Mary Hawking wrote:
> In message <[log in to unmask]>, Jeff Green
> <[log in to unmask]> writes
>
>> Ewan Davis wrote:
>>
>>> Some GP systems (certainly TPP SystmOne) will allow you to prescribe
>>> at dm+d AMPP (actual medical product pack) level which will allow
>>> prescribing of a particular brand or manufacturer.
>> I see loads of generic scripts where a manufacturer is specified.
>> Overwhelmingly it is for no reason and is ignored. (Just like the
>> word AEROSOL that seems to appear under hypromellose eye drops 0.3%
>> scripts.)
>
> How do you know it is for no reason - and who is liable if a
> dispenser ignores a prescriber's instructions? And how on earth does
While I would accept that due to poor system configuration scripts often
appear with manufacture specified for no good reason - The pharmacist can't
know this and is REQUIRED to follow the prescribers instruction unless they
agree a change with the prescriber. The pharmacist would have no defence if
there was a good reason and harm results. Where a script is obviously
incorrect (as in the aerosol example) and the prescribers intention is
obvious the dispenser might be on firmer ground but guessing what a
prescriber might have meant is always a risk, which for good practical
reason pharmacist take all the time.
Sadly GP and pharmacist sit down together locally to discuss these things
much-much less than one would hope. In my early work with ETP one of the
collateral benefits was that GP and pharmacist were brought together to
discuss the process and many irritations that had existed for years were
sorted out in minutes.
If your getting lots of scripts for branded generics you need to talk to
then practice that is producing them. I saw this with a practice using TPP
SystmOne where branded generics were at the top of the picking list, being
picked for no good reason and driving the local pharmacist to distraction. I
know little about SystmOne but it took me all of 90 seconds to spot the
configuration option which immediately solved this problem.
> "AEROSOL" get attached to eye drops?
> Where does the word appear? On the prescription or the pharmacy
> system?
The Aerosol example probably points to a drug data error either in the EMIS
Mentor or FDBE drug databases (all suppliers use one of these) or just
possibly a software fault - Both data and system suppliers will fix these
sort of problems, but only if someone tells them. If you have example of
errors like these and send a scan of the script to me (with patient but not
practice identifiers obliterated) I will make sure they get to the right
people. If you know the which system originated the script it would help,
but is not essential.
> If on the prescription is it one practice, one system or random?
> Impossible forms being prescribed reminds me somehow of EDLs - and
> are a patient safety issue!
>
>>
>>> AMPP's are often excluded from picking
>>> lists as in is not generally desirable to prescribe a particular
>>> brand of generic and it may require some extra keystrokes to get
>>> them to display. I a pretty confident that this approach will work
>>> with ETP.
>> At my end of the system ETP hides information that was on my PMR -
>> stuff like which brand of diltiazem.
>
> Aren't slow release diltiazems among the things that should not be
> prescribed generically?
>>
>> It's not all bad though - it stops some of the common pharmacy errors
>> like repeating last months script when the dose has been changed.
>
> How? It doesn't seem to round here!
>
> Mary
>>
>> Jeff
Ewan Davis - Director - Woodcote Consulting
See our website at www.woodcote-consulting.com
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