A prescription request service can improve patient experience and reduce over prescribing

Pilot project to evaluate a prescription request service to reduce waiting times for medicines and over prescribing of supportive medicines in a busy haematology outpatient clinic Fleur Harvey

Introduction

Haematology patients are often prescribed a large number of supportive medicines, although many of these will be repeat prescriptions these medicines are often prescribed on the day in clinic. Medicines prescribed on the day are often automatically repeated from previous prescriptions, leading to over prescribing of unneeded supplies. On the day prescriptions are often delayed due to competing work flows and patients often have a poorer experience having to wait for prolonged periods for their medicines.

Aim

To improve patient experience by reducing waiting times for medications. To reduce over prescribing of unneeded medicines prescribed on repeat.

Method

In a 12 week pilot patients  for a Monday clinic were contacted the week prior to their appointment to request what medicines were required on their next visit. Medicines requested were prescribed and dispensed in advance. Data on waiting times and cost avoidance of medicines, not dispensed on repeat, were analysed.

Results

  • Average waiting time for medicines requested in advance was reduced by over 1 hour

Waiting times were evaluated for 77  patient attendances on 3 separate days. Patients that had not been contacted prior to clinic  had an average waiting time of 1hr 43 mins from point of prescribing to collection of medicines. Patients that had been contacted and had their prescription prepared in advance had an average waiting time of 34mins. Average waiting time for medicines requested in advance was reduced by over 1 hour. 

Prior to 12 clinic days a total of 187  patients were successfully contacted, evaluation of  the cost of medicines avoided including dispensing costs was £66,876.98.

Discussion

Contacting patients in advance of their appointment, to request medicines required, had a positive impact on patient waiting times and reduced over prescribing, generating cost savings. Alongside the above benefits informal feedback from patients was extremely positive .

The pilot demonstrated a clear need to expand the project to target a wider group of patients. 

Limitations

Contacting patients by telephone was time consuming, and would be a limitation to further increasing this service. 

Recommendations

  • The  findings have been shared with the wider haematology and pharmacy team.
  • The pilot has led to development of an email prescription request service allowing access to a larger number of patients.