Discovered double-doctoring? What’s your next step?

Recently, the college has received a number of phone calls from pharmacists who have discovered patients who are double-doctoring and visiting multiple pharmacies for prescriptions such as zopiclone 7.5mg.

As a reminder, the HPA Standards for Pharmacist Practice state:

Standard 2. A pharmacist must consider appropriate information for each patient.

2.2  Appropriate information means the following information in relation to a patient:

(c) treatment history including drug therapy and outcomes for the condition;

            (g) other drugs or blood products being used;

Standard 3. A pharmacist must determine whether a patient has or is likely to have a drug-related problem.

    3.2  A drug-related problem includes the following circumstances in relations to a patient

(d) Over dosage – Taking or receiving too much of the right drug or blood product

Standard 5.  A pharmacist must not dispense a drug or blood product under a prescription unless the pharmacist has determined that the prescription is current, authentic, complete and appropriate.

        5.6 A pharmacist must determine the appropriateness of a prescription for the condition being treated by considering relevant factors that a reasonable pharmacist would consider in the circumstances including, but not limited to, whether:

 (d) there is therapeutic duplication

Some of the information required under the standards can be found on Netcare.

Questions to ask yourself:

1. Have I considered the appropriate information for this patient?
2. Do I know this patient and their prescriptions?
3. Is this patient receiving similar (e.g., another hypnotic) or the same prescription from multiple doctors?
4. Is this patient early for their refill?
5. Has this patient used up his/her refills in a short period of time?
6. Has the patient asked for another prescription because he/she lost the medication? Is this a frequent occurrence?  

Taking the time to answer these questions will help ensure that you are providing safe, effective, responsible, and quality patient care.

Originally published in the July 14, 2009, issue of The Link