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GPs should write longer duration prescriptions for long-term conditions

Prescriptions covering just 28 days are not based on 'sound' evidence and could be increased for stable conditions, a new study has suggested.

The paper, published in the BJGP, said that medication adherence could improve if longer prescriptions were given.

Lead author on the study, Dr Sarah King, has said that CCGs might wish to reconsider current recommendations for patients with stable chronic conditions.

The research team carried out a literature search across major scientific and literature databases and found 13 studies that met the inclusion criteria, between 1993 and 2015.

All papers looked at primary care in middle and high-income countries, with randomised controlled or observational studies which compared longer-duration and 28-day prescriptions included.

Comparisons were then made between prescription lengths, with various groups including cardiovascular disease, hypertension, diabetes, and depression.

Nine of the studies suggested that longer duration prescriptions were associated with patients being more likely to take their medications.

The paper said ‘studies do suggest medication adherence may improve with longer prescriptions'.

'UK recommendations to provide shorter prescriptions are not substantiated by the current evidence base,' it added.

Dr King said: ‘Currently, the UK Department of Health and Social Care advises that the frequency of repeat prescriptions should balance patient convenience with clinical appropriateness, cost-effectiveness and patient safety but does not specify a recommended period.

‘Given our study results, CCGs and local NHS may wish to reconsider current recommendations for 28-day prescription lengths for patients with stable chronic conditions.’

Fellow study author Dr Rupert Payne, from the University of Bristol’s centre for academic primary care, said: ‘This has been a contentious issue for many years. Our research shows that the current recommendations to issue shorter prescriptions have been based on a lack of sound scientific evidence.

‘There is the potential for longer prescriptions to lead to important benefits, by improving patients’ adherence and thus the effectiveness of the drugs, lessening workload for health care professionals, and reducing inconvenience and costs to patients.’

Last year it was reported that digitally dispensing repeat prescriptions had saved the NHS more than £212 million since 2011 due to the reduction in administrative time for GPs. 


Readers' comments (12)

  • David Banner

    “You look worried sick”
    “Yeah, my GP told me I have to take these tablets every day for the rest of my life”
    “That doesn’t sound too bad”
    “ Well he only gave me 28 pills......”

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  • LOL

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  • Cobblers

    Currently 'in discussion' with my practice about 84 day scripts for my meds as opposed to 28. Review date a year away!

    No brainer in my opinion and would reduce their workload from 13 scripts a year to 4.

    Only losers would be the pharmacy and dispensing fees. I can live with that.

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  • I reckon a standard prescription should cover at least 6 months for stable reliable patients. Arranging repeats all the time is a pain for both staff and patients alike.

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  • the only reason as i understood for shorter scripts was avoiding wastage due to pts losing/spilling/stockpiling if not complying , changes in treatment and eg hospital admissions we've just started trying out repeat dispensing for stable conditions ,looking to be workable

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  • 28 days supply is pointless for hypertension patient whos bp is controlled. gp does not take bp every 28 days. by the time you order and collect script it is time to order again. you may not take medication for few days only because you are not there to collect script every 28 days.
    longer duration of supply will reduce nhs income as cost of script is same for 1 day medication or 3 months.

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  • Dispensing profits keep my surgery afloat.
    Thus two fingers, rampant.

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  • Nhsfatcat

    NHS income is almost irrelevant for PPA costs money to run and most Rxs do not attract a fee. Now pharmacists will lose income. I suspect if we all went to 3 and 6 months prescribing we'd see the Pharmaceutical Society with pitchforks

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  • Cobblers

    Grinding Premolars.

    Shall we put it to the vote?


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  • If few meds and stable we use electronic repeat dispensing. For most happy to do 3 or 6 x 56 days depending on review frequency. Best of both worlds as reduced Admin and cam cancel Rd if changes in that time period

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