Days supply Cii dilemma

[ZakMeister]

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So we often get prescriptions of IR opioids with sig which says take x no of times upto y number of days. I just graduated and have been seeing techs filling the prescriptions by the y number of days not the actual days supply which comes out. Eg- for #15 of it says q8h up to 7 days they would do it for 7 instead of 5.

What is approriate in such situation? I would interpret the sig as the md wants doesn not patient to take the med beyond y no of days. But doesn’t mean pt can’t run out of pills by that time right? Any insight on such scenario and how you guys handle it should be appreciated.

 

[zelman]

So we often get prescriptions of IR opioids with sig which says take x no of times upto y number of days. I just graduated and have been seeing techs filling the prescriptions by the y number of days not the actual days supply which comes out. Eg- for #15 of it says q8h up to 7 days they would do it for 7 instead of 5.

What is approriate in such situation? I would interpret the sig as the md wants doesn not patient to take the med beyond y no of days. But doesn’t mean pt can’t run out of pills by that time right? Any insight on such scenario and how you guys handle it should be appreciated.

Seven days would be appropriate. The MD is essentially ordering the medication to average 2 tabs per day, and on days with more pain, keep doses 8 hrs apart.

 

[npage148]

Until you know the prescribing practices I'd check with offices becaue sometimes they literally don't understand their e-rx system and will send over sigs they don't intend to. I've seen it go both ways

 

[pharm B]

Seven days would be appropriate. The MD is essentially ordering the medication to average 2 tabs per day, and on days with more pain, keep doses 8 hrs apart.

If the Rx specifies a days supply, I normally go with that...

Until you know the prescribing practices I'd check with offices becaue sometimes they literally don't understand their e-rx system and will send over sigs they don't intend to. I've seen it go both ways

...But that’s because I’m in a small town and have spoken with pretty much every provider at some point about it.

If the patient raises a stink when filling another Rx too soon, we just contact the doctor to clarify, document, etc.

 

[Charcoales]

If qty and days supply don't match on a c2 - 5 I always call. I don't feel like dealing with the fallout for getting that wrong.

 

[BidingMyTime]

E-rx systems will automatically fill in the days supply if the doctor doesn't put it in--so what comes through may not be what the doctor means, it just means they were too busy/lazy to proofread their RX. Also, doctor's (anybody's) math can be off, and they figured out the days supply wrong.

Myself, I would go with the actual days supply based on the prescribed dosing schedule.

 

[Dr Wario]

I have a real day supply issue that involves very high level math that I am just too stupid to figure out. Doctor writes a script with sig as follows, "Take 1 tablet every 4 hours as needed". The problem I am having is I just can't seem to figure out how many tablets this patient is allowed to take per day. Both the patient and doctor think the correct answer is 7, but I simply cannot come up with that answer no matter how many times I rework the calculation, perhaps I need to consult Dr. Stephen Hawking?

 

[owlegrad]

I have a real day supply issue that involves very high level math that I am just too stupid to figure out. Doctor writes a script with sig as follows, "Take 1 tablet every 4 hours as needed". The problem I am having is I just can't seem to figure out how many tablets this patient is allowed to take per day. Both the patient and doctor think the correct answer is 7, but I simply cannot come up with that answer no matter how many times I rework the calculation, perhaps I need to consult Dr. Stephen Hawking?

What amazes me is how people must set an alarm to wake up in the middle of the night so as not to miss that last dose of the day.

Sent from my SAMSUNG-SM-G920A using SDN mobile

 

[npage148]

We have a patient that is 1 q6h (may take up to 5xd) #150 for 30 days and they are in every 30 days exactly. It's amazing how often they need to extra dose. Just leave off the q6h at this point.

 

[wagrxm2000]

We put may take up to every 8 hours, must last 7 days.

If the office made a mistake they can call us to fill the next one when it should have been due.

 

[grumpyRph]

We have a patient that is 1 q6h (may take up to 5xd) #150 for 30 days and they are in every 30 days exactly. It's amazing how often they need to extra dose. Just leave off the q6h at this point.

um. no. that needs to be re-written. why can't the doctor just say q 4 to 6 h, or 1-2 q 6 h, not more than 5 per day? 1 q 6, no more than 5 doesn't exist in the dimension we live in.

 

[BidingMyTime]

um. no. that needs to be re-written. why can't the doctor just say q 4 to 6 h, or 1-2 q 6 h, not more than 5 per day? 1 q 6, no more than 5 doesn't exist in the dimension we live in.

I would agree, I would ignore the "may take up to 5 per day", as that is inapplicable on the 24hr/day planet that we live on. I'd give them #120/30 days.

 

[BidingMyTime]

um. no. that needs to be re-written. why can't the doctor just say q 4 to 6 h, or 1-2 q 6 h, not more than 5 per day? 1 q 6, no more than 5 doesn't exist in the dimension we live in.

I would agree, I would ignore the "may take up to 5 per day", as that is inapplicable on the 24hr/day planet that we live on. I'd give them #120/30 days.

 

[panicatthepharmacy]

um. no. that needs to be re-written. why can't the doctor just say q 4 to 6 h, or 1-2 q 6 h, not more than 5 per day? 1 q 6, no more than 5 doesn't exist in the dimension we live in.

1 q4.8 hours.