Repeat meds checks - what is your policy?

RE: Repeat meds checks - what is your policy?

Braden Collins — Tue, 08 Mar 2016 13:58:36 GMT

do you believe in the benefit of these rechecks? If you're not convinced yourself completely of the value, you'll never be able to "sell" it to the clients.

We always let the client know that they need a recheck every 6 months when we first start them on chronic medications. By warning them at the start (and recording we have told them), we get very few arguments. There is still the occasional difficult person, but we believe in what we offer so they either need to bring the pet in or go elsewhere.

The vets have discretion to insist on rechecks more frequently than every 6 months, but no POM's are dispensed if the pet hasn't been seen in the previous 6 months. Fortunately Advocate, etc aren't prescription medications in Australia so we don't have to worry about that.

RE: Repeat meds checks - what is your policy?

Fiona French — Tue, 08 Mar 2016 13:41:54 GMT

Many thanks for all your replies. It sounds like we are being a bit soft, and need to be a bit more insistent that the pets receive their checks, and explain why. Most clients are fine, but there's always the odd one who kicks up a stink for the sake of saving themselves a few quid! I guess these are not the sort of clients we want anyway....

RE: Repeat meds checks - what is your policy?

Michael Woodhouse — Wed, 02 Mar 2016 22:36:43 GMT

12 months flea and worm.

6 months max for POM-V, with 2 months max meds (couple of opportunities for 'how is he getting on'). Unstable cases much sooner.

If you are going to run out of treatment then we will give 7 day supply (or smallest bottle) to tide over. I can only think of 2 occasions when we have not followed this and both involved owners in hospital.

More flexible regarding bloods etc if case going well.

RE: Repeat meds checks - what is your policy?

Martin Atkinson — Wed, 02 Mar 2016 19:15:17 GMT

[quote user="Nicola M"]

Also, I'll always try and tie in one meds check a year with the vaccination.

[/quote]I do the same and bring it forward or delay a little while to tie in so they think you're being generous.

RE: Repeat meds checks - what is your policy?

Nicola Cole — Wed, 02 Mar 2016 18:37:24 GMT

Also, I'll always try and tie in one meds check a year with the vaccination.

RE: Repeat meds checks - what is your policy?

Stephanie Wellings — Wed, 02 Mar 2016 18:28:31 GMT

We aim for every 3 months (check up and usually monitoring bloods) for stable patients, but we do use disclaimers for e.g. Stable hyperthyroid cats, long term NSAIDs, where the owners want to keep costs to a minimum, basically saying they have declined the recommended check up or monitoring and they accept responsibility for any adverse effects.

The signing of the disclaimer has to be discussed with a vet - and I find probably over half the clients who flatly refuse a healthcheck/blood test when the receptionist offers it, will accept it if explained by a vet in a balanced way, related to their animal Rather than as a 'policy'. 'So and so is due a blood test' is less convincing than 'I would like to make sure we are getting his dose right, especially as he has lost a bit of weight, we might find we can control the t4 a bit more tightly'.

RE: Repeat meds checks - what is your policy?

Nicola Cole — Wed, 02 Mar 2016 18:24:52 GMT

Depends on which drug-if ongoing stable condition then every 6 months, if unstable or a drug/condition that requires closer monitoring then usually 1-3 months depends on case and entered on notes. Policy is always to warn owner in initial consult of how often check ups are required to dispense medication so it doesn't come as a surprise to them. As to how strictly enforced-if at the end of their time interval then they are asked to come in for appointment. If they can't make it in for a few a days then the owner is asked to make an appointment within a few days and the number of tablets needed to tide over til appointment slot given (this happens rarely as usually if you can get yourself to the vets to pick up meds you can bring your pet with you).

For aggressive animals its case by case....

RE: Repeat meds checks - what is your policy?

Martin Atkinson — Wed, 02 Mar 2016 17:56:45 GMT

Strictly every 3 months. We may give a few tablets to tide them over a week or so but some try to use this as a way through the back door. We do however give a big (30%) discount if they buy 3 months at a time and none on small amounts so that encourages them.

RE: Repeat meds checks - what is your policy?

Holly Norman — Wed, 02 Mar 2016 17:07:07 GMT

We do repeat med checks every 3-6months depending on condition/stability etc. We make it very clear in the clinical notes how many repeats are allowed and when the animal is next due to be seen.

Some clients will always complain. Yes, we will refuse to dispense medication if the animal hasn't been seen.

RE: Repeat meds checks - what is your policy?

Gillian Mostyn — Wed, 02 Mar 2016 16:56:47 GMT

3-6 months, varies on drug, how stable animal is, temperament etc. Previous vet stipulates on record length of time till next check. (Can be 1 month for unstable DM etc).

As far as clients, some will always complain. That is a given. Just make sure no one ever backs down. Ever.

As far as where an animal will suffer if meds are withheld, we give 2 weeks worth and make it crystal clear they will receive no more without us seeing the animal. Any welfare problem is the clients responsibility.

RE: Repeat meds checks - what is your policy?

Robin Grimmer — Wed, 02 Mar 2016 16:51:19 GMT

Every 3 months, strictly enforced. If everyone is singing from the same hymn sheet it works much better. Meds cu is a reduced consult fee. Some try it on by trying to get an order in just before the 3 months is up, but we insist on a meds cu and only give them enough meds to keep them going til the appointment.

RE: Repeat meds checks - what is your policy?

J G Wray — Wed, 02 Mar 2016 16:46:14 GMT

[quote user="Fiona French"]We have practice guidelines for how often pets needs to be checked by a vet when on long term medications - so for example we say every 6 months for NSAIDs. We inform the clients of this when they start long term meds and most are happy to book in for a recheck when they are due, but we do get the odd client who insists that they do not want to pay for a health check, they just want the medication.......[/quote]

Are you all, to a man/woman, clear about why the policy exists? I'm not asking about why, in the sense that it's policy therefore... but how it was derived for that situation. Is it driven by the needs of the patient and their condition or your convenience or possible unwanted side effects with 6months and one day's usage? If you all have that clear and are all articulating the same message then it becomes a message which is clear to the clients that that is how you see your practice delivering optimal care in a predictable manner.

You may also be building a rod for your own back if any clinician is rushing these exams and the client is perceiving poor value from them. We've all worked in practices where these consults are seen as catch-up consults. Guess what happens if you do.

Rather than make up new policy, how about checking everyone's on message and giving value for the meds check consult?

RE: Repeat meds checks - what is your policy?

grumpyoldman — Wed, 02 Mar 2016 16:30:47 GMT

6 months NSAIDS ,3 months Cardiac meds ,hyperthyroidism , renal depends upon the case .