Medication refill safety review
Structured refill assessment to reduce medication errors, interaction risk, and delayed escalation.
Last reviewed February 7, 2026
Red flags
- Refill request without clear ongoing indication or recent clinical reassessment.
- Symptoms suggesting treatment toxicity or serious adverse effect.
- High-risk medication with missing monitoring data.
Assessment priorities
- Confirm active indication, recent response, and current adherence barriers.
- Reconcile all prescribed, over-the-counter, and supplement medications.
- Check for high-risk interaction, renal/hepatic concerns, and duplicate therapy.
Initial management
- Prioritize safety-critical medications and monitoring-dependent therapies.
- Assess risks from both continuation and interruption; arrange a safe bridging or taper plan when indicated instead of abruptly withholding essential or dependence-forming medicines for a routine monitoring gap.
- Update plan with dose, indication, and stop/escalation criteria.
- Align refill duration with risk level and follow-up reliability.
Follow-up and escalation
- Set review interval before next refill for high-risk regimens.
- Escalate when adverse effects, instability, or monitoring gaps persist.
- Document patient counseling and return precautions.
References
- Choosing Wisely Canada recommendations (opens in a new tab)
- Institute for Safe Medication Practices Canada (opens in a new tab)
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