It has been brought to our attention by a small number of our customers that there is an issue relating to prescription writing that was introduced in Genie v9.3.9. This impacts Advantan Fatty Ointment, Qvar, Protophane and Bonjela printed scripts.
SUMMARY
The prescribing information supplied from MIMS contains two similar pieces of text describing each branded product.
One of these two pieces of text describes the formulation or form of the product more specifically than the other. In version 9.3.9 the less specific text is used on the printed script, raising the possibility of ambiguity regarding which particular form of the product was intended for the patient. This issue does not affect drugs on the List of Excluded Medicinal Items (LEMI).
In nearly all cases, the ambiguity is removed by other text present on the script, such as the active ingredient list, dose/strength, form and pack/qty/volume details.
After a detailed investigation, we have discovered only four instances where a printed script remains ambiguous as a result of this issue. These are:
- Advantan Fatty Ointment
- Qvar
- Protophane
- Bonjela
The most significant issue arises in prescriptions of Advantan Fatty Ointment, which will appear on the printed script as Advantan Ointment. The Fatty Ointment preparation has less water content than the Ointment preparation, thus has a different texture and theoretically a slightly different active ingredient bioavailability than the Ointment. This difference is unlikely to cause any major clinical consequence, but is likely to be annoying and concerning to prescriber and patient.
A second issue arises in prescriptions of Qvar. In this case, the script will not differentiate between the Autohaler Inhaler (breath actuated), and the pressurised “puffer” style MDI inhaler. For established users of the product, this is likely to be cleared up at the Pharmacy when the product is dispensed. For patients receiving this product for the first time, the outcome is less certain, and if the Autohaler was specifically chosen by the prescriber for a patient due to concerns about their ability to co-ordinate MDI actuation, it is possible that they will not receive an effective dose if the alternate MDI form is dispensed. This risk is likely to be minimised by good pharmacy practice, but the optimal outcome cannot be guaranteed.
A third issue involves Protophane, where a prescription for the 3ml InnoLet form of the product does not differentiate between the InnoLet form and the penfill form of the product. However, the patient will already own the injection device and it is inconceivable that the wrong form will be dispensed, as the two products are physically incompatible with the wrong device.
The fourth issue involves Bonjela, where the script will not differentiate between the Teething Gel and the Mouth Ulcer Gel forms. As there is no discernable difference in the products other than the labelling, this product is available over the counter and thus rarely prescribed, and has no PBS listing, this is not of clinical concern.
We are continuing to investigate and if any other instances are identified we will notify you.
Our team is currently working to correct this error with a resolution to be released as part of 9.4.1. In the meantime, we recommend reviewing the impacted printed scripts and handwriting the additional clarifying information on the script after it is printed.
We apologise for any inconvenience caused.
Kind regards,
The Genie Solutions Team.
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