If there is confusion for the pharmacist about the reason for a prescription or if there are other questions for the provider, the pharmacist should contact the provider directly. A 2017 study showed that of the prescriptions requiring clarification, 74% were new prescriptions and only 36% of clarifying prescriptions were prescribed electronically. The most common reasons the pharmacist contacted the prescribing physician were pre-approvals and lack of prescription information. The study found that the most effective way to correct these misconceptions was through telephone contact. [5] EPCS was introduced in 2010 by the DEA, which stipulated that clinicians could submit prescriptions for controlled substances electronically; He also said pharmacies could dispense these e-prescriptions. The use of EPCS from a clinician`s and pharmacy`s perspective is voluntary, and each party can choose whether or not to use the system (however, some states such as New York make the use of e-prescribing mandatory with some exceptions). Practitioners can still write and sign prescriptions for Schedule II-V drugs if they wish; Verbal orders are only permitted for Schedule III-V drugs. The introduction of e-prescribing has significantly reduced the number of medication errors from a prescribing point of view (readability, dosage, frequency, etc.). [3] [2] Controlled substances can be prescribed by a variety of clinicians: physicians, dentists, mid-market suppliers, podiatrists, etc.
The prescribing physician must be licensed by the DEA and practice at the specified place of origin of prescription. A 2017 study found a significant reduction in prescribing errors for patients discharged from emergency rooms when medications were prescribed electronically rather than by hand. Specific results were that e-prescribing showed a decrease in the incidence of missed doses, inaccurate frequency of medications, inaccurate dose, and general ability to read the document (e.g., clinician`s handwriting was illegible). [7] F. A pharmacist may dispense a controlled substance on the prescription of a non-governmental physician for medicine, osteopathy, podiatry, dentistry, optometry or veterinary medicine, a nurse or medical assistant authorized to issue such a prescription, if the prescription complies with the requirements of this chapter and the Drug Control Act (§ 54.1-3400 et seq.). A physician who has established a bona fide physician-patient relationship with a patient in accordance with the provisions of this subsection may prescribe controlled substances in Schedules II to VI by telemedicine to that patient if the prescription meets the federal requirements for the practice of telemedicine and, in the case of a prescribed substance in Schedules II to V, The prescribing physician practises in a physical location in the Commonwealth, or is able to refer patients appropriately to a Commonwealth licensed physician to ensure a personal examination of the patient if required by the standard of care. Partial filling for a table II may also occur in patients in long-term care facilities or a patient with an incurable disease, so partial filling may be an individual dose; The pharmacist must document that the patient is terminally ill or in a long-term care facility before partially filling the medication. The remaining portion of the medication must be completed within 60 days of the prescription date, unless the prescription is cancelled because the medication is no longer needed. [1] Partial filling of a prescription for a Schedule II drug is only permitted if the pharmacist cannot provide the patient with the full prescribed amount.
The pharmacist must indicate on the written prescription or electronic record how many tablets or capsules have been dispensed. Under the Narcotic Control Act, the partial dispensing of Schedule II drugs must occur within 72 hours of the initial allocation, after which the prescription for the remaining undispensed quantity is no longer valid. If this task cannot be accomplished, the pharmacist must contact the physician to obtain a new prescription. [4] Complete and correct prescribing avoids delays in patient care It is estimated that more than 230 million medication errors occur each year in England (Elliott, 2021). Of these, 21% occur at the prescribing stage and over 50% have the potential to cause moderate to severe harm to patients (Elliott, 2021). Prescribing errors, including those made when writing prescriptions, are relatively common but largely preventable causes of harm, occurring in 4.9% of primary care prescriptions (Avery, 2012) and 7-10% of physician services (Maxwell, 2016). It is hoped that by highlighting legal requirements and best practice recommendations for writing prescriptions, this article will reduce the associated risks by ensuring a clear, and comprehensive legal prescription. In accordance with good practice, the Ministry of Health strongly recommends that the maximum amount of CDs prescribed in the lists should not exceed 2, 3 or 4 30 days. In rare cases, a prescription may be issued for more than 30 days to address a legitimate clinical need and after considering potential risks. However, the reason for this must be clearly stated in the patient`s notes. It`s important to remember that individual states can pass laws that change the way they regulate prescribing requirements for different drugs.
An example of this is marijuana, which is considered a Schedule I drug at the federal level, while some states allow its medical use and distribution. Pharmacists and practitioners should be aware of the legislation in their practice to ensure the most appropriate patient care. [1] G. A nurse licensed to prescribe controlled substances in accordance with § 54.1-2957.01 may, in the course of his professional activity, provide his patient with prescriptions or samples from the manufacturer of controlled substances and devices within the meaning of the Drug Control Act (§ 54.1-3400 et seq.) for bona fide medical or therapeutic purposes. The use of e-prescribing systems reduces the frequency of prescribing errors; However, they do not completely eliminate them or change the types of errors that occur (Donyai, 2008). While e-prescribing reduces errors caused by illegible or incomplete prescriptions, it increases incorrect selection of drug, route, dose, frequency, formulation or pathway from drop-down menus. This could, for example, lead to the prescription of medications twice a day instead of twice a week (Donyai, 2008). In order for a pharmacist to dispense a controlled substance, the prescription must contain certain information to be considered valid: Step 1: The pharmacist will ask you if you have visited this pharmacy before. If the answer is no, you will be asked to complete a consent form. This allows the pharmacist to fill your prescription. If the answer is yes, they will be asked for an identifier (date of birth or home address).
This allows you to easily search for your prescription documents in the pharmacy`s computer system. You will then be asked if you have ever received this medication and when it is used. This information allows the pharmacist to personalize your medication consultation when taking charge of the medication. Controlled substances listed in Annex II § 1306.11 – Mandatory requirement. § 1306.12 – Renewal of prescriptions; Issuance of several recipes. § 1306.13 – Partial enforcement of orders. § 1306.14 – Substance Labelling and Prescribing. § 1306.15 – Provision of prescription information between retail pharmacies and central filling pharmacies for prescriptions of List II controlled substances.