DAW P?

      The concept of expanding the role of pharmacists could include giving us more power to substitute one prescription for another.  But will that ever happen? 

      I remember about a year ago I was at work during one of my long shifts (think 12+ hours).  At the beginning of my day my back began to hurt a little.  No big deal but I could tell it was a little tweaked. 

      As the day went on, my back got progressively worse.  By lunch, I was having difficulties walking around the pharmacy or bending over to pick up prescription labels.  It was at that time I called my scheduler.

      I told her I was hurting and that I needed her to cover for me in the evening so I could go to the doctor.  I was desperate to get out of any part of my shift to go get some relief from all of my pain.

      She covered the last couple of hours of my shift and I drove straight to the nearest urgent care center.  By this point, I was really hurting.  My back was killing me.

      The physician’s assistant that evaluated me at the urgent care immediately told me I pulled a back muscle.  We could both feel it was swollen.  I’m not sure how I did it, but I knew I was in pain. 

      After telling me what was wrong, the next thing out of the P.A.’s mouth was “So, what do you want for it?”  He knew from my chart that I was a pharmacist.  He wanted to see which medication I’d suggest. 

      To his credit, after I told him Skelaxin he was aware it now had a generic.  I chose this because it is one of the few muscle relaxers that I personally can take without being knocked out for ten plus hours in bed. 

      I wanted pain relief but I didn’t want to be knocked out.  He agreed with my suggestion and wrote me the prescription.   I drove back to the pharmacy to have it filled and went home to get some rest. 

      After thinking about that old trip to the urgent care, I’d be willing to bet almost every pharmacist on the planet has gone through a similar exchange with their doctors.  Either the doctor defers us automatically for a drug recommendation or we’ll demand a particular drug based on our professional judgement.

      Once we have a clinical diagnosis, pharmacists can prescribe.  After all, we’ve been trained to do so.  It is our area of expertise. 

      One commenter on my last blog post brought up the idea of a new DAW code that would designate a pharmacist’s freedom to substitute medications.  Collaborative practice agreements is another way to give pharmacists more control. 

      To do these functions effectively, pharmacists need a couple of things.  First, we need to know the patient’s diagnosis.  We can’t recommend a drug for a person if we don’t know what’s wrong with them. 

      And second, we will need the authority to act.  If necessary, create a new DAW code.  I’d suggest DAW P just to be different (DAW codes are typically numbers).  What you actually use for the code is irrelevant, as long as it’s clear on the prescription.   

      Pharmacists are more than capable of making therapy decisions for patients.  If we happen to need something like a DAW P to do so, then make it happen.  Just give us the tools and information we need to make an informed decision. 

     We’re literally waiting to show what we are capable of doing.  What’s holding us back?  Let’s make this happen.  Sign those prescriptions DAW P!

The Redheaded Pharmacist

3 Comments to “DAW P?”

  1. By Crazy RxMan, January 7, 2013 @ 11:48 pm

    I think this is an amazingly good idea. Brilliant.

      (Quote)

  2. By Pharmaciststeve, January 8, 2013 @ 10:22 am

    In LTCP.. it is very common for antibiotics – especially IV’s for the MD to order “pharmacy to chose/dose/monitor pt”
    I just wrote about a incident where the ARNP wrote such a order .. and IMO- the decision on what should have been prescribed was basically a “no-brainer”

    In this particular LTCP.. they have therapeutic substitution letters from various medical directors and/or specific docs… of course the RPH’s are prompted by the computer system to make the Therapeutic Interchange and gives us the drug(s) of choice… We mark on the label “this substituted for that” and some of the nursing staff .. it just drives them crazy.. because they don’t READ the labels..

    http://www.pharmaciststeve.com/?p=2631

    we have been going to the same PCP for some 15 yrs.. and I often just leave a VM, or send a fax.. saying ” I have and I need” and I cannot remember a time that he did not call in a Rx..

    Everyone seems to be on board with this concept.. except those that right the laws and those that pay the bills..

      (Quote)

  3. By Hirka T'Bawa, January 9, 2013 @ 12:21 am

    I was reading this and thought it sounded like a great idea…. then I thought it sounded familiar…. I went and looked at your last blog entry… Saw my own post suggesting this… and was Wow! I got mentioned in a blog! Amazing!!!! I feel special now!

      (Quote)

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