“I understand that this is an unusual choice for medication abuse, and…”
This is an excerpt from an email we recently received at the college:
“We have a patient at our pharmacy who has been abusing inhalers (Advair/Ventolin). Due to multiple DINs (brand/generic/HFA/diskus) it is not automatically rejected by her insurance program.
“I understand that this is an unusual choice for medication abuse, and we are working closely with her insurance and doctor to try to ensure safe therapy. Unfortunately, we have noticed on Netcare that she is getting pharmacists to prescribe “refills” of her inhalers, in addition to double-doctoring, allowing her to fill a month’s supply every 5-7 days. Narcotics are not the only medications that can be abused/diverted/misused and pharmacist prescribing is clearly another source of access for this particular patient. Is it possible to include an update on this in the next email mail-out to pharmacists to increase awareness?
“This could be avoided if pharmacists with whom she is not a regular customer checked Netcare prior to prescribing/filling.”
The lessons?
- Check Netcare BEFORE preparing a prescription. This is a must for patients who are not regular customers, but is also sound practice for all your patients. Pharmacists must consider appropriate information for each patient (see Standard 3).
- Always assess appropriate use of medication to prevent both abuse and misuse.
If you hold additional prescribing authorization, also ensure that you conduct a thorough patient assessment (including checking Netcare) before making any prescribing decisions. See Standard 14 for assessment requirements.
