Illegible Prescription Orders

Sometimes people don’t understand why a pharmacist takes so long to process a prescription. The medication is on the shelf and all it takes is to count out perhaps 30 tablets or capsules and slap a label on the vial. And yes we charge you also a dispensing fee for it.

That is far from the truth. In fact when we look at a prescription, we have to check if the drug is reasonable for the indication or diagnosis, whether the dose is appropriate, if there are any significant drug interactions.  Sometimes, the prescription is incomplete.  The dose may be missing, the frequency or direction may be unclear, the drug may come in different strengths or forms and there are sometimes coverage issues to resolve.

But the worst of it all is illegible writing.  I know prescribers are busy. But they sometimes have no idea what we go through to decipher their illegible prescription orders. We will read their orders again and again, hoping to gain some revelation from reading the same thing again. We try to read their progress notes (if they are written at all) to gain some insight. And if this effort fails to identify what has been written, we ask colleagues to read the order, hoping they can see through the order.  Often when we call the prescriber’s office, the reception may try to decipher the order, many times with effort in vain.  It seems that we always avoid calling the prescribers directly, for fear that we are wasting their time or the inability to read the prescription is interpreted as incompetent. But in fact, we need to seriously push the ownership back to the prescribers, that illegible writing is dangerous, unsafe and a risk factor for delayed treatment or medication errors.

Maybe e-prescribing is the solution. I know there may be push back from the prescribers because they can no longer scribble something and walk away, waiting for nurses and pharmacists to deal with the aftermath. E-prescribing is not without its problem.  There are glitches, process to fine tune and likely new set of errors to understand and prevent. But at least we can read the damn orders and decide what to do next.

Here’s my vent for the day. Thank you for reading my post and have a wonderful weekend! 🙂

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drugopinions

My name is Cynthia Leung and I am a practicing pharmacist in Kingston Ontario, Canada. This blog is for me to share my ideas, opinions and perspectives on how medications are used in our health care system. Note that these posts are my own opinions and do not represent the opinions of my current or former employers and / or organizations that I may belong to. Any possible case scenarios described in my posts would be modified to maintain patient confidentiality. This blog is not a platform for professional advise for patients or health care providers and the content is not meant to support any clinical decisions or replace professional opinions. Also the images are either taken or created by the author, or adapted with permission. I hope you will enjoy reading my posts!

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