Repeat Prescription Review of Long Term Medicines
Audit and Report template
Auditor:
Date of Audit:
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Select 15 random patients for the practice. Patients must be on long term medicines.
Audit
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NHI
Specific Medicines Reviewed
1.
2.
3.
4.
Date of last medication review
Is there an indication for each
medicine?
Are the directions and dose for
each medicine appropriate?
Is each medicine still effective?
Is each medicine well tolerated?
Are there any potential drug
interactions to the specific
medicine/s?
Is each medicine still
appropriate and cost-effective?
Is the medicine still funded by
PHARMAC?
Adapted from RNZCGP CORNERSTONE General Practice Accreditation Programme 2011
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Audit
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Is the medicine still needed for
the patient?
Is the patient being monitored
for potential adverse effects
and/or organ function? e.g.
renal, hepatic, lipids?
Does the patient need any other
medicine at this time?
Are all sensitivities / allergies
recorded in the medical notes?
Have the computer notes been
clearly marked with a date for
this review?
Has the patient received
education / counselling
regarding each medicine?
Does the patient take any
complementary OTC / herbal
therapies? What are they?
Other issues
Comments:
Adapted from RNZCGP CORNERSTONE General Practice Accreditation Programme 2011
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Action Plan:
#
Action
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By whom
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Discussed at Clinical Meeting/Staff Meeting
Yes /No
Date:
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Signature:
(print name)
Date:
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Adapted from RNZCGP CORNERSTONE General Practice Accreditation Programme 2011