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Shedding some light on
telephonic prescriptions.
We do charge a nominal fee for telephonic prescription – the
reason for this is the time and professional effort required so
to do.
The fee is refundable by certain medical aids and the amount may
vary from time to time.
Below is a list of the processes performed during the issue of a
telephonic prescription.
• Is this the right person? We need to check that the document
we are about to prescribe on is definitely assigned to the
patient we have seen, or talked to on the telephone.
• Do they need it? After properly assessing the patient, we need
to assess if medication is really appropriate and consider the
evidence base/guidance supporting the prescribing.
• Pharmacists, geriatricians and GP’s have an important role in
reducing polypharmacy in the elderly, a frequent cause of
preventable adverse drug reactions.
• Have we prescribed the right agent? Drug names are easily
confused. There are many similar sounding generic and
proprietary names.
• Is the formulation, dose, frequency and route of
administration correct?
• Is the prescription legible and understandable?
• Are there any reasons why this might not be a good idea? We
need to check that there are no contraindications, interactions
with other drugs (including complementary and over-the-counter
prescriptions), allergies or potential adverse drug reactions.
Hepatic and renal impairment are often overlooked and
significantly alter prescribing patterns for many drugs. The
same is true for pregnant patients and lactating mothers.
• Does the patient know what’s going on? This is very important.
Error is much more likely when this is not so.
• Do I need to monitor anything as a result of this
prescription? We may need to arrange follow-up, blood tests or
advise a colleague that we have altered a patient’s drug
regimen. Failing to do this can be just as dangerous as faulty
prescribing.
• Files have to be drawn and checked for every telephonic script
and this takes time, particularly when there may be many
requests daily.
Please remember we would always rather see the patient (at a
proper consultation) than prescribe telephonically.
We hope this puts “some light” on the issue.
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