, it can cause significant harm. For example, many blood pressure pills require your kidney function and salt levels to be checked each year. Picking these changes up early can avoid emergency hospital admissions. We prescribe a lot of medication which historically would only have been prescribed by hospital specialists (eg methotrexate). We can now prescribe these medications if all set criteria are met. One is usually that you need to have been settled on them for a period of time, but another is that your monitoring is up to date. If your monitoring becomes very overdue, we may need to stop your prescriptions to avoid harm going undetected.

Some situations would allow you to decline monitoring and continue your treatment. For example, if you’re under a specialist team and they’ve carried out all the required monitoring. We would check to ensure their monitoring does align completely with ours, and then either download their blood results to your record, or except you from the monitoring requirements for that occasion. You will still be invited the next time the monitoring becomes due.

What happens if I am overdue monitoring?

We will send you multiple reminders to arrange your monitoring. However, if it becomes very overdue, we will reduce your medication supply to fortnightly, then weekly, then we will stop the medication until the monitoring is carried out. There are many medications we cannot safely prescribe without the required monitoring.If you respond to the first invitations each time, your supply of medication will be seamless.

Thank you for your cooperation with this process, it is designed to keep you safe and well.