The introduction of Active Ingredient Prescribing (AIP) from 1 February has already seen some concerns raised over errors in writing and dispensing prescriptions.
Leading provider of pharmacist’s professional liability insurance Pharmaceutical Defence Limited (PDL) has reported that it has already received a small number of reports and one error relating to the change.
In a communique to members, PDL notes: “Members are reminded to read prescriptions carefully as prescribing software is likely to present the order of active ingredients alphabetically which might be different to previous computer generated or electronic prescriptions.
“One noted example is Targin® tablets which have been routinely prescribed as oxycodone + naloxone. Prescribing software programs are likely to generate Targin® as naloxone + oxycodone which could easily lead to confusion or error. There is a report the strengths of the ingredients may still be presented in the previous format of oxycodone/naloxone.
“Other examples reported include insulin prescribed without a brand or delivery device specified, and hormone combinations including oral contraceptives and HRT without brand or form specified. Please make your dispensary team aware of this recent change and remind them to carefully interpret prescriptions when dispensing and checking.”
The Guild has received similar reports as well as an example of a prescription for 'Insulin 100U/ml' without specifying what type of insulin it was. A prescription such as this one simply cannot be dispensed as there is insufficient information for the pharmacist to make a safe and appropriate clinical decision of what to supply for the patient.
PDL advises pharmacists to discuss the change with patients so that they understand that their prescriptions might look different.
“Members are also reminded that patients have a right to choose their preferred brand when presenting their prescriptions, and please ensure generic substitution does not occur if the prescriber has specifically stated this on the prescription.
“PDL asks pharmacists to report any inconsistencies or errors to PDL or other representative organisations for prompt action with the relevant agencies.”
Given the significance of this change for prescribers, pharmacies and patients, the Guild was successful in advocating for a six-month grace period until the 31 July 2021; prescriptions that were not deemed compliant for PBS purposes could still have a PBS subsidy applied for eligible patients during this time.
It is recommended that if pharmacies notice prescriptions being written that are not compliant with the new AIP requirements and are not exempt, they should contact the prescriber to remind them of the updated obligations.
The Guild is monitoring any issues with the new AIP requirements and examples of AIP-related prescription and/or safety issues can be sent to the Guild at AIP@guild.org.au.
