Don't Leave Off Key Details in Rx Sigs

State board inspectors and payers will be auditing pharmacies to ensure Rx directions are clear, correct, and complete.

It's partly because not including Rx info on the label...such as the indication or duration...can lead to patient confusion and harm.

Use these tips to help patients understand how to take their meds...and prevent your pharmacy from getting dinged on audits.

Closely read through the ENTIRE Rx before starting data entry. Overlooking e-Rx notes or special instructions can cause problems.

For instance, if you see "1 tablet PO daily" in the sig of a warfarin e-Rx...but miss the sig "One-half tablet on Mon, Wed, Fri" in the notes field...the patient will get the wrong dose.

Help clarify any "as directed" sigs with the patient or prescriber.

Include all directions and info for the patient from the sig and e-Rx notes on the label. This can help improve med use and limit mishaps.

For example, if a tramadol Rx says "1 tablet PO BID PRN," but you leave off "as needed," the patient may take the med around the clock...increasing the risk of side effects or opioid misuse.

And if an antibiotic suspension Rx says to take "for 10 days," make sure this makes it onto the Rx label. That way patients know when to stop therapy...especially if there will be leftover med in the bottle.

Perform a final review before completing data entry. Catching typos, omissions, or other issues early may head off delays later.

Double-check auto-populated sigs against the original Rx. The sig or e-Rx notes may not be transcribed completely or accurately...and you may need to edit details or add in missing points.

For instance, if an atorvastatin Rx auto populates as "Take one tablet orally at bedtime"...but the original Rx also stated "for cholesterol," you will need to add the indication.

This will remind the patient what the med is for...which can be especially important when taking multiple meds.

Also think of it as another safety check in the dispensing process. For example, an Rx for the heart med digoxin with the sig "Take 1 tablet by mouth daily for thyroid" is a red flag that something's amiss.

Use our checklist, Avoiding E-Prescribing Errors, to help stop other issues in their tracks.

Key References

  • www.cms.gov/Medicare-Medicaid-Coordination/Fraud-Prevention/Medicaid-Integrity-Education/Downloads/pharmacy-selfaudit-checklist.pdf (3-25-21)
Pharmacy Technician's Letter. April 2021, No. 370410



Practical advice for a better career, with unlimited access to CE

Pharmacy Technician's Letter includes:

  • 12 issues every year, with brief articles about new meds and hot topics
  • 200+ CE courses, including the popular CE-in-the-Letter
  • Helpful, in-depth Technician Tutorials
  • Access to the entire archive

Already a subscriber? Log in

Volume pricing available. Get a quote