POMS, PRESCRIPTIONS AND PRESCRIBERS Notes

LEARNING OUTCOMES

  • Understand Prescription Only Medicines (POMs).
  • Different types of prescriptions.
  • Different types of prescribers.
  • Legal validity of a prescription.
  • Basic clinical screening.

CLASSIFICATION OF HUMAN MEDICINES

  • Focus is on human medicines only.
  • Overview of the classification system.

PRESCRIPTION ONLY MEDICINES (POM) DEFINITION

  • POM: A substance that can be provided to the public only via a practitioner's prescription, per the Prescription Only Medicines (Human Use) Order 1997.
  • Some POMs may be obtained without a prescription under specific circumstances, such as:
    • Emergency supply
    • Patient Group Directions (PGD)
    • Exemptions during pandemics.

RESTRICTIONS ON POM

  • Sale, supply, and administration are tightly controlled by legislation.
  • Pharmacists can only dispense POMs when authorized by a prescription from an appropriate practitioner.
  • Critical for pharmacists to know:
    • Types of prescriptions available.
    • Who is considered as an appropriate practitioner.
    • Information required on a legally valid prescription.

EXAMPLE OF A PRESCRIPTION

  • Components:
    • Drug name, dosage, formulation, and strength.
    • Patient's name and address.
    • Prescriber’s details including name and signature.
    • Dates and quantity of medication dispensed.
  • Illustration: Amoxicillin 500 mg capsules prescribed as 1 tds for 7 days (21 caps).

TYPES OF PRESCRIPTIONS

  • NHS Prescriptions:
    • Community prescriptions (dispensed by community pharmacists).
    • Hospital prescriptions (for in-patients and out-patients).
  • Private Prescriptions:
    • For veterinary use.
    • From private prescribers.

NHS PRESCRIPTION FORMS USED IN ENGLAND

  • Forms and Colors:
    • Green (FP10SS): For GP and various nurses.
    • Blue (FP10MDA): For controlled drugs, annotated prescriptions by type of prescriber.
    • Yellow (FP10D): Dentist prescriptions.
    • Lilac (FP10PN): From community practitioners.
  • Key Notes:
    • Must indicate the type of prescribers (e.g., community nurse, independent prescriber).
    • Annotations such as "repeat dispensing" or "repeat authorization" are necessary for specific forms.

ELECTRONIC PRESCRIPTION SERVICE (EPS)

  • Commonly used in community pharmacies for electronic submission of prescriptions.
  • Patients will not need to bring paper prescriptions; the GP will submit the information electronically.
  • Pharmacists will download the prescription via a barcode from the dispensing token.

EPS AND CONTROLLED DRUGS

  • Controlled drugs may be included in the EPS system, but specific handling guidelines exist.
  • Legal requirements and best practices for handling controlled drugs must be adhered to.

APPROPRIATE PRACTITIONERS

  • Include:
    • Doctors, Dentists.
    • Independent prescribers (e.g., pharmacists, nurses).
    • Supplementary prescribers such as nurses and physiotherapists.
  • EEA and Swiss Prescribers: Recognized under UK law for prescribing.

SUPPLEMENTARY PRESCRIBING

  • A voluntary collaboration between an independent prescriber and a supplementary prescriber.
  • This requires a shared management plan agreed upon with the patient.

PRESCRIPTION RECORD KEEPING

  • Private Prescriptions: Must be kept for 2 years.
  • POM Register: Record details of supply, prescription dates, patient and prescriber information.
  • Use bound books or electronic systems for documentation.

BASIC CLINICAL SCREENING

  • Assess the patient's suitability for the prescribed drug:
    • Check for appropriate age and possible drug interactions.
    • Confirm appropriateness of dose considering patient's condition.
    • Ensure the formulation is suitable for the patient.