Illegible Scripts Cause Misfilled Prescriptions
27 Jul 2007
Your doctor's handwriting may be more than a bad joke. It can be the cause of a misfilled prescription.
Poor penmanship on the part of physicians may once have been humorous, but now it is a vital cause for concern in the pharmacy industry.
Anne Bokma, editor of Canada's leading pharmacy journal, Pharmacy Practice, claims to have seen some jawdropping examples of illegible scripts. A regular feature in the publication is called "Read That Script." In a 1999 article in the Medical Post, she says she has received hundreds of examples of illegible scripts, each of which required the pharmacist to call the prescribing physician to clarify the drug order.
Why are illegible scripts a problem? Anne Bokma says they are a waste of time for pharmacists who must call to clarify drug orders, for physicians who then need to get back to the pharmacist with the correct information, and for the poor patient who is forced to needlessly wait in the pharmacy for all this miscommunication to be sorted out.
Bokma highlights the true danger posed by these scripts - the very real threat to patient health they represent.
She believes there is an arrogance implicit in a prescription prepared in such a way that it is indecipherable. She feels they demonstrate a blatant disregard for patient care.
Bokma cites the case of Bernard Klieb, a Toronto man who died because he was given the wrong medication due to an illegible script. She says one of the recommendations from the coroner's jury in the case was a plea for physicians to take more care in preparing their scripts.
Unfortunately, Bokma believes there is still overwhelming evidence that messy scripts are increasing the possibility for errors that land patients in hospital--or even the grave.
As a result, Pharmacy Practice embarked on a campaign to shed some light on this neglected area of patient care. Last fall the publication sent out a package of some 100 illegible scripts to physician regulatory bodies across the country, encouraging them to urge their members to take this issue more seriously.
Most responded by noting their standards already indicate physicians need to communicate clearly with pharmacists regarding drug orders. Several stated the responsibility lies with pharmacists to initiate complaints about physicians who persistently demonstrate poor penmanship.
Bokma feels that reducing this issue to the fine print of a long list of guidelines isn't enough. Nor should it be left to pharmacists to police physicians. What's needed, according to Bokma, is a commitment to develop more effective protocols relating to illegible prescriptions.
Anne Bokma should be commended for her attention to this dangerous situation. But, there is a person who can also act to remedy the problem. That person is the patient who is handed a prescription by a doctor.
What can the patient do to assure that an illegible script does not lead to a misfilled prescription?
The following steps might be worth taking:
- Try to read the prescription yourself before leaving the doctor's office. If the drug or dosage schedule is not clearly readable ask the doctor to rewrite the prescription form.
- Ask the doctor to tell you verbally the drug and dosage schedule and compare that with what you can read on the prescription form.
- Ask the pharmacist to read the prescription aloud to you at the window before the filling process begins.
- Read the label on the prescription container to see if it matches your understanding of what you were to receive.
- Ask the pharmacist to open the prescription container and confirm that the medication inside is what you were to receive.
These steps may be time-consuming and, at times, awkward. If they prevent the misfilling of a prescription that you or a family member will be taking, however, they are worth the effort.
