PSD 2

Rx Law: Prescriber Requirements

Full Name

Professional Title

Address

Phone Number

Signature

Rx Law: Patient Requirements

Full Name

Address

Rx Law: Drug Requirements

Name

Strength

Directions

Quantity

Refills

DEA #

Prescription Laws

Legitimate Medical Purpose (50/50%)

Signed and dated on day of issuance

5 Core Elements of Medication Therapy Management

CAPIF basically

1. Medication Therapy Review

2. Personal Medication Record

3. Medication Action Plan

4. Intervention / Referral

5. Documentation and Follow-up

Types of DRPs

•Problem not treated or not maximally treated

•Drug patient is receiving is: Not indicated, Contraindicated

•Problem being caused by a medication being taken

•Patient not properly monitored for therapy received

•Drug interaction (Existing or Potential)

•Inappropriate dose

•Drug interfering or masking manifestation of a disease or

altering interpretation of lab test

•Medication administered inefficiently

•Patient not receiving the medication appropriately

Explain 5 Core MTM

write it down idiot

Initial Filling Time

6 months

CII-CV Controlled Initial Filling Time

14 Days

CII-CV Controlled Refill Time

CIII-CV = 6 months

CII = No Refills

Refill Time

1 year

Describe Workflow process

write n check idiot

OBRA ‘90 Requires

Prescriptive Drug Utilization Review

Offer to counsel, provided by pharmacist or supervised intern

Record of comments of an individual’s therapy

Benefits of Patient Care

Reduces medication errors

Increases patient understanding and management of medications

Minimizes the incidence of adverse effects and drug interactions

Enhances patient outcome and satisfaction

Components of Counseling Session

• Material Review

  • Prescription details

  • Patient profile

  • Drug Resources

• Conversation

  • Introduction

  • Purpose

  • Assessing knowledge of patient

Three Prime Questions (New Prescriptions)

1. What did your doctor tell you this is for

   1. Specific Indication

2. How did your doctor tell you to use this

   1. Drug label (ROA, Directions, DOT, Administration, Devices)

3. What did the doctor tell you to expect

   1. Safety & Efficacy & Interactions

Three Prime Questions (Refill)

1. What do you take this medication for

2. How do you take this medication

   1. What problems are you having with this medication

Teach Back Method

Patient repeats key points of counsel session to you to assess and clarify

Parts of SOAP

Subjective (describe what in them)

Objective

Assessment

Plan

Define DUR

Drug Utilization Review

An authorized, structured, ongoing review of providers prescribing, pharmacist dispensing, and patients’ use of medication

Three Types of DUR

Prospective

Concurrent

Retrospective

Pharmacists Role Employing DUR

• Prospective

  • Checking dosing, interactions, directions, and duplications

• Concurrent (Hospital Settings)

  • Check therapy with the patient records

• Retrospective

  • Finds patterns in the pharmacist dispensing and providers prescribing that is often used in research

Why are DURs used?

To reduce the inappropriate use of medication.

Precipitant Drug

Drug causing the interaction

Object Drug

Drug affected by the interaction

Pharmacokinetics

ADME (What our body does to the drug)

Pharmacodynamics

Additive/synergistic effects; antagonistic effects

What the drug does to our body

Identify Drug Info Resources to Manage Drug Interactions

Lexicomp

Micromedex

Facts & Comparisons

Daily Med

Questions to Ask to Avoid DURs

Why & How are they taking this?

Who prescribed it?

Timeline (New Rx, Refill, Duration of Therapy)

ROA

Dose

Alternatives

Clinical significance (age, illness, diseases, renal/hepatic function)