THE CORRESPONDING RESPONSIBILITY BESTOWED ON PHARMACISTS
The corresponding responsibility doctrine requires that a registered pharmacist must ensure that the prescription presented to them is valid and for a true medical purpose. This may entail due diligence on the part of the pharmacist by making an enquiry to the prescriber to discuss any legitimacy concerns that a pharmacist may have. Further, the pharmacist must satisfy themselves that the prescription was issued in the usual course of professional treatment or in legitimate and authorized research.
In the scenario, there are several instances that raise red flags and which would require the pharmacist to make enquiries with the prescriber. They include;
- Customers presenting in a group and have the same prescriber and prescription – Patients A, B and C all went to the pharmacy together and they all have the same prescription from Dr. Whitecoat. Further, patient B and C have the same exact prescription quantities even though patient C is an older woman. These are suspicious circumstances which should prompt the pharmacists to make enquiries with Dr. Whitecoat as to the validity of the prescriptions.
- Paying cash for an opioid – Patient A wants to pay cash for the opioid medication he is seeking. This is a red flag as payment for opioids in most instances will be catered for by insurance.
- Use of street slang to describe an opioid – Mary Evans, the young female customer, describes alprazolam 2mg as “bars”. The use of street slang in this instance is a red flag which should prompt a verification inquiry from the pharmacist to the prescriber.
- Unusual distance from the pharmacy – Patient A lives 75 miles from the community pharmacy. It would be suspicious to travel such a long distance and disregard many pharmacies along the way just to get to this particular one. As such, the pharmacists should treat this as a red flag.
Pharmacist Jim disregards the clear red flags that occur when he is working. He does not verify with the prescriber when customers who arrive in a group present prescription from the same prescriber neither does he question an unusually long distance travelled by a customer to get opioids, among other instances. As such, he is not meeting his duty under corresponding responsibility that he is tasked with.
On the other hand, Pharmacist Jeff declines to fill a prescription for the customer from the oncology clinic without giving any reason. While Jeff’s cautious attitude may be understandable in light of his son’s passing, he must balance such caution with the wellbeing of customers. In this instance, he should have made an enquiry with the customer’s prescriber to ensure its validity. As such, he is not meeting his duty under the corresponding responsibility.
The changes that would ensure Jim complies with the corresponding responsibility bestowed upon him would be to make enquiries regarding the validity of all prescriptions which seem suspicious. For instance, he should have called the prescriber of the customer who had travelled 75 miles or the prescriber of the customer who described her opioids in slang to verify validity.
On the other hand, Jeff should cease declining filling prescriptions of customers without any reason, yet they may be in genuine need of the opioids and have a genuine prescription. For instance, he should not have declined to fill the prescription of the customer from the oncology clinic. Rather, he should have made a call to the prescriber and authenticated the prescription.
REFERENCES
- 21 C.F.R Section 1306.04 (a) of DEA Regulations
- https://www.youtube.com/watch?v=WY9BDgcdxaM < Accessed on 29th March 2019>
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