Recommendations for Enhanced Communication

Between Physicians and Pharmacists

The following recommendations are the result of a working group of physicians, pharmacists and nurses. The objective is to convey communication tips that:

  1. Reduce unnecessary calls/faxes between pharmacists & physicians
  2. Enhance patient care
  3. Facilitate up-to-date patient profiling at the pharmacy
  4. Allow monitoring of patient adherence and re-enforcement of the most current directions
  5. Prevent discontinued medications from being ordered in error
  6. Improve availability of a current patient profile for planned or unexpected hospitalizations

Recommendations to Decrease Unnecessary Calls/Faxes

Communication Item / Physician Action / Pharmacist Action
Dosage Changes / Write on Rx:
  • intention to change dose of prescription
  • subsequent verbal changes communicated to pharmacist
/
  • Reinforce rationale for change to improve adherence
  • Update patient profile

Discontinued Meds / Write on Rx: intention to stop or change prescription / Ensure patient understands rationale for change & note discontinued med as
“inactive” on profile to prevent inadvertent refilling
Prescription Directions / Write on Rx: Complete dosage instructions as discussed with patient rather than as directed / Reinforce physician directions & assess patient adherence
Potential Allergy / Write on Rx: “aware of allergy – will monitor” / Counsel patient on potential signs & symptoms; document patient-specific allergy & follow-up with patient to determine tolerance
Potential Interaction / Write on Rx: “aware of interaction – will monitor” / Counsel patient on potential signs of interaction; follow-up with patient to determine tolerance
CPSO Number / Include your CPSO number on all prescriptions / When there is difficulty deciphering your signature, the pharmacist can check the CPSO website to ensure correct spelling of your name and contact information
Multiple Office Locations / When the prescription includes several office or hospital locations, indicate where the patient was seen / Ensure the correct location is entered on the patient file, to facilitate future communication, when needed

Recommendations to Enhance Patient Care

Communication Item / Physician Action / Pharmacist Action
Indication clarification / Write on Rx: indication for use if possible / Note indication on prescription label & reinforce MD treatment goals
Recommendations for Patient Care / Write on Rx: treatment goals / Reinforce rationale for goals & increase patient awareness on current/target levels
Prescription Clarification &/or Pharmacist Recommendation / Respond to Rx clarification or pharmacist-initiated recommendation in a timely manner / Fax MD utilizing standardized Pharmaceutical Opinion template
Referral for Consultation / Refer patient to pharmacy services including medication review, diabetes education, heart health, etc. / Provide requested service
Information Sheets / Write on Rx: counseling preferred (verbal, written, both) / Pharmacist will conduct verbal counseling only
Patient Annual Physical / When patient books their appointment, office staff suggest having a MedsCheck review with their pharmacist / Pharmacist performs MedsCheck review to develop ‘Best Possible Medication Record’ and gives a copy for the patient to take to their physician
Planned Hospital Admission / Hospital or family physician suggests the patient have a MedsCheck review with their pharmacist / Pharmacist performs MedsCheck review to develop ‘Best Possible Medication Record’ and gives a copy for the patient to take for their pre-op assessment and/or hospital admission
Patient Discharged from Hospital / Any medication changes made during the hospitalization are readily available for the family physician to follow-up post discharge / Pharmacist reviews list of discharge medications, revises the patient’s ‘Best Possible Medication Record’, explains changes to patient and/or caregiver, gives them a copy, and faxes a copy of the revised ‘Best Possible Medication Record’ to the family physician

We kindly appreciate your feedback regarding the suggested recommendations.

Thank you for your support.

Sincerely,

Ancaster-Dundas

Physician-Pharmacist Collaboration Project