The bottom line is - if any pharmacist makes a change to a person's takeaway regime or TA allowance in an emergency situation such as family illness, death or some other urgent travel requirement, and I am not available or on leave, then I will always provide a backdated prescription to cover that. I trust your judgement and if you had been able to get in touch with me then I would have certainly approved the extra takeaways. For stable patients I would allow up to seven consecutive TA for emergency travel. Send me an email with the number of extra TA you have provided and I will forward a prescription as soon as I am back from leave.
An alternative is to bring TA from next week through to this week to allow travel, and then I will arrange for the person to be dosed as a transfer to a pharmacy near where they are going. Again, send an email with details.
In 25 years I have never failed to provide an appropriately dated prescription to allow urgent travel. The alternative is that a patient misses an important life event, or they travel anyway and need to buy illegal black market drugs - far more dangerous than providing extra TA to a stable patient.
I have a phone that I keep for pharmacists. I make every effort to answer that phone when it rings if possible, most days of the week if I am in range. If I cannot then I return the call as soon as I am able. I am also able to respond to SMS for more minor matters and that is often an efficient way to sort out dose changes. An SMS also forms part of the patients clinical record and is something in writing for us to refer back to to ensure accuracy of doses or transfer dates for example.
If you are a pharmacist (or health worker) and do not have that number then please phone my usual reception number 0468 869 873 and identify yourself as a pharmacist. Reception will transfer you to my mobile phone and If you would like that number, please add it to your address book.
I politely request that patient's are not given that number for obvious reasons.
There are five urgent scenarios for pharmacists who will usually contact me for advice, phone orders or prescription changes.
1. Script inadvertently expires
2. Urgent travel out of town
3. Missed doses.
4. Lost or stolen doses.
5. Patient conflict.
The following pdf guidelines outline my standard clinical decision making in these situations. They are an amalgam of personal experience, the state and federal guidelines and quality evidence.
They are a mixture of practicality, safety and acceptability to clients. Retaining patients in treatment at this stage is vital, and it is at these moments where people decide that they can live on the program long term or they decide it is all too hard and return to black market drugs.
Pharmacists, doctors and patients can read my personal clinical policies so they know in general the approach I will take so it is transparent and as standardised from person to person as possible.