Wednesday, October 26, 2011

What Up, Walgreens?

Why has this happened to me more than once? A patient calls and says they need to transfer their prescription from me TO a Walgreens. They have contacted the Walgreens, as they should, but the Walgreens tells them I have to call THEM (Walgreens) to give them the prescriptions. (For the non-pharmacy folk, this is not the way it's done. The pharmacy that will be filling the prescriptions calls the other pharmacy for the information). I hate to put the patient in the middle of this, but they are adamant that the Walgreens refuses to call me, as they are supposed to. Sure I could call them and happily give away my business, but it's the principle of the thing.

When this happened the other day, I held my ground and told the customer to call the Walgreens back. They know better, I told him. I know it wasn't the patient's fault, but why does this keep happening?

Saturday, October 22, 2011

E-Prescribing can be E-vil

The prevalence of electronic prescribing and faxing of prescription orders has generally made things more convenient for customers and probably decreases wait time as well, but as all pharmacists know it is a mixed blessing. The attempts to plug in a 'personalized' prescription into a computer program can lead to some pretty interesting prescriptions, like "Apply 9999 applications topically ", or my personal favorite from this week, a prescription for Plan B, quantity 60 tablets, with 11 refills. Customer then arrives and is totally taken aback that it's not 'ready yet,' either because we have received no prescription or the one we did receive is completely nonsensical. Heaven help me, there are days when I really miss the old fashioned exercise of someone visiting their doctor, being handed a prescription, and then being responsible for choosing a pharmacy and bringing that prescription TO IT. Y'know, kind of like having a little responsibility all their very own self.

So now we not only have the responsibility to fill your prescription correctly, with all the usual challenges associated with that, but we seem to be charged with hunting down that prescription and obtaining it for you as well. If we didn't get it, then it's up to us to seek it out, right? Clear the decks, folks, I'm about to spend 20 minutes on the phone trying to track down one prescription from Giganto Orthopedic Surgery Group and by the way, it's lunch time and please leave a message.

The problem is even worse when, like me, you work in a medical building/clinic when we seem to be held accountable for any prescription written by any doctor in the building whether the patient fills it with us or not. It doesn't matter how many times you tell me "THEY TOLD ME THEY SENT YOU MY PRESCRIPTION" --- I can't fill a prescription that I don't freakkin HAVE. Really, I wouldn't lie to you. We actually had a customer claim her doctor had faxed us
her prescription, watched us tear apart the pharmacy looking for it, acted like a complete bitch and finally rolled her eyes and said, "Well, I've got it out in my car -- do you want me to go get it?" I said, yeah that would be swell. Then I went in back and looked for a sharp object to do myself in with.

And then there are the people who want to 'read' you their prescription over the phone because they didn't want to be bothered stopping at the pharmacy, nor do they want to wait while it's being filled. Sigh.

When it comes to electronic prescribing I know there's no going back, but some days I feel there are just as many errors, just as many problems to clarify, AND the added bonus of leaving people with the notion that everything's going to be done for them. It's the fast-food, drive-through-ability of everything. We'll find the prescription, we'll figure out what your insurance is, we'll wrap it up and tie a bow on it and do it in 10 minutes. Dang, it's frustrating.

Sunday, October 16, 2011

What Can You Say.

From the New York Times, Oct 14th:

A 13-month-old boy died after he apparently swallowed pills from a bottle of prescription drugs that his parents had given him to play with as a rattle, the authorities said on Friday.

The boy, Edwin Perocier Jr., was put in his crib in his parents’ apartment, on Southern Boulevard near 156th Street, in the Bronx, about 9 p.m. on Thursday, a law enforcement official said.

One or both of the parents, Edwin Perocier, 44, and Zoraiva Santiago, 22, gave the child a bottle of Suboxone that belonged to Mr. Perocier, the official said. The medication is used to treat people who are addicted to illegal or prescription opioid drugs.

A short time later, Ms. Santiago went to check on Edwin and found the bottle open. Some of the pills had fallen out and one of them was wet. Ms. Santiago took the pills away, gave the child a bottle of milk, and went to sleep, a law enforcement official said.

At 7:45 a.m. Friday, the parents awoke and found Edwin unconscious in his crib. They called 911, and Edwin was taken to Lincoln Medical and Mental Health Center, where he was pronounced dead on arrival.

No charges had been filed as of Friday night, a police official said.

Ms. Santiago’s 4-year-old daughter was taken into custody by the Administration for Children’s Services, according to a law enforcement official.

Saturday, October 8, 2011

Adderall and the Gift of Function

Back in March of this year I wrote a post called "The Supply Chain, Adderall, and Flying by the Seat of your Pants" and it has been very interesting and informative for me that I am still getting comments on it 7 months later. It looks like the supply of generic Adderall and Adderall XR are going to continue to be spotty for at least the rest of 2011.

I continue to find it worrisome that we fill so many prescriptions for ADD meds for children and adolescents, however I do recognize that it's a godsend for many of them in conjunction with other forms of therapy. No argument there. Is there lots of inappropriate use? --- Probably. But again, the folks who really benefit from it are penalized by the abusers, just like with other controlled substances.

I have gained a lot of sympathy from the comments by adult patients. I appreciate the fact that they are not blaming me for the shortage situation -- I personally try to help people figure out alternatives, make some phone calls for them, and I certainly don't look down on them for just trying to fill their prescription. However, as I said in the post, frustration sets in when a few people's sense of entitlement overshadows the reality that we're all 'in the same boat' here.

I especially sympathize with people who unquestionably need the medication to function --- to hold down a job, to go to school, to interact socially. Let's face it, without these basics it's a very tough road. These needs go to the root of a successful and happy life, and a mental disorder that interferes with them certainly is terribly burdensome. Then, when someone finds a medication that actually helps and allows them to function, I can see how being told that medication is unavailable indefinitely can cause utter panic.

One commenter said their doctor will no longer prescribe Adderall tablets --- maybe this is because his office got tired of phone calls from patients and pharmacies saying they couldn't get it. If I get a phone call asking me if we have it in stock, I have no problem giving a yes or no answer. Unfortunately though, I can't "reserve" it for anyone. If I hear of another pharmacy that has stock, I'll pass that on. I'll check the other pharmacies in my organization. I would hope most pharmacists would try to offer some assistance, as long as people realize we may not be able to drop everything and deal with it right away. It's another part of the job that we didn't ask for -- so if your pharmacist finds your medication somewhere else for you...... show 'em some luv.