Dispensing Authority

Being able to predict what trends will gather in the world of prescription is one motivating part in dispensing. Let’s forget predictable prescription from KNH, Mathare, Mbagathi and Mama Lucy hospitals just to name a few, I’ll tell you how that’s boring if you already don’t know, most of these public hospitals often dispense predictable prescriptions. It is wearisome seeing the same prescription dispensed more than five times to different people the same day, of course, you will have so many assumptions. If you are working in a hospital setting, you may have to force yourself to learn how to deal with too much repetition. For folks working in the community pharmacies get breaks from such since they have a wide range of prescriptions from different consultants and hospitals.

Looking back to 2012 prescribing is undergoing a natural progression to where it is now, while some would argue that only one type of prescription is valid i.e. letterhead, stamped, name of the patient and all that, prescriptions have lost their original authenticity and pith. Probably you are familiar with prescriptions that come with {MB, ChB, Msc., Ph.D., FRcPS, M.Med (psych), M.Med (Fam Med)}, at the moment we’re getting prescriptions via text. Soon or later, you will get to dispense a prescription without the name of patient, age or even the prescribers’ information. Prescription errors, therefore, are high for this cases and it is difficult to prevent such errors.

So, what actually determines the weight of a prescription? With Nairobi prescribers in mind, there is so much “food for thought” on that. I personally have to classify prescriptions differently but that is just me saying, the only thing is when you release a new generic drug to the market every few months there is only so much you can change in the prescription trends in Nairobi. The Kenyan market is crowded with voluminous generics making it too painful to remember a generic that you dispensed like say two months ago. The sales driver being the prescriber it is hard to substitute a prescription. (According to Sanisphere Pharmacies Observation Post – POP Kenya Q1 2016 sales transactions percentages are 15.6% in retail pharmacies and 78.3% in outpatient pharmacies). This means the prescriber controls mostly what pharmacists dispense at the pharmacy level, although most prescriptions end up substituted.

Self-belief is vital, but a huge ego can be detrimental, especially when you are handling “ghost prescriptions”, prescriptions via text or repeat prescriptions. So why am I sharing this?

1. You may assume the prescriber misspelled one of the drugs then give out what you think is right without confirming

2. You may assume the prescriber is right ending up with the wrong dose frequency, worst-case scenario being an overdose.

While most of us are tech savvy or reliant on technology, you might still end up in a stalemate with a prescriber via text despite all of us growing up in a world which is not only pervasive but also virtually unavoidable tech wise. How would you dispense a prescription only medicine (POM) via text at a time where quite a majority of people have WhatsApp or email accounts? This might make the pharmacist suspicious and they might end up not filling the prescription.

It is little surprise that literary that might happen in most chemists but I am impressed most pharmacists will call to confirm with the prescriber.

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