Step 2: Decoding physicians' handwriting

 

It's of no doubt that handwritten prescriptions are one of the main obstacles that face pharmacists in all healthcare settings. Imagine you receive a prescription as in the opposite figure. Of course, a prescription like that is impossible to read. This will necessitate contacting the prescribing physician to understand what is written in such Rx.

Luckily, only few prescriptions are that bad, and most of Rx can be easily read with a little difficulty. So here are some tips you can use to "Decode any Rx"

1. Look at prescribing physician speciality: This can be beneficial because pharmacists are aware of medications prescribed for each condition especially common and chronic conditions. So by knowing what speciality the physician is, you can interpret the list of medications.
2. Look at the Diagnosis: Again, each condition has specific medications that are commonly prescribed to treat it. Knowing what condition the patient has might help decode the Rx easily.
3. Patient Medical and Medication History: In cases of chronic diseases or recurrent conditions, the patients come for a refill or repetition of therapy. By checking the patient medical and medication history, you can easily know what medications they are frequently prescribed. This is a very good way to interpret the Rx. 
4. Search the databases: Sometimes, a couple of letters are not clear. This is problematic in case of medications that are alike Examples: Zyprexa and Zyrtec, Celebrex and Celexa, Chloropamide and chlorpromazine and a lot more. It's important to know the diagnosis and the medical and medication history of the patient, Then you can search the database such as Google you write the letters that you can read and the unclear letters you can leave a blank, Google will suggest the common Names for your search. Although it is not a very efficient way, it is of help when you never have heard of the trade name before. 
5. Know your patient: Most of the times, the person who wants to dispense the Rx is not the patient himself. So, you must know for who the Rx is being dispensed for. This is important of course in case of pediatric Rx. Doses in Pediatrics differ completely from adults. Also, Pregnant or breastfeeding women. Some drugs are a complete contraindication to this population. Geriatrics and those with kidney or liver impairment also are a population we must consider while dispensing medications. Thus, it's very important to know the patient for whom you are dispensing the Rx as this might eliminate a handful of medications and help you with the decoding process.
6. Talk to your patient: Sometimes patients are well educated enough to know their medications especially if they have a chronic condition. Even in less educated patients, they might know the shape of the medication or even have the old one with them. This of course can be so helpful to identify the medications in the new Rx.
7. When all fails, Contact the physician: In case you tried all the above tips and still you couldn't Decode the Rx, you have no other choice but to contact the physician. Don't ever dispense any product you are not a 100% that it's the one prescribed. We are talking about a patient's life here. 

So, here is a simple to Example to try and test yourself and check if the previous tips work

Decoding Rx is a very important and a crucial step for all pharmacists. Wrong interpretation of medications and dispensing completely wrong ones can lead to deleterious effects that might lead to morbidities or in worst cases, Mortality. So be careful and be patient because this is a matter of Life and Death.

References:

https://dx.doi.org/10.1258%2Fjrsm.99.12.645