Hi nancym. I am a HIV/AIDS Care-coordinator in a large clinic and med refills is a large part of my daily job. Because there are so many problems associated with HIV/AIDS besides the virus, these patients may be swamped with medications. I will give you guides that I use. I have approximately 10-15 Doctors at any given time that are caring for our patients.
1. Whenever we get a new doc on board, I ask how he/she wants their med refills handled (rarely there is one that wants to solely do their own). I obtained their expressed permission.
2. I always do a chart reveiw before calling in any refill, nothing extensive, but I check the last few clinic notes to make sure nothing was a trial matter, or no change was planned. I also do this to verify what the patient or pharmacy is requesting, since I have been given conflicting info by the patients and have found errors with the pharmacies.
3. If the request is for a prn that its obvious that the patient has not used in sometime, I always verify with the doc first. An example would be a Rx for antianxiety med ordered almost a yr ago at #15. It alerts me and the doc that the patient may have another problem going on.
4. I never refill antibiotics other than the routine HIV/AIDS prophylaxis.
5. I always document who called, what med was needed, what I called in and the entire order. I then leave this in the MDs box for them to sign, it then becomes part of the record.
6. I also use this opportunity with the patient on line to see if they are doing okay, if they know when their next appt is, and if their labs are current. It is an excellent way of touching base with the patient and obtaining info if your clinic allows for this. Of course, I document any pertinent info that I obtain from the patient.
7. By the way, if the patient has not been seen in clinic for awhile...I may and often do, only order enough meds until they can be seen. I just explain that the doc cannot adequately treat them without seeing them, or checking labs, etc. This has been a great incentive to the patient and helps keep the docs in compliance also.
Hope this helps, you can e-mail if you want more.