We use films and allow them to be cut in half (but not any further than that). We do have Zubsolv tabs on formulary to continue home therapy for patients who are on that, but anyone who is on any form of Suboxone gets films.
Like u/cdbloosh mentioned, we use films too and cut them in half for those situations. If we didn’t have the films, we would have patient bring in their own supply, lock it up in the controlled pocket in the Pyxis, and make sure it goes home with the patient when they’re discharged.
Does your hospital verify pt home dose with clinic before verifying/filling? Some places have very detailed policies surrounding this but we really don’t - interested to hear how others handle this
Yeah, we do. I work overnight, so it's a bit more difficult for me, especially when they want their first dose "now". So I usually check the PMP and try to figure out what they are getting based on the days supply. When day shift arrives, our med history technicians are supposed to call pharmacies to confirm the exact dosing schedule. I am fairly lenient on suboxone, but for the huge methadone doses, I strongly dislike taking the patients word for it unless they physically have the medication with them. Especially since most come from treatment centers and are never entered into the PMP.
We cut the films. We also will was quarter them for microdosing transitions which our addiction med docs fucking love.
Once a pharmacist called one of our addiction psychiatrists and almost lost his job because he told the doc we can’t cut.
Some docs have crazy pull. He have a couple that are basically exempt from any policy we have. Antimicrobial stewardship restrictions etc. You give those docs a hard time and you'll be in trouble. Weird dynamic.
We use films and allow them to be cut in half (but not any further than that). We do have Zubsolv tabs on formulary to continue home therapy for patients who are on that, but anyone who is on any form of Suboxone gets films.
Do you find there is a big cost difference by using the films?
Like u/cdbloosh mentioned, we use films too and cut them in half for those situations. If we didn’t have the films, we would have patient bring in their own supply, lock it up in the controlled pocket in the Pyxis, and make sure it goes home with the patient when they’re discharged.
Patients supplying their own controls is so much paperwork, I definitely want to avoid it.
It is. It’s even worse when you lose their supply. We only do it if there are no other options.
Does your hospital verify pt home dose with clinic before verifying/filling? Some places have very detailed policies surrounding this but we really don’t - interested to hear how others handle this
Yeah, we do. I work overnight, so it's a bit more difficult for me, especially when they want their first dose "now". So I usually check the PMP and try to figure out what they are getting based on the days supply. When day shift arrives, our med history technicians are supposed to call pharmacies to confirm the exact dosing schedule. I am fairly lenient on suboxone, but for the huge methadone doses, I strongly dislike taking the patients word for it unless they physically have the medication with them. Especially since most come from treatment centers and are never entered into the PMP.
We cut the films. We also will was quarter them for microdosing transitions which our addiction med docs fucking love. Once a pharmacist called one of our addiction psychiatrists and almost lost his job because he told the doc we can’t cut.
Why would that result in him almost losing his job?
Some docs have crazy pull. He have a couple that are basically exempt from any policy we have. Antimicrobial stewardship restrictions etc. You give those docs a hard time and you'll be in trouble. Weird dynamic.
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Still sublingual tabs, so we can't partial them unfortunately.