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Alert: multiple-doctoring with Adderall prescription

February 24, 2009

ACP would like to alert you to a drug-seeking operation we have just learned of. A ten-year-old girl in Edmonton is being treated with Adderall for ADHD. Her physician has become aware that the girl’s father is using her medication and also taking her to other physicians to obtain prescriptions for Adderall in her name, but for his use.

If you receive a prescription for Adderall for a young girl, please check Netcare to see if other Adderall prescriptions issued by other physicians have already been filled for the individual.

This case is an example that demonstrates that although a prescription may be current, authentic and complete, a pharmacist must also ensure it is appropriate for their patient. You are reminded to ensure that before dispensing a drug, you determine the prescription is appropriate in accordance with Section 5.6 of the Standards of Pharmacist Practice:

Factors to be considered in determining the appropriateness of a prescription

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:

(a) the prescription is accurate;

(b) the prescription orders a drug or blood product for an indication that is:

(i) approved by Health Canada,

(ii) considered a best practice or accepted clinical practice in peer-reviewed literature; or

(iii) part of an approved research protocol;

(c) the dose, frequency and route of administration are appropriate;

(d) there is therapeutic duplication;

(e) there are actual or potential adverse reactions, allergies or sensitivities;

(f) there are actual or potential drug interactions;

(g) the regimen for administration is practical, based on the patient’s functional ability;

(h) the patient’s organ function, such as renal and hepatic function, will tolerate the drug or blood product;

(i) the results of laboratory or other tests, if applicable, support that prescription; and

(j) other patient-specific characteristics such as age; pregnancy or lactation status; cognitive, mental and physical challenges; lifestyle; cultural beliefs or living environment may negatively affect the appropriateness of the drug or blood product.

Take advantage of all available technology and resources when applicable to help determine appropriate medication therapy.

Originally published in the February 24, 2009, issue of The Link