• Describe the challenges patients may face related to physician prescribing practices.
• Review the safety implications and inefficiencies of poor prescribing habits.
• Review certain laws relating to schedule II prescriptions.
• Describe the Alabama Department of Public Health Prescription Drug Monitoring Program database and how it can be used to monitor their patients for narcotic abuse.

Trina McKenzie, MD
School of Public Health, University of Alabama at Birmingham
VA Quality Scholars Fellow
Birmingham, Alabama

Juan McKenzie, PharmD
Walgreens Pharmacist

The University of Alabama School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The University of Alabama School of Medicine designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

The boards of nursing in many states, including Alabama, recognize Category 1 continuing medical education courses as acceptable activities for the renewal of license to practice nursing.

As a physician, you prescribe a variety of medications each day. In order for these medications to be effective, your patients must first have them filled by a pharmacy. Physicians are often unaware of the safety implications poor prescribing habits can have for their patients once the prescription leaves their office. However, there are things you can do as a physician to greatly influence the pharmacist’s ability to fill your patients’ prescriptions efficiently and accurately. There are also things you can do to ensure your prescriptions are not misused. Thus, participation in this module may help you:

• Appreciate the challenges patients face related to physician prescribing practices.
• Realize how poor prescribing practices can lead to unnecessary delays and potentially threaten patient safety.
• Familiarize yourself with laws regarding schedule II medications.
• Learn about one resource for monitoring your patients for narcotic abuse.

Mr. Clark presented to his physician several months ago complaining of frequency, hesitancy, and nocturia. His physician diagnosed him with BPH, and he was started on medication therapy. His dose has been increased, but he is still symptomatic. His physician decides to increase his medication further, and he writes the following prescription.[1]

He also writes several other prescriptions, and Mr. Clark takes them to the pharmacy to have them filled. The pharmacist sees this prescription, but she is unable to read the physician’s handwriting. She attempts to call Mr. Clark’s doctor, but since it is Friday afternoon, his office is closed. The pharmacist apologizes to Mr. Clark and lets him know that his prescription will not be ready until Monday at the earliest since she must fax the prescription to his physician for clarification.