When scripts are changed by MAs/liability question

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g40631

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Ok so lets say hypothetically I call on an interaction. Patient has been on simvastatin 40 mg for some time and physician is starting patient on Norvasc 5 mg now. I contact the prescriber's office to alert them of the interaction and recommend that they reduce the dose of simvastatin to 20 mg. MA for the doc takes the call, says hold on, and I presume grabs the chart. A few moments pass and she says "lower the dose of simvastatin to 20 mg." Of course I, on the other line, have no impression/reason to believe this person has actually run this past the prescriber. So basically, all I can do is document that we had the conversation as a phoned in prescription with their name (I also document the reason for the therapy change).

My question is, what if the MA never runs it past the prescriber and doesn't bother to document, and the prescriber discovers the change and it is determined that they would have never authorized such a change? Can the pharmacist be held responsible due to the lack of documentation by the MA?

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The pharmacist documented everything he/she needed and had the conversation, explained the reason for the change, everything looks fine.

Worst case in this scenario, the 20mg change of statin dose yields a single digit % increase in LDL.

There is no way of knowing if physician told patient of interaction so be sure to counsel the patient.

Alternatively, you could call to change to atorvastatin, rosuvastatin, etc.

There is no way you can get in trouble, document persons name, time, date, reason, and your fine!
 
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