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Active Ingredient Prescribing

31 March 2021

Active Ingredient Prescribing on computer-generated prescriptions became mandatory for prescribers from 1 February 2021. Most prescribing software has been updated to reflect the new requirement. There is also information and resources for prescribers available from the Safety Commission, including medicines that are excluded from the requirements and medicines for which prescribers are recommended to consider including a brand.

(https://www.safetyandquality.gov.au/our-work/medication-safety/active-ingredient-prescribing).

Since its national roll-out, the Pharmacy Guild of Australia has been receiving reports from pharmacists about prescriptions for which there are significant safety concerns. Some of the problems relate to specific software and it is important that prescribers report any identified problems to their software provider.

Some prescriptions are confusing or unclear (e.g. omission of strength) and require clarification from the prescriber before they can be dispensed. Other examples include prescriptions in which the medicine is incomplete (e.g. ‘Insulin 100iu/ml vial’ without specifying the type of insulin). In such cases, delays in the pharmacist clarifying the prescription with the prescriber may have significant consequences for patients.

Pharmacists are reporting prescriptions for multiple ingredients in which the strengths do not correlate with the ingredient. For example, Targin 5/2.5mg appears as naloxone/oxycodone 5/2.5mg rather than oxycodone/naloxone 5/2.5mg.

There are also examples of prescriptions being generated that are not consistent with the recommendations from the Safety Commission. As an example, a prescription for four or more active ingredients (e.g. Bexsero) should be prescribed by brand. Likewise, the Safety Commission recommends for high-risk medicines such as insulin or warfarin that prescribers include a brand on the prescription.

Pharmacists are also reporting that some patients are upset and confused and worried that they have the wrong prescriptions. Prescribers can help allay any concerns when writing the prescription and this can be reinforced when the patient presents to the pharmacy.

If you are issuing an electronic token prescription, information which is entered into the ‘notes section’ when prescribing (eg clarification of brand intention for a combined oral contraceptive or clarification of strength of drug if it is not clear from software) is considered part of the legal prescription and can be used by pharmacists.  However, if issuing a paper prescription (even if it is sent via a prescription delivery service) the legislation states that all pertinent information including strength of drug must be printed on the prescription, and as such electronic notes associated are NOT sufficient for the pharmacist to legally dispense the prescription.

 The Pharmacy Guild of Australia and the Primary Health Network are encouraging all prescribers and pharmacists to be extra vigilant in checking computer generated prescriptions and communicating with each other and their patients to avoid prescription-related errors and allaying any patient concerns.