Medication Orders and Prescriptions
Lec (2)
Lecturer
Noor
Yousif
Fareed
I
n
t
e
r
p
r
e
t
a
t
i
o
n
o
f
p
r
e
s
c
r
i
p
t
i
o
n
a
n
d
m
e
d
i
c
a
t
i
o
n
o
r
d
e
r
s
A
prescription is
an
order for medication issued
by a
physician, dentist,
or
other
properly licensed medical practitioner, designates
a
specific medication and dosage
to be
prepared
by a
pharmacist and administered
to a
particular
patient.
The
information
generally
found
on
a
completed
prescription
is
shown
in
Figure
4.1.
I
n
h
o
s
p
i
t
a
l
s
a
n
d
o
t
h
e
r
i
n
s
t
i
t
u
t
i
o
n
s
,
t
h
e
f
o
r
m
s
a
r
e
s
o
m
e
w
h
a
t
d
i
f
f
e
r
e
n
t
a
n
d
a
r
e
r
e
f
e
r
r
e
d
t
o
a
s
m
e
d
i
c
a
t
i
o
n
o
r
d
e
r
s
.
A
t
y
p
i
c
a
l
m
e
d
i
c
a
t
i
o
n
o
r
d
e
r
s
h
e
e
t
i
s
s
h
o
w
n
i
n
F
i
g
u
r
e
4
.
2
.
A
prescription
or
medication
order
for
an
infant,
child,
or
an
elderly
person
may
also
include
age,
weight,
and/or
body
surface area
(BSA)
of
the
patient.
An example
of a
prescription
written
for
a
pediatric patient is shown
in
Figure
4.3.
This information
is
sometimes
necessary in
calculating the appropriate medication
dosage.
It
is important to recognize two broad categories of
prescriptions:
(1)
Those
written
for
a
single
component
or
prefabricated
product
and
not
requiring
compounding or
admixture
by the
pharmacist,
(2)
Those
written for
more
than a single
component
and
requiring
compounding.
A
prescription may
include
the chemical
or
nonproprietary
(generic)
name
of the
substance
or the
manufacturer’s brand or trademark
name.
Examples
are
shown
for
prescriptions calling for trade-name products (Fig. 4.1 and
Fig. 4.3), a
generic drug (Fig. 4.4), and compounding (Fig.
4.5).
E- prescribing/ e-
prescriptions:
A
medication
order,
for
a
patient
is
entered
into
an
automated
data
entry
system
as
a
personal
computer
(PC)
or
a
handheld
device
loaded
with
e-prescribing
software
and
sent to
a
pharmacy
as an
e-prescription.
When received,
a
pharmacist immediately reduces the order to
a
hard
copy
and/or
stores it
as a
computer
file.
Prescription and medication order accuracy
It
is the responsibility
of the
pharmacist
to
ensure that each prescription
and
medication order given in correct
form,
each
medication should
be:
•
therapeutically appropriate for the
patient;
•
prescribed
at
the correct
dose;
•
dispensed in the correct strength and dosage
form;
•
correctly
labeled
with
complete instructions for the patient
or
caregiver;
and
•
for
the patient
in a
hospital or other health
care facility, each
medication must
be
administered to the correct patient,
at
the
correct
time,
and by the
correct rate and
route of
administration.
Use of Roman numerals on
prescriptions
Roman numerals commonly
are used in
prescription writing to designate
quantities,
as
the:
(1)
quantity
of
medication to
be
dispensed
and/or
(2)
quantity
of
medication to
be
taken
by the
patient
per
dose.
The following rules apply
in
the use
of
Roman
numerals:
1.
A letter
repeated once
or
more,
repeats
its value (e.g., xx
=
20; xxx
=
30).
2.
One or
more
letters
placed
after
a
letter of greater value increases the value
of
the
greater letter (e.g.,
vi =
6;
xij =
12; lx
=
60).
3.
A letter
placed
before a
letter
of
greater value
decreases
the value
of
the greater
letter (e.g.,
iv=
4;
xl =
40).
Capital
or
lower case letters may
be
used.
A
‘‘j’’
may be used
as
the final ‘‘i’’
in a
sequence (e.g., viij).
Use of abbreviation and
symbols
The
use of
abbreviations
is
common
on
prescriptions and medication orders. Some
are
derived
from the
Latin through its historical use in medicine and pharmacy,
whereas others have evolved through prescribers’
use of
writing shortcuts.
A
list of
some
of these
abbreviations
is
presented
in Table
4.2.
T
A
B
L
E
4
.
2
S
E
L
E
C
T
E
D
A
B
B
R
E
V
I
A
T
I
O
N
S
,
A
C
R
O
N
Y
M
S
,
A
N
D
S
Y
M
B
O
L
S
U
S
E
D
I
N
P
R
E
S
C
R
I
P
T
I
O
N
S
A
N
D
M
E
D
I
C
A
T
I
O
N
O
R
D
E
R
s
a
,
b
qt.
ss
or
ss
(semissem
tb
sp
.
tsp
.
qua
rt
one
ha
lf
t ab
l
espoonfu
l
teaspoonful
o
f
each
up
to;
to
make
dispense
d
i
v
i
de
g
i
ve o
f
s
u
c
h
doses
Signa/Pat
i
ent
I
n
st
ruct
i
o
n
s
before
meals
a
t
p
l
easu
r
e,
fr
ee
l
y
adm
i
n
i
ste
r
m
o
rn
ing
ma
k
e
m
i
x
n
u
mb
e
r
do
not
repeat
a
su
ff
i
cien
t
quan
t
i
t
y
aa
.
o
r
(ana)
ad
(ad)
disp.
(d
i
spensat
ur
)
div.
(dividatur)
d.
t
.d.
(dentur
tales
doses
)
ft
(fiat)
M
.
(mice)
No
.
(numero)
non
rep.
or
NR
(no
n
r
epata
t
ur)
q.s.
(quan
t
um
s
uff
i
c
it
)
q.s.
ad
(qua
n
t
u
m
s
uff
i
c
i
a
t
ad)
Sig.
(Sig
n
a)
a sufficient
quantity
to
make
w
rit
e
(d
ir
ect
i
ons
o
n
label)
Q
u
ant
i
t
i
es
and
M
eas
u
r
eme
nt
cm
B
SA
3
for
fl
(
fl
u
idus)
f
l
3
o
r
f
3
f1
5
ss
orf
5
ss
wa
t
er
aro
u
nd
t
he
c
l
oc
k
twice
a
day
with
day
d
i
lu
t
e
and
hour
at
bedtime
between
mea
l
s
min
u
t
e
m
o
rn
ing
and n
i
gh
t
na
u
sea
and
vom
it
ing
n
i
g
ht
noth
i
ng
by
mo
ut
h
after
meals
afternoon;
evening
by
mouth
(orally)
as
needed
every
every
morning
every
_
hours
four
times
a
day
g
ga
l
g
tt
(gutta)
l
b
(/ibra)
k
g
l
m
2
or
M
2
mcg
mEq
mg
mg/
k
g
a.c
.
(ante
c
i
bos)
ad
lib.
(ad
libitum)
adm
in
A.
M
.
(ante
meridiem)
aq.
(aqua)
A
T
C
b.i.d.
(bis in
d
i
e)
c
or
e
(cum)
d
(d
i
e)
d
i
l.
(dilutus)
e
t
h.
or hr.
(ho
r
a)
h.s.
(hora
somn
i
)
i.
e.
(inter
cibos)
min
.
(minutum)
m&n
N
&
V
noct.
(nocte)
NPO
(non
per
os)
p.c.
(pos
t
c
i
bos)
P.M.
(pos
t
meridiem)
p.
o
.
(pe
r
os)
p.r.n.
(p
r
o
r
e
nata)
q
(quaque)
qAM
q4h,
q8h,
etc.
q.i.d.
(quarte
r
i
n
d
i
e)
rep.
(repetatur)
s
(sine)
s.
i.
d
.
(semel
in
die)
s.o.s.
(si
op
u
s
s
i
t)
mg/m
2
mL
mUh
r
epea
t
w
it
h
out
once
a
day
if
t
he
r
e
is
need;
as
needed
immediately
t
hree
t
im
es
a
day
as
d
ir
ected
wee
k
stat.
(s
t
at
im
)
t
.
i.d
.
(
t
e
r
in
d
i
e)
ut
d
i
et.
(ut
dictum)
w
k
.
Me
d
i
ca
t
i
ons
APA
P
ASA
A
Z
T
acet
a
m
i
n
ophen
asp
iri
n
z
i
dovud
i
n
e
mOsm or
mOsmol
oz.
body
su
r
face
area
cubic
cent
im
ete
r
o
r
mill
il
i
t
e
r
(m
l
)
flu
i
d
flu
i
d
dram
(
;,;,
t
easpoo
n
fu
l,
5
m
l
)
hal
f
-
fl
u
i
dounce
(;,;,
t
ablespoonfu
,
l
1
5m
l
)
gram
gallo
n
d
r
op
po
u
nd
k
i
log
r
a
m
li
te
r
squa
r
e
me
t
e
r
m
i
c
r
og
r
am
m
i
ll
iequiva
l
ent
milligram
m
i
ll
ig
r
ams
(o
f
d
ru
g)
pe
r
k
i
log
r
a
m
(o
f
body
we
i
gh
t
)
m
i
ll
ig
r
ams
(o
f
d
ru
g)
pe
r
sq
u
ar
e me
t
e
r
(o
f
body
surface
area)
milliliter
m
i
lli
lit
ers
(of
drug
ad
min
is
t
ered)
pe
r
hour
(as
throug
h
i
nt
r
avenous
ad
min
is
t
r
a
t
i
o
n
)
m
i
ll
iosmoles
ounce
(
continued
)
T
A
B
L
E
4
.
2
C
o
n
t
i
n
u
e
d
ABBREVIATION
MEANING
(LATIN
ORIG
I
N')
EES
ABBREVIATION
(LATIN
ORIG
I
N')
DSNS
MEANING
erythromycin
ethy
l
succin
ate
hyd
rocort
i
sone
hydroch
l
orot
h
i
az
i
de
methotrexate
n
i
troglycer
i
n
DSW
010W
elix.
i
nj.
NS
½
NS
dextrose
5
%
i
n
normal
sa
l
i
ne
(0
.
9
%
sod
i
um
chlor
i
de)
dextrose
5
%
i
n
water
dextrose
1
0
%
in
water
e
l
i
x
i
r
in
j
ect
i
on
norma
l
sa
l
ine
h
a
l
f-strengt
h
norma
l
sa
l
i
ne
ointment
HC
HCTZ
MD<
NTG
C
l
i
n
ic
a
l
BM
BP
BS
CHO
CHF
GERO
oint
or
ungt.
(unguentum)
pulv
.
(pulvis
)
R
,
L
R/L or
LR
powder
R
i
nger's
Lactate or
Lactated
Ringer
'
s
solution
suppos
i
to
ry
G
I
GFR
GU
HA
HBP
HRT
sol.
(solut
i
o
)
supp.
(suppos
i
tor
i
um
)
susp.
syr.
(syrupus
)
tab.
(tab
l
etta
)
suspension
syrup
tablet
Routes of
Adm
i
nistrat
ion
C
I
VI
HT
or
HTN
I
OP
Ml
OA
Pt
SOB
TPN
URI
UTI
bowe
l
movement
b
l
ood
preasure
b
l
ood
sugar
coronary
heart
d
i
sease
congestive
heart
fai
l
ure
gastroint
est
i
na
l
r
ef
l
ux
d
i
sease
gastroint
est
i
na
l
g
l
om
erular
fi
l
trat
i
on
rate
genit
our
i
nary
headache
h
i
gh
b
l
ood
pressure
hormone
rep
l
acement
therapy
hypertension
i
ntraocular
pressure
myocard
i
a
l
i
schem
i
a/
i
nfarct
i
on
osteoarthr
i
t
i
s
pat
i
ent
shortness of
breath
tot
a
l
parentera
l
nut
rit
i
on
upper
resp
i
ratory
i
nfect
i
on
ur
i
nary
tract
i
nfect
i
on
Dosage
Forms
/Veh
i
cles
am
p
.
cap.
DSLR
ampu
l
capsule
dextrose
5
%
i
n
lactated
R
i
ng
er's
I
D
I
M
I
T
I
V
I
VB
I
V
Dr
i
p
I
VP
I
VPB
NGT
p
.
o.
or
PO
(per
os
)
rect
.
SL
SubQ
Top.
Vor
PV
continuous
(24
hour
)
i
ntravenous
i
nfusion
i
ntraderma
I
int
r
amuscu
l
ar
int
ratheca
l
intravenous
intravenous
bo
l
us
intravenous
i
nfus
i
on
intravenous
push
intravenous
p
i
ggy
back
nasogastr
i
c
tube
by
mouth
recta
l
or
rectum
sub
l
i
ngual
subcutaneous
l
y
top
i
ca
l
ly
vag
i
nally
The portions of
the
prescription presenting directions
to
the pharmacist (the
Subscription)
and
the directions to
the
patient (the Signa) commonly contain
abbreviated
forms
of
English
or
Latin
terms
as
well
as
Arabic and Roman
numerals.
Medication scheduling and patient
compliance
Medication scheduling may
be
defined
as the
frequency (i.e., times
per
day)
and
duration (i.e., length
of
treatment)
of a
drug’s prescribed
or
recommended
use.
Frequency
of
medication scheduling
is
influenced
by
The patient’s physical
condition
The nature and severity
of the
illness
The condition being
treated.
P
a
t
i
e
n
t
c
o
m
p
l
i
a
n
c
e
i
s
d
e
f
i
n
e
d
a
s
p
a
t
i
e
n
t
u
n
d
e
r
s
t
a
n
d
i
n
g
a
n
d
a
d
h
e
r
e
n
c
e
t
o
t
h
e
d
i
r
e
c
t
i
o
n
s
f
o
r
u
s
e
.
Compliance includes taking medication
at
the desired strength, in the proper dosage
form,
at the
appropriate
time
of day and
night,
at
the proper interval
for
the duration
of
the
treatment.
P
a
t
i
e
n
t
n
o
n
c
o
m
p
l
i
a
n
c
e
i
s
t
h
e
f
a
i
l
u
r
e
t
o
c
o
m
p
l
y
w
i
t
h
a
p
r
a
c
t
i
t
i
o
n
e
r
’
s
o
r
l
a
b
e
l
e
d
d
i
r
e
c
t
i
o
n
i
n
t
h
e
s
e
l
f
-
a
d
m
i
n
i
s
t
r
a
t
i
o
n
o
f
a
n
y
m
e
d
i
c
a
t
i
o
n
.
N
o
n
c
o
m
p
l
i
a
n
c
e
m
a
y
i
n
v
o
l
v
e
u
n
d
e
r
d
o
s
a
g
e
o
r
o
v
e
r
d
o
s
a
g
e
,
i
n
c
o
n
s
i
s
t
e
n
t
o
r
s
p
o
r
a
d
i
c
d
o
s
i
n
g
,
i
n
c
o
r
r
e
c
t
d
u
r
a
t
i
o
n
o
f
t
r
e
a
t
m
e
n
t
,
a
n
d
d
r
u
g
a
b
u
s
e
o
r
m
i
s
a
d
v
e
n
t
u
r
i
n
g
w
i
t
h
m
e
d
i
c
a
t
i
o
n
s
.
Causes of
patient non
compliance:
1.
unclear
or
misunderstood
directions,
2.
undesired side effects
of
the drug that discourage
use,
3.
lack
of
patient confidence
in
the drug and/or
prescriber,
4.
discontinued use because the patient feels better
or
worse,
5.
economic reasons based on the cost
of
the medication,
6.
absence
of
patient counseling and understanding
of
the need for and means
of
compliance,
7.
confusion over taking multiple
medications.
Consequences
of
patient non
compliance
1.
worsening of the
condition,
2.
the
requirement
of
additional and perhaps more expensive
and
extensive
treatment methods
or
3.
surgical procedures, otherwise unnecessary hospitalization,
and
4.
increased total health
care
cost.
Some
of the
different types
of
problems relating
to
patient compliance
with
medication
are
exemplified
by the
following
examples.
How many milliliters
of
medicine should be
dispensed?
Answer:
5
mL
times
4
(doses
per
day)
equals
20
mL
times
10
(days)
equals
200
mL.
A
pharmacist may
calculate a
patient’s percent compliance rate
as
follows:
Example:
What
is
the
percent
compliance
rate
if
a
patient
received
a
30-day
supply
of
medicine
and returned in 45
days
for a
refill?
A prescription is a crucial order for medication issued by medical practitioners, specifying medication details for a specific patient. This includes dosage, patient information, and may require compounding by pharmacists. Different types of prescriptions exist, such as those for single-component products or compounding. E-prescribing is becoming more common, enhancing accuracy and efficiency in medication orders. Roman numerals are used to indicate quantities in prescriptions to ensure precise dosing.
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Lec (2) Lecturer Noor Yousif Fareed Interpretation of prescription and medicationorders A prescription is an order for medication issued by a physician, dentist, or other properly licensed medical practitioner, designates a specific medication and dosage to be prepared by a pharmacist and administered to a particularpatient. Theinformation generallyfoundon a completed prescriptionis shown in Figure4.1.
In hospitals andotherinstitutions, theforms are somewhat different andare referred to as medication orders. A typical medication order sheet is shown in Figure4.2. Aprescription ormedicationorderfor an infant,child,or an elderlyperson may also include age, weight, and/or body surface area (BSA) of the patient.
An example of a prescription written for a pediatric patient is shown in Figure 4.3. This information is sometimes necessary in calculating the appropriate medication dosage. It is important to recognize two broad categories of prescriptions: (1)Those written for a singlecomponent or prefabricated product and not requiring compounding or admixture by the pharmacist, (2) Those written for more than a single component and requiring compounding. A prescription may include the chemical or nonproprietary (generic) name of the substance or the manufacturer s brand or trademark name.
Examples are shown for prescriptions calling for trade-name products (Fig. 4.1 and Fig. 4.3), a generic drug (Fig. 4.4), and compounding (Fig. 4.5).
E- prescribing/ e- prescriptions: A medication order, for a patient is entered into an automated data entry system as a personal computer (PC) or a handheld device loaded with e-prescribing software and sent to a pharmacy as an e-prescription. When received, a pharmacist immediately reduces the order to a hard copy and/or stores it as a computer file. Prescription and medication order accuracy It is the responsibility of the pharmacist to ensure that each prescription and medication order given in correct form, each medication should be: therapeutically appropriate for the patient; prescribed at the correct dose; dispensed in the correct strength and dosage form; correctly labeled with complete instructions for the patient or caregiver; and for the patient in a hospital or other health care facility, each medication must be administered to the correct patient, at the correct time, and by the correct rate and route of administration. Use of Roman numerals on prescriptions Roman numerals commonly are used in prescription writing to designate quantities, as the: (1) quantity of medication to be dispensed and/or (2) quantity of medication to be taken by the patient per dose.
The following rules apply in the use of Roman numerals: 1. A letter repeated once or more, repeats its value (e.g., xx = 20; xxx = 30). 2.One or more letters placed after a letter of greater value increases the value of the greater letter (e.g., vi = 6; xij = 12; lx = 60). 3.A letter placed before a letter of greater value decreases the value of the greater letter (e.g., iv= 4; xl = 40). Capital or lower case letters may be used. A j may be used as the final i in a sequence (e.g., viij). Use of abbreviation and symbols The use of abbreviations is common on prescriptions and medication orders. Some are derived from the Latin through its historical use in medicine and pharmacy, whereas others have evolved through prescribers use of writing shortcuts. A list of some of these abbreviations is presented in Table 4.2.
TABLE 4.2 SELECTED ABBREVIATIONS , ACRONYM S, AND SYMBOLS USED IN PRESCRIPTIONS AND MEDICATION ORDERsa,b ABBREVIATlON (LATIN ORIGIN') Prescriptio n Filling Directions aa. or (ana) ad (ad) disp. (dispensatur) div. (dividatur) d.t.d. (dentur tales doses) ft (fiat) M. (mice) No. (numero) non rep. or NR (non repatatur) q.s. (quantum suff icit) q.s. ad (quantum suff iciat ad) Sig. (Signa) ABBREVIATION (LATIN ORIGIN') pt. qt. ss or ss(semissem tbsp. tsp. Signa/Patient Instruct ions a.c. (ante cibos) adlib. (adlibitum) admin A.M. (ante meridiem) aq.(aqua) ATC b.i.d. (bis in die) c or e (cum) d (die) d il. (dilutus) et h. or hr. (hora) h.s. (hora somni) i.e. (intercibos) min. (minutum) m&n N&V noct. (nocte) NPO (non per os) p.c. (post cibos) P.M. (post meridiem) p.o. (per os) p.r.n. (pro re nata) q (quaque) qAM q4h, q8h,etc. q.i.d. (quarter in die) rep. (repetatur) s(sine) s.i. d . (semel indie) s.o.s. (si opussit) MEANING MEANING pint quart onehalf t ablespoonfu l teaspoonful of each up to; to make dispense divide give of such doses before meals at pleasure, freely administer morning make mix number do not repeat water around the clock twice aday with day dilute and hour at bedtime between meals minute morning and night nauseaand vomiting night nothing by mouth after meals afternoon; evening a suff icient quantity a sufficient quantity to make writ e(directions on label) Quantities and Measureme nt cmB SA 3 body surfacearea cubic centimeter or mill iliter (ml) fluid fluid dram (;,;, teaspoo nfu l, 5 ml ) hal f -fl u idounce(;,;, tablespoonfu, l 15ml ) gram gallon drop pound kilogram liter square meter microgram milliequiva lent milligram milligrams(of drug) per kilogram (of body weight) mill ig rams (of drug) per squar e meter (of body surface area) milliliter millilit ers (of drug administered) per hour (as throug h int ravenous administration) milliosmoles ounce for fl (fl uidus) fl3 or f3 f15ss orf5ss g gal gtt (gutta) lb (/ibra) kg l m2 or M2 mcg mEq mg mg/kg by mouth (orally) as needed every every morning every _ hours four timesa day repeat without once a day if t here is need;as needed immediately three timesa day as directed week mg/m2 stat. (statim) t.i.d. (ter in die) ut diet. (ut dictum) wk. Medications APAP ASA AZT mL mUh acetaminophen aspiri n zidovudine mOsm or mOsmol oz. (continued )
TABLE 4.2 Continued ABBREVIATION (LATINORIGIN') ABBREVIATION (LATIN ORIGIN') MEANING erythromycin ethylsuccinate hydrocortisone hydroch lorot hiazide methotrexate ni troglycer in MEANING dextrose 5% in normal sal ine (0.9% sodium chloride) dextrose 5% inwater dextrose 10% in water elixir in ject ion norma l saline half-strength normal saline ointment EES DSNS HC HCTZ MD< NTG DSW 010W elix. inj. NS NS Clinical BM BP BS CHO CHF GERO bowel movement b l ood preasure b l oodsugar coronary heart disease congestive heart failure gastroint estina l reflux disease gastroint estinal glomerular filtration rate genitourinary headache hi gh blood pressure hormone replacement therapy hypertension intraocular pressure myocardial ischem ia/ infarct ion osteoarthritis patient shortness of breath tot al parenteral nut rition upper respiratory infection ur inary tract infection oint orungt. (unguentum) pulv. (pulvis) R , L R/L or LR powder Ringer's Lactate or Lactated Ringer 's solution suppository GI GFR GU HA HBP HRT sol. (solut io) supp. (supposi tor ium) susp. syr. (syrupus) tab. (tabletta) suspension syrup tablet HT or HTN IOP Ml Routes of Administration CIVI continuous (24 hour) intravenous infusion intradermaI int ramuscular int rathecal intravenous intravenous bolus intravenous infusion intravenous push intravenous piggy back nasogastric tube by mouth rectal or rectum sublingual subcutaneously topically vaginally ID IM IT IV IVB IV Drip IVP IVPB NGT p.o. or PO (per os) rect. SL SubQ Top. Vor PV OA Pt SOB TPN URI UTI Dosage Forms /Vehicles amp. cap. DSLR ampul capsule dextrose 5% in lactated Ringer's
The portions of the prescription presenting directions to the pharmacist (the Subscription) and the directions to the patient (the Signa) commonly contain abbreviated forms of English or Latin terms as well asArabic and Romannumerals. Medication scheduling and patient compliance Medication scheduling may be defined as the frequency (i.e., times per day) and duration (i.e., length of treatment) of a drug s prescribed or recommended use. Frequency of medication scheduling is influenced by The patient s physical condition The nature and severity of the illness The condition being treated.
Patient compliance is defined as patient understanding and adherence to the directions for use. Compliance includes taking medication at the desired strength, in the proper dosage form, at the appropriate time of day and night, at the proper interval for the duration of the treatment. Patient noncompliance is the failure to comply with a practitioner s or labeled direction in the self-administration of any medication. Noncompliance may involve underdosage or overdosage, inconsistent or sporadic dosing, incorrect duration of treatment, and drug abuse or misadventuring with medications. Causes of patient noncompliance: 1. unclear or misunderstood directions, 2. undesired side effects of the drug that discourage use, 3. lack of patient confidence in the drug and/or prescriber, 4. discontinued use because the patient feels better or worse, 5. economic reasons based on the cost of the medication, 6. absence of patient counseling and understanding of the need for and means of compliance, 7. confusion over taking multiple medications. Consequences of patient non compliance 1. worsening of the condition, 2. the requirement of additional and perhaps more expensive and extensive treatment methods or 3. surgical procedures, otherwise unnecessary hospitalization, and 4. increased total health care cost.
Some of the different types of problems relating to patient compliance with medication are exemplified by the following examples. How many milliliters of medicine should be dispensed? Answer:5 mLtimes 4 (dosesper day) equals 20 mLtimes 10 (days) equals 200 mL. A pharmacist may calculate a patient s percent compliance rate as follows: Example: Whatisthepercentcompliancerateifapatientreceiveda30-daysupplyofmedicine and returned in 45 days for a refill?
