Identifying Forged Prescriptions
Prescription forgeries are on the rise, and it is important for all pharmacy staff to be alert.
Prescription forgeries continue to be presented to pharmacies in person, however the College is increasingly receiving reports of forgeries being faxed or called in over the phone. Electronic or computer-generated prescription forgeries are becoming much more common, however pharmacies continue to receive handwritten prescription forgeries, photocopied legitimate prescriptions, altered, or falsified written prescriptions and/or verbal order forgeries. Pharmacy staff are reminded to objectively review all prescriptions for potential signs of a forgery.
Faxed Prescriptions
Potential signs of a forgery:
- Incorrect/missing clinic fax, phone number and address on the prescription header
- The fax number origin does not match that registered to the medical clinic or prescriber
- Missing fax cover sheet or confidentiality statement
- The signature does not match that of the prescriber (if the signature is unknown to the pharmacist, it should be verified)
- The template looks different from the clinic’s typical template
Verbal Prescriptions
Potential signs of a forgery:
- The individual providing the verbal order cannot answer identifying questions such as clinic information, the prescriber license number, etc.
Prescriptions Presented in Person
Potential signs of a forgery:
- White-out, overwriting, smudging, or different colour ink (especially if involving the date, drug quantity or the addition of a trailing zero)
- Changes without initials
- No ink signature/photocopy (this is most easily identified before electronically scanning a prescription)
- The signature does not match that of the prescriber (if the signature is unknown to the pharmacist, it should be verified)
- The template looks different from the clinic’s typical template
All Prescriptions
Potential signs of a forgery:
- Spelling and/or punctuation mistakes, unusual abbreviations, symbols, terminology, sig codes used inappropriately
- Unusually large quantities
- The dosage or directions do not fall within guidelines/outside of the usual dosage patterns
- Directions are fully written out with no medical or appropriate abbreviations or terminology
- Changes in font size or type or other inconsistencies in formatting (margins, spacing)
- Evidence that the prescription was presented to another pharmacy and not filled
If a forgery is suspected, the prescriber must be contacted to confirm the prescription. Once a forgery is confirmed:
- Retain prescription. If patient demands prescription, make copy of prescription and mark original to alert next pharmacy. Do not compromise safety of pharmacy staff or patients.
- Contact police. Provide a copy of original prescription to police if requested and allowed.
- Report attempted forgeries to CPhM using the new online attempted forgery reporting tool. A manual form is available upon request. https://forms.office.com/r/8abeQy3cf1
- * Report the forgery to CPhM and the Health Canada Office of Control Substance ONLY if it was filled by completing and submitting a loss/theft report.
A record must be maintained when refusing to fill a prescription. If refusing to fill a drug on the M3P schedule it must also be documented on DPIN. In the case of forgeries, it is also recommended to document non-M3P drugs on DPIN as well. More information on documenting a refusal to fill on DPIN can be found at the following here.
Prescription Not Required for Children’s Over-the-Counter Fever and Pain Medicine
Supply of pediatric acetaminophen and ibuprofen is currently limited due to increased demand. Pharmacies in Manitoba may have difficulty sourcing these products.
Recent media coverage has implied a prescription may be required to obtain pediatric acetaminophen and ibuprofen. This may cause some uncertainty or confusion among the public. The College reminds pharmacy professionals that a prescription is not required, and these drugs remain available for over-the-counter purchase.
Pharmacy professionals are well positioned to help the public navigate this issue. Pharmacy professionals should continue to use their clinical knowledge and expertise to help guide parents and caregivers. Pharmacists may want to consider the following when consulting with parents and caregivers:
- A clinical assessment to determine the appropriateness of alternative dosage forms
- Counseling parents and caregivers
- On appropriate dosing and administration
- When non-pharmacological methods may be appropriate.
- Pharmacists can refer caregivers to the Healthy Parenting Winnipeg website here for more information on fevers.
- On only buying what is needed and avoiding stockpiling On the importance of buying these products from a reputable source
CPhM, in collaboration with other stakeholders, will continue to monitor the situation.
If you have questions or require further guidance, please contact fieldops@cphm.ca.
Indigenous Trauma and Equity Informed Practice Webinar and Workshop
To honour National Day for Truth And Reconciliation on September 30, 2022, and to respond to Call to Action 24 in the Truth and Reconciliation Commission of Canada: Calls to Action Report, Continuing Professional Development for Pharmacy Professionals (CPDPP), in collaboration with Saskatchewan College of Pharmacy Professionals, Alberta College of Pharmacy, and College of Pharmacists of Manitoba, presents an informative and meaningful learning experience with Len Pierre Consulting.
The day will start with a webinar titled, Indigenous Trauma- and Equity-Informed Practice, from 10:00 a.m. – 11:30 a.m. (central time). This webinar is open to all pharmacy professionals, students, and staff who support pharmacy practice.
At 10:45 a.m., a smaller virtual workshop titled, Cultural Safety in Practice begins. We have a limit of 150 people for this 2.5 hr. workshop with 50 participants from each SK, MB, and AB. The target audience for this workshop is people in a position to facilitate change and focus on immediate takeaways for implementing systemic transformation concepts.
See the CPDPP webpage for more details and registration links.
Save the Date for the 2022 Medical Examiner Professional Development Event
CPhM is pleased to announce its fourth annual Medical Examiner professional development event.
WHEN: Tuesday, October 4, 2022, from 7:00 to 8:45 p.m.
SPEAKERS:
- Talia Carter MOT, BSc, O.T. Reg. (MB), Prescribing Practices Program Coordinator, The College of Physicians & Surgeons of Manitoba
- Mike Sloan, B.Sc. (Pharm), Pharmacy Manager
ACCREDITATION: This CPhM program can be claimed for up to 1.5 accredited CEU in the online PD Log.
The event will be held virtually and is free to attend for pharmacists and pharmacy staff.
Event title, learning objectives and registration link will be provided closer to the event date.
CCCEP Article – A Prescription for a Satisfying Career and Better Patient Care
The Canadian Council on Continuing Education in Pharmacy (CCCEP) recently published an article titled, A Prescription for a Satisfying Career and Better Patient Care.
This is the second article in a series about the value of high-quality continuing education for pharmacy professionals, the difference it can make to their practice and careers, and the role accreditation can play in ensuring the quality of continuing education.
To read the full article, click here.
Career Opportunity: Practice Consultant – Policy and Legislation
The College of Pharmacists of Manitoba is presently in search of a Practice Consultant – Policy and Legislation, to fill a term position. This individual will collaborate closely with colleagues across all divisions of the organization to analyze, develop, and maintain policies, standards, and other guidance items for pharmacy practice. This is a full-time term position, Monday to Friday, based on a 37.5 – hour work week. Start and length of term to be negotiated, based on successful candidate’s availability. There may be potential to extend the term beyond the initial duration.
For a complete description of the duties, qualifications, and required attributes for this position, and to apply, click here.
Applications will be reviewed from all sources as received until the position is filled.
The College values diversity and inclusion and encourages all qualified people to apply.
Upcoming Events & Professional Development Opportunities
Targeting Isolation Pharmacy Survey
Click here to participate in a University of Manitoba, research study entitled Reducing social isolation and loneliness among older adults.
Mental Health First Aid Standard (Virtual) Certification Courses
See website for dates and registration information. Please note this is a non-accredited learning activity.
ISMP Incident Analysis and Proactive Risk Assessment for Health Care Practitioners and Patient/Family Advisors
September 29-30, October 22-23, November 24-25, and December 8-9, 2022
Register here.
ISMP MedRec and BPMH Training for Health Care Professionals
September 23 and November 18, 2022
Register here.
Medication Safety Considerations for Compliance Packaging
Register here.
Preventing and Analyzing Medication Errors
Register here.