Pharmacists - why so slow?

What happens to a prescription when the pharmacy receives it?

1.. Identification.
On receipt of the prescription the pharmacist must first identify that the prescription is for the patient who presents it. In the pharmacy that I work in we have 770 patients with the same surname. 35 of these have Michael as a first name and 26 have Mary as a first name. Some of those with the same first name and the same surname live at the same address. The local doctors would have the same problem. Where possible patients should provide their address and their date of birth. A mobile phone number would also be useful.

2.. Is the prescribed medication suitable for that patient?
If the prescription is for a Penicillin antibiotic; is the patient allergic to Penicillin?
Sometimes a patient will see a locum doctor or a weekend doctor. These doctors might not be fully aware of the patient’s medical history or aware of the patient’s medication. Sometimes when a patient may not remember their own medication. For example a patient on heart medication should not be prescribed Domperidone (Motilium).

3. Is the dosage of the prescribed medication correct?
For example; inadvertently the prescribing doctor may have prescribed a child’s dose for an adult.

4.. Is there an interaction between the prescribed medication or with any other medication that the patient is on?
For example a patient prescribed a Potassium sparing diuretic should not also be on a Potassium supplement.
Another example; a patient on Warfarin should not be prescribed oral Miconazole. (the combination caused a death in Ireland two years ago)
Patients on Statins (anti-choloesterol) should temporarily go off the Statins if they are prescribed an anti-biotic called Clarithromycin.
5.. Checks and balances.
Several pharmacies have two professional staff checking each prescription. Other pharmacies have strict Standard Operating Procedures for checking the accuracy of prescriptions and dispensing. Frequently a pharmacist will contact the prescriber to verify a prescription.
In a recent survey of Irish pharmacists; 96% said that they correct 3 or more prescribing errors every day. The same survey showed that 60% of Irish pharmacies correct more than 6 prescription errors every day.

6.. Legal and Legislative considerations.
A pharmacy is required to keep a record of every prescription dispensed for two years. The pharmacist has to record each dispensing of a repeat prescription. In addition the pharmacist has to sign, date and stamp each prescription. In some circumstances the pharmacist has to make an additional record of a prescription together with the name of the prescribing Doctor, doctor’ address, patient’s name and address, the name and amount of the drug and the balance of the drug remaining in the drug safe,

7.. Patient consultation.
Many prescriptions involve a discussion between the patient and the pharmacist. For example; some liquid anti-biotics need to be stored in a fridge once they have been re-constituted. Other prescriptions will require different consultations between patient and pharmacist.

8.. Adherence.
Some patients may not use their inhalers properly and may need help and advice. Other patients may neglect some of their prescribed medication or may not take their medication properly or at all; in these cases the pharmacist should ask questions and should encourage compliance.

9.. Confusing drug names.
Some drug companies place two or more drugs in the same tablet. An example of this is a tablet called Acerycal. Acerycal is a combination of two drugs called Perindopril and Amlodipine. There are four presentations of Acerycal; 5/5, 10/5. 5/10 and 10/10. Sometimes a prescriber just writes Acerycal on the prescription; in cases like this the pharmacist has to do a lot of checking.

10.. Hand writing.
Some doctors have really nice hand writing. However in some cases the prescription looks like a drunken spider has written on the page. It can take a few minutes to decipher some hand writing.

palmcut wrote: »

What happens to a prescription when the pharmacy receives it?

That's a great post palmcut. I love getting an insight to someone else's job - you only ever get a glimpse of how complicated it is from the outside.

MHGE, you might also browse and buy some thing else in your waiting time.
The 1/4M clear profit has to be made up some way. You must contribute as much as you can.

palmcut wrote: »

2.. Is the prescribed medication suitable for that patient?
If the prescription is for a Penicillin antibiotic; is the patient allergic to Penicillin?
Sometimes a patient will see a locum doctor or a weekend doctor. These doctors might not be fully aware of the patient’s medical history or aware of the patient’s medication. Sometimes when a patient may not remember their own medication. For example a patient on heart medication should not be prescribed Domperidone (Motilium).

3. Is the dosage of the prescribed medication correct?
For example; inadvertently the prescribing doctor may have prescribed a child’s dose for an adult.

4.. Is there an interaction between the prescribed medication or with any other medication that the patient is on?
For example a patient prescribed a Potassium sparing diuretic should not also be on a Potassium supplement.
Another example; a patient on Warfarin should not be prescribed oral Miconazole. (the combination caused a death in Ireland two years ago)
Patients on Statins (anti-choloesterol) should temporarily go off the Statins if they are prescribed an anti-biotic called Clarithromycin.

How do ye know what each patient is on? I get a different prescription for each drug, and I don't go to the same pharmacy each time?

Just on the doctor's handwriting- hospital staff (and I'm sure GPs) have very little time to write our notes. Often you have an intern SHO writing the notes while standing by the bedside with nothing to lean on while the consultant is leading rounds. This is why notes look scrawled.

Depends on the circumstances. They could have had a few long prescriptions dropped in before you handed in yours. Generally if it's quiet you should have the antibiotic in under 5 minutes.

mhge wrote: »

How is it done in other countries though, I lived abroad and I don't remember ever having to wait unless it was something that needed to be mixed from scratch. They seemed to rely on the prescription, and only if there was something wrong with the way prescription was written (more often printed) it would stop the process. Are people dropping like flies over there or what... You wouldn't have this chain of people that seems to be the thing here either, no wonder prescriptions are so eye wateringly expensive if they are handled by so many people for so long.
Is this system unique? Is it the same in the UK for example, or Spain?

It's the same in the UK because we have roughly the same system as them in terms of prescription drugs/OTC and dispensing law. Spain probably seems quicker because more of their drugs are OTC as opposed to being prescription-only.