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In message <D5C456DC474C4B77BDDA81210A84EB0D@Randan>, Ewan Davis <[log in to unmask]> writes >>> Ho hum - only a few weeks to retirement. >> >> If we find a suitable brand I do include it in the dosage >> instructions - I suppose that would help? Not that any of our local >> Pharmacies use ETP yet! > >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. 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. > >I am also not sure why EMIS is not picking up the sensitivity to the >excipient, maybe their drug data doesn't include excipients I believe other >drug databases do. I'm not sure whether this is possible - and am very interested about other systems drug databases! If you have true generics, the excipients may vary - so if a drug is prescribed generically, what would the warning say? "Warning: patient sensitive to maize" "brand x contains maize" (implying brand y doesn't)? What happens if the excipeints are changed? Mars bars had a press announcement - and found they couldn't do it commercially: the same mightn't apply to generic medication whre the consumer/patient cannot make the final decision. >If an sensitivity to an excipient is recorded and >automatic checking is not supported it seem to me that the system should >warn of the recorded sensitivity when any attempt is made to prescribe or >there is a danger of a user assuming a check has occurred when it has not. In EMIS LV you can record a non-drug adverse reaction which is displayed (with all the adverse reactions) with a soft ping whenever you start to add a prescription: useful for things like vegetarians who won't take anything in capsules. >Might be slightly irritating to get excessive warnings, but better than >prescribe a drug with an excipient to which the patient has a serious >sensitivity and there won't be that many patients with a recorded >sensitivity to an excipient. The real problem is knowing the excipient - or possible excipient - in numerous different medications - when trying to prescribe: once I've done the work (or the drug information centre has done the work) the patient gets a copy - and I tend to prescribe only by brand name - which the pharmacist can now ignore at will! Still, one possibly beneficial s/e - patients with reactions to excipients tend to be cautious about taking anything at all! Mary > > > >Ewan Davis - Director - Woodcote Consulting > >See our website at www.woodcote-consulting.com > >[log in to unmask] Voice +44(0)8456 170100 Mobile +44(0) 7774 >272724 > >Treasurer British Computer Society - Health Informatics Forum > >Member of British Computer Society Primary Health Care Specialist Group >Visit... www.phcsg.org for membership details > -- Mary Hawking