Veterinary prescriptions can be challenging for community pharmacies

With the rise of pet ownership in the United States, community pharmacies are seeing a rise in animal related prescriptions come through their doors. Pharmacists are receiving prescriptions for new patients across a variety of species like dogs, cats, birds, horses, rabbits, that they might not have seen before. You may be thinking: Are community pharmacies trained to handle prescriptions for different species?

The Journal of the American Pharmacists Association has published a study that sought to identify, understand, and solve potential medication errors related to veterinary prescriptions. Researchers looked at a hard copy of the prescription compared to an image of the ultimate label.

On the prescribing end, veterinarians often omitted key information that is needed for a pharmacist to fill a veterinary medication. To fill animal prescriptions, weight and species is vital information to fill a medication safely, but veterinarians failed to provide weight on almost every prescription. Without the animal’s weight, pharmacists cannot check if the medication dosage is correct. Although not legally required, weight is clinically required for the pharmacist.

With the variability in weight and species, pharmacists often compound prescriptions to fit their patient. Of the prescriptions included in the study, 16.7% were medications that needed to be compounded for the patient. Compounding a medication includes any combination, mixing, or alteration in ingredients that changes the original medication. Although most pharmacists are properly trained, the FDA prohibits compounding of medications unless done by a 503b outsourcing facility that has been approved by the agency. None of the pharmacies in the studies were outsourcing facilities, but they still compounded the prescriptions and gave them to the patient.

On the filling end, the study found that pharmacists often did not catch the omission of the key information. With the weight being excluded from most of the prescriptions, it is unknown how pharmacists are filling these medications safely.

Another issue involved prescriptions for controlled substances. On many of these studied prescriptions, the veterinarian did not include the DEA number. It is important to note that DEA requirements for controlled substances are about the use of the controlled substance, not the species of the patient. Veterinarians and their patients are not exempt from DEA regulations and are required to include the DEA number on each prescription.

Investigators concluded that training needs to be improved for both the pharmacists filling the prescription and the veterinarians prescribing the medication. Researchers found that handwritten prescriptions had more errors than verbal prescriptions, which could be attributed to how veterinarians were taught in school. Only 22.2% of veterinarian students know how to physically write a prescription, indicating that they are being taught mostly electronic prescribing mechanisms. With 83.9% of veterinarians employed in small private practices, they often do not have the luxury of an e-prescribing system. According to the authors, students should be taught how to write prescriptions and include necessary information for pharmacists to fill medication safely. This same idea applies for pharmacists and pharmacy school. Schools need to teach pharmacy students about the requirements of veterinary prescriptions, so they can be prepared in practice.

Reference

McDaniel M, Glazier E, Truong N, et al. Veterinary prescription errors in a community pharmacy setting: A retrospective review. J Am Pharm Assoc. 2022;62(2):512-518. doi:10.1016/j.japh.2021.11.007