Repeat prescriptions and blood monitoring forms

If you are prescribed Azathioprine/mercaptopurine:

To ensure a smooth process for patients, we have a system in place, which most patients will be familiar with when requesting repeat prescriptions from their GP practices. Patients identify when their next prescription needs ordering and request electronically or via a text message reminder.

This will ensure prescriptions are provided in a timely manner, allowing time for the pharmacy departments to process the prescriptions and reduce any unnecessary delays in medication availability. Importantly, this will allow more members of the IBD team to be available to increase the capacity of the IBD phone clinics and further support patients.

As part of your treatment with thiopurines, it is important to attend for regular blood monitoring. When first commencing treatment, we advise the below regime for safe monitoring and prescribing of your treatment.

• Fortnightly for 8 weeks
• Monthly for 4 months
• Every 3 months thereafter

It is important to continue having 3 monthly blood tests in order to ensure that it is safe to continue your medication. THIS IS YOUR RESPONSIBILITY.

In order to make this process work well, the following is respectfully expected of you:

• Ensure you attend for regular blood tests (as listed above),

     NO BLOODS NO PRESCRIPTION     

• Three weeks before your medication is due to run out- please send an email or sms request to the IBD team to repeat your prescription.
• E: ibd.team@nhs.net M:07824 408435 (this number does not take calls)
• The above portals are strictly for requisitions and not for advice on symptoms or non- medication related queries.
• If you change any of your contact details, including your mobile or landline telephone numbers, please ensure the IBD team are aware of the changes.

Whilst you do not need to have an appointment with the IBD team for repeat prescriptions, you must still attend your routine clinic appointments and adhere to blood monitoring requirements as the hospital needs to monitor your health. The hospital will not be able to continue prescribing thiopurine treatment without these check-ups. It is important that you attend all hospital appointments and blood monitoring requests arranged for you.

Identify: 2 weeks of medication remaing (see below)

Request: IBD.TEAM@NHS.NET, 07824 408435, Name, date of birth, hosptiail number and medication required.

Supply: Precription issued, 2 week preiod for prescription to be processed.

If you are prescribed treatment that is delivered to your home address i.e. adalimumab, ustekinumab, golimumab, vedolizumab, infliximab, methotrexate (all these are subcutaneous injections), tofacitinib, upadacitinib, filgotinib (tablets):

Homecare is a way of delivering certain medicines prescribed by the hospital, directly to your home or any place you choose, without the need for you to come to the hospital every month to collect prescriptions.

Homecare providers currently use an automated emailing system to generate reminders to the IBD team to provide a repeat prescription. From generating a prescription to being processed by the Homecare provider for delivery, a time lag of up to 3 weeks is expected.

To ensure a smooth process for patients, we have a process which most patients will be familiar with in their GP surgery. Patients identify when their next prescription needs ordering and request electronically or via a text message reminder.

As part of your treatment monitoring, regular blood tests are needed to ensure you are tolerating the medication. Initially these are required monthly. If after the first 2 tests the results are stable, the tests can be performed 3 monthly thereafter. These are your responsibility to schedule when due. Blood forms are requested in advance via the same email or text number as for repeat prescriptions. No bloods, No prescription.

Blood tests can be pre booked at your GP practice or there are drop in phlebotomy services at Calderdale Royal Hospital and Acre Mill Outpatient Department in Lindley.

This will ensure prescriptions are provided to Homecare providers in a timely manner, allow the Homecare provider to process as per their protocols and timeframe, ensuring there are no delays in delivery of medication. Importantly, this will allow more members of the IBD team to be available to increase the capacity of the IBD phone clinics and further support patients.

In order to make Homecare delivery of medications work well, the following is respectfully expected of you:

• Three weeks before your medication is due to run out- please send an email or sms request to the IBD team to repeat your prescription.
• E: ibd.team@nhs.net M:07824 408435 (this number does not take calls)
• The above portals are strictly for requisitions and not for advice on symptoms or non- medication related queries.
• If you have arranged a delivery time with the Homecare provider, please make sure you are in to receive the delivery as failed deliveries put a strain on the system.

If you change any of your contact details, including your mobile or landline telephone numbers, please ensure the IBD team and the Homecare provider is aware of the changes.

• If you are going away for a while and think you may miss a delivery, please contact the Homecare provider (customer services) and the IBD team. They may be able to arrange to deliver your medication earlier for you or to another address but they will need plenty of time to organise this for you.
• If you think you may be running out of your medication and have not been contacted by the Homecare provider to arrange a delivery, please call their customer services number.

If problems persist, contact the IBD team via the given email addressing.

Whilst you do not need to come to the hospital for prescriptions, you must still attend your routine clinic appointments and adhere to blood monitoring requirements as the hospital needs to monitor your health. The hospital will not be able to continue Homecare for you without these check-ups. It is important that you attend all hospital appointments and blood monitoring requests arranged for you.

Identify: 3 weeks of medication remaing (see below)

Request: IBD.TEAM@NHS.NET, 07824 408435, Name, date of birth, hosptiail number and medication required.

Supply: Precription issued, 3 week preiod for prescription to be processed, Homecare provider will schedule delivery.

When to repeat:

Adalimumab fortnightly                   Two pens remain

Adalimumab weekly                         Three pens remain

Filgotinib                                            21 Tablets remaining

Golimumab Monthly                         Repeat request one week after having injected last pen

Methotrexate weekly                        Three syringes remain

Tofacitinib                                         Three blisters of tablets (21 tablets) remain

Vedolizumab                                      Two pens remain

Upadacitinib                                      One blister pack of tablets (14 tablets) remain

Ustekinumab                                     Three weeks before next scheduled dose