A first...pharmacist refused to fill script....

[Aether2000]

Got a call from a patient today stating the pharmacist refused to fill a prescription for a 2 day supply of buprenorphine I called in yesterday because the prescription did not have a date on it. Huh????

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[Disciple]

Been having issues with pharmacists refusing to fill prescriptions, increasingly over the past year.

The latest, I D/C Norco and substitute with a 25mcg/hr fentanyl patch for an elderly patient with multiple joint osteoarthritis. The pharmacy faxes a form asking me to write in the patient's diagnoses, ICD-10 code and explanation of medical necessity.

I fill it out, fax it back, then get a call later from the patient that the pharmacist refused to fill the script because she "didn't feel comfortable".

 

[guitar45]

Pharmacists work under a LOT of regulations: DEA, their corporation, their Pharmacy Board. In this era of serious opioid abuse, it probably behooves prescribers to expect a LOT of interacting with pharmacists re: strong narcotic Rx's. If it isn't cancer, you would be wise to document a lot. To be honest, it protects prescribers as well. My recollection for Fentanyl though is patient must have been on narcotic stronger than hydrocodone, esp. if elderly. As for buprenorphine w/o a date, pharmacists have to answer to their Board of Pharmacy. Incomplete C-II Rx'scan be rejected. It is a pain, but you must be accurate.

 

[deleted480308]

I don't think pharmacy should be required to fill something they find inappropriate. But if they were consistently wrong I would just stop sending prescriptions to them

 

[Aether2000]

Guitar, you missed the main point- the buprenorphine script was called in (Schedule III), not written. Do you ever specify the date when you call in a script? This was incompetence of the pharmacist and their staff to not put the date on a script that was called in. When I called them to verify, they had no answer as to why they caused a patient to go into withdrawal.

 

[guitar45]

Guitar, you missed the main point- the buprenorphine script was called in (Schedule III), not written. Do you ever specify the date when you call in a script? This was incompetence of the pharmacist and their staff to not put the date on a script that was called in. When I called them to verify, they had no answer as to why they caused a patient to go into withdrawal.

You are right; I missed your point that they were totally at fault. For the pharmacy professionals who have 0 common sense, I truly apologize. And I have seen it a lot. They have no idea a real human physiological being is being presented before them. They just blindly follow black and white rules, and give no thought about possible death from withdrawal. Someday I hope there is a lawsuit for idiocy, but I doubt it. Boards of Pharmacy back this up, now that opiate addiction is so serious a problem as well.

 

[Aether2000]

Most pharmacists are conscientious and a bit OCD about scripting, and they have indeed corrected my scripts in the past with my profound thanks. A few have overdosed my patients with one giving a patient 80mg oxycontin instead of 20mg....go figure. I have had scripts rejected by pharmacies due to not spelling out the date on a written script or not spelling out the actual number of tablets rather than the more traditional numeric. I have also had scripts rejected for my failing to specify the reason for the script- chronic pain or addiction. But this incident was indeed a first for me

 

[pastafan]

I had a local chain store pharmacist "uncomfortable" filling a patient's prescription for one Percocet to be taken pre- procedure.

 

[bedrock]

I had a local chain store pharmacist "uncomfortable" filling a patient's prescription for one Percocet to be taken pre- procedure.

Wow.

 

[guitar45]

Most pharmacists are conscientious and a bit OCD about scripting, and they have indeed corrected my scripts in the past with my profound thanks. A few have overdosed my patients with one giving a patient 80mg oxycontin instead of 20mg....go figure. I have had scripts rejected by pharmacies due to not spelling out the date on a written script or not spelling out the actual number of tablets rather than the more traditional numeric. I have also had scripts rejected for my failing to specify the reason for the script- chronic pain or addiction. But this incident was indeed a first for me

I once again agree....good pharmacists, like any professional, are vital. Patients need a team, since anyone can make a mistake. Sadly, many pharmacy chains are slave-like (metrics taking precedent over care), so serious errors can occur. I guess the same can be said for medical practices that pressure physicians to see specific numbers of patients. In the end: buyer beware. All patients need to be on guard as well. But your original comment is, in hindsight, pretty comical.

 

[guitar45]

Wow.

no common sense once again....