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Gwyn
21-03-2007, 12:01 PM
What do other practices do with patients that are prescribed medication associated with mental health eg olanzapine but who won't come in for reviews. We currently give out the prescriptions on repeat to several patients who WERE up to date with reviews but who have now stopped coming in. Continue prescribing blind and risk the patient becoming ill - stop prescribing and risk the patient becoming ill!!

Any help or guidance would be much appreciated.

Gwyn

pruritus
21-03-2007, 05:54 PM
Difficult one. It is that wise saying that if you want to go somewhere it is better to start anywhere else other than where you are!

To prescribe in absentio is foolish, make the drug prescription conditional on attendance. Involve the Mental Health Team and spread the risk. Get them to see, visit, assess.

Once this therapeutic bump is over inform the Mental Team that you will be instituting a shared care protocol, particularly for atypicals. These should not be prescribed in Primary Care until patient is stable and then only under this mutually agreed shared care basis. Include in protocol non compliance = Mental Health team involvement.

Oddly I haven't prescribed atypicals for years. Can't think why ;-)