Nearly one-third of the prescription medications that incorrectly appeared inactive on the PIP profiles had been dispensed in compliance packs. These packages are often prepared ahead of time to ensure that they are ready for the patient at the time of pick-up. Therefore, the fill date in the PIP profile often reflects the date when the prescription was processed by the pharmacy rather than the date the pack was started by the patient. As a result, the number of days’ supply in the PIP profile counts down to zero and the medication appears inactive before the patient has completed the compliance pack. Pharmacists should be encouraged to enter into the PIP system the date on which use of the compliance pack will start, not the dispensing date.

PIP entry errors in the dispensing pharmacy constituted another reason why medications incorrectly appeared inactive on the PIP profile. When a prescription is dispensed from a community pharmacy, the pharmacist must enter the total quantity dispensed and the number of days’ supply. In the current study, a total of 12 prescription discrepancies were identified in which an incorrect number of days was entered by the dispensing pharmacy. This resulted in a calculated daily dose significantly greater than the patient’s actual daily dose and led to the medication incorrectly appearing inactive on the patient’s PIP profile. For example, in one case, an Atrovent (ipratropium) inhaler was incorrectly dispensed as a one-day supply. Community pharmacists should be reminded of the importance of entering the correct number of days’ supply when dispensing prescription medications. Calculating the dose from the patient’s PIP profile is not a reliable substitute for completing a medication history with the patient. eriacta tablets

For the majority of discrepancies involving as-needed or as- directed prescription medications, the medication incorrectly appeared as inactive on the patient’s PIP profile. This problem is difficult to avoid, as the dispensing pharmacy must enter the number of days’ supply for each medication, which is often based on a “best guess” for usage. Salbutamol inhalers, nitroglycerin spray, and insulin were the 3 most common as- needed or as-directed medications that patients reported using
but that appeared inactive on the corresponding PIP profile.

For 28 (28%) of the 101 discrepancies involving prescrip­tion medications, the patient’s total daily dose differed from the daily dose recorded in the PIP profile. This problem is difficult to avoid for medications for which doses are adjusted on the basis of blood tests (e.g., warfarin) or signs and symptoms (e.g., furosemide) and drugs with tapering regimens (e.g., prednisone). The reliability of the PIP profile in these circumstances is questionable, and dosing information must be obtained from the patient. cialis super active