What
are Pharmacy Prescriptions?
The
legal document that doctors must fill out when prescribing a drug, or more than
one drug, is called a prescription (community) or, in the case of hospitals,
it’s referred to as a medication order. Here in our review of pharmacy
prescriptions, we discuss how they are written, processed and entered.
Prescriptions are not always written in standard, clear English. Often, pharmacy abbreviations are included. As part of your PTCB test prep, candidates are expected to know these abbreviations and how to interpret pharmacy prescriptions. If you have already studied prescription processing and entry, take a few moments to review our complete guide to pharmacy abbreviations.
Though
prescriptions are most commonly written by physicians, they may also be written
by other healthcare professionals, depending on the US state you reside in.
These
healthcare professionals include:
- Dentists
- Veterinarians
- Physician assistants
- Certified nurse practitioners
Though these professions can write prescriptions, there are limitations on what medicines can appear on their pharmacy prescriptions.
Prescriptions
do not need to be handwritten, either. They can also be sent via fax,
electronic device or through phone. However, all written or faxed
prescriptions must include the doctor’s signature.
In
the case of calls, federal legislation states that nurse practitioners
may phone-in the prescription on the physician’s behalf, though this must be
communicated to the pharmacist and pharmacist only.
Details
on Pharmacy Prescriptions
All
pharmacy prescriptions included mandated details. For the PTCB exam, candidates
are expected to know each of these details. For example, you may be presented
with a question that tests your knowledge of what details should or should not
be included with the prescription.
Each
prescription should include the following details:
- Name, address, and contact details of
the prescriber
- Name of the patient
- Date the
prescription was made
- Inscription –
name, dosage form, strength, and quantity of medicine
- Sig – directions
of use
- Subscription –
details to the pharmacist on whether refills are permitted, or whether a
generic drug can be used in lieu of a trade name. If these details are not
needed, DAW – or ‘dispense as written’ should be noted
- Drug Enforcement Administration (DEA) number
of the prescriber
- Signature of the
physician
Pharmacy
technicians should know how to interpret prescription documents. Recall that
identifying errors is one of the primary roles of the pharmacy technician.
Interpreting prescriptions at early stage is one of those critical checkpoints.
How
to Process a Prescription
To
correctly process a prescription, pharmacy technicians need to forensically
review the document for any possible errors. A systematic approach should be
used to eliminate any possible sources of error.
In
this regard, technicians should search for the following seven criteria:
- Ensure that the prescription is valid
by reviewing date, name, medication, and what quantity of medicine has been
prescribed.
- Verify that the name stated on the
prescription matches the name given by the patient. For
additional authentication, some pharmacies may ask for photo identification.
- Date of birth should be recorded.
This is necessary for insurance purposes as well as to distinguish between
patients who happen to have the same name.
- Phone number should be recorded.
Patients may need to be contacted regarding their treatment.
- Address should be recorded.
This has two functions: first, to ensure that the pharmacy’s patient database
is up to date. Second, an address is needed for controlled substances (II through
to V) according to the Controlled Substances Act.
- Discuss patient allergies.
Discuss with the patient whether they have any allergies. This has two
functions. First, to prevent any potential allergy with the medicine
prescribed, but also to prevent any future allergies in any future
prescriptions.
- Record insurance details.
Insurance details must be collected to ensure that patients do not pay full
price of the medicine; they are recorded purely for billing purposes.
These
remain the seven fundamental rules on how to process a prescription. Next, we
discuss how pharmacy technicians should enter prescription details.
How
to Enter Prescription Details
Pharmacy
technicians are healthcare professionals one of whose functions is to identify
any potential errors. There are two potential errors when entering prescription
details: billing errors and patient profile errors.
Let’s
review the primary steps technicians take to eliminate these risks:
- Patient identification. When searching for a patient in the pharmacy’s database, it’s important that you correctly enter the patient’s surname, as well as the first letter of their first name. A list of names appears, and you should choose the correct name and verify that name with the patient’s date of birth.
- Verify insurance details. This is done when the patient presents their new insurance card.
- Prescriber identification. In the same manner that technicians search for the patient, the same process should be followed for identifying the prescriber. An insurance audit may be performed, or an oversight on behalf of the pharmacist, if the incorrect provider is listed.
- Drug to be dispensed. This can be achieved by entering the drug name or entering the National Drug Care (NDC) number, which is an 11-digit number with the following sequence: 28754-2500-45. The first 5-digits refer to the drug manufacturer; the next 4-digits refer to drug/strength; whilst the last 2-digits refer to package size.
- Quantity dispensed. Due to insurance limitations, the quantity may have to be adjusted. For example, most insurance companies cover quantities up to 30-days-worth of medicine, and not more.
- Directions for use. This is important because if the pharmacy technician incorrectly interprets the prescription, and the pharmacist also misses the mistake, the patient may be prescribed a harmful dose of the medicine.
- Daily supply. If the quantity of drug is specified as 30 tablets and the directions for use state BID (twice daily), the daily dose is 2 tablets per day.
- Refills. Number of refills must be stated and be in accordance with the law. For example: controlled drugs (III through to V) are permitted to have up to 5 refills, with the prescription valid for 6 months only. Controlled drugs II are not permitted to have refills. Non-controlled drugs may have up to 11 refills and the prescription is valid for 1-year from the date it was written.
- Expiration date. Pharmacy technicians must enter a valid expiration date from the stock bottle. An incorrectly entered expiry date could result in a patient taking expired medicines. In the case of the antibacterial drugs, tetracyclines, this can result in Fanconi syndrome.
- Patient insurance. The final step through which the patient’s insurance is processed to ensure that the medicine can be dispensed through that pharmacy.
When
reviewing these steps, always consider the potential for error.
If
these steps were rushed, for example, it is easily conceivable to see how
errors can emerge. Pharmacy technicians must be responsible and handle each of
these tasks with due diligence to prevent any possible patient errors.
Conclusion
As
part of the PTCB exam, you are expected to have a detailed understanding of
pharmacy prescriptions:
- How prescriptions are written and
what details are necessary
- Who is lawfully permitted to write
one?
- How those prescriptions are
accurately interpreted
- How to correctly process a
prescription in the pharmacy
- How to enter prescription details
into the pharmacy patient database
If you are already a registered member of PTCB test prep, we recommend that you now test your knowledge of pharmacy prescriptions through our PTCB practice tests and full-length practice exams.
PTCB
Test Prep is the leading online platform that trains pharmacy technicians in
the United States. Check back to our pharmacy technician blog soon for more
great articles on the must-know details to help you pass the 2019 PTCB test.
