The Pharmaceutical Journal
Vol 268 No 7198 p683-685
18 May 2002

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Letters to the Editor

Dispensing

No wonder patients get confused

From Mr J. Blake, MRPharmS

Ask 100 patients at random how many days there are in a month. Most will reply 30, or 31, but how many would venture 28 — unless you asked the question in February? From this arises the problem that we have as pharmacists in convincing patients that a "patient pack" of 28 tablets constitutes a month's supply.

This is even more difficult when the medicine comes from a container of 500 or 1,000 tablets, and is dispensed loose into a bottle, when their prescription was for a 30-day supply. Patient packs would have been a good idea if they had been introduced as had been intended and, indeed, as they have been on the continent of Europe. Our continental partners laugh at us, spending so much time using scissors.

The problem is exacerbated by those generic manufacturers that still insist on marketing two pack sizes — one of 28 and one of 30. If all this were not enough to make the physical side of dispensing so ambiguous, we also have to fight our way through a range of patient packs that are devoid of variation in colour and styles of text.

There have been numerous occasions where I have selected items such as atenolol and thyroxine tablets off the shelf to find these two particular generics muddled together. Different strengths of the same drug also pose potential problems where patient safety could be compromised.

No wonder patients get confused. At one recent pharmacy I encountered eight different brands of metformin 850mg in the dispensary, and I was forced to dispense using four different brands on a single prescription.

There are further complications when we are forced to remove expiry dates and batch numbers when we snip away with our scissors. So what is the greater crime the pharmacist can perpetrate here? Should he not supply the prescribed quantity or should he dispense without the details printed on the end of the patient pack?

Please can someone put some common sense into this ongoing saga.

John Blake
Nerja, Spain

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