Policy:        

In the interest of client safety and in accordance with Canadian Medical Protective Association, the College of Physicians and Surgeons of Ontario, College of Nurses of Ontario, and the Ontario College of Pharmacists, when possible; prescriptions are renewed at scheduled appointments with the client’s primary care provider or designate.

Procedure:

All RCHS employees will continue to encourage clients to bring all prescriptions to all scheduled appointments for medication review or renewal.

When primary care providers receive a request to refill a prescription that has run out, they must consider whether the drug is still appropriate and whether the patient’s condition is stable enough to warrant the prescription refill without further assessment.  It is recommended that primary care providers also consider whether requests for prescription refills received earlier or later than expected may indicate poor adherence, possibly leading to inadequate therapy or adverse events.

  1. If a client walks or telephones in for a prescription renewal the following steps will be followed:
    • If the client has an upcoming appointment before the prescription runs out, the prescription renewal will be done at the scheduled appointment.
    • If the client does not have a scheduled appointment booked with a primary care provider, an appointment will be scheduled with instructions to bring all medications to the appointment.
    • If an appointment is not available with the provider prior to the client running out of medication, the client is asked to call his/her pharmacy to obtain a short-term supply until the next available appointment.
  2. For prescription renewals received via fax, the following steps will be followed:
    • A copy of the renewal request will be sent electronically through the EMR to the provider by a member of the administration team.  If the provider deems the request is appropriate, the completed prescription will be e-faxed to the appropriate pharmacy. 
    • Faxed prescription renewals will be completed within 5 business days.
  3. For prescriptions received via fax when a primary care provider is on an extended leave of more than three business days, the following steps will be followed:
    1. A letter will be sent to pharmacies (that do not charge a fee) requesting the pharmacist renew chronic, long-term medication - not including narcotics, controlled drugs, and benzodiazepines.
    2. Renewals that cannot be done by the community pharmacist will be completed by the covering primary care provider. 
    3. If the covering primary care provider does not feel comfortable renewing medications without an appointment, but there are no appointments available, the community health centre pharmacist will be asked to review the client’s chart and make recommendations (e.g., monitoring, offer appointment for medication review, chart review, etc.) to assist in assessing the appropriateness of the prescription renewal.