Prescriptions for medications whose dosing is standardized in the industry often come with directions that simply state, “Use as directed.” These types of products typically have the standard dosing right on the package being dispensed to the patient like bowel preps for colonoscopy, EpiPen®, starter dose kits (e.g., Eliquis® 30-Day Starter Pack), and dose packs (e.g., Medrol® DosepakTM). Similarly, migraine rescue medications, insulin with a sliding scale, and topical medications tend to be generically written with directions that have no mathematical way to calculate the days’ supply.
- ALWAYS clarify “Use as directed” or “as needed” directions.
- Clarify starter kits, dose packs, and bowel preps as “Use as directed per package” or with specific directions.
- Migraine rescue medications should have the maximum number of tablets allowed per day, per week, or per month clarified with the prescriber. Check out the December 2021 Newsline article, Self-Audit Series #11 – Migraine Prescriptions to read more.
- Topical medications should have mathematically calculable directions. See the November 2021 Newsline article, Calculating the Incalculable – Your Math Teacher Was Right (Show Your Math) for more.
- Insulin with sliding scale directions should have maximum units per day listed.
- Use the Insulin Medication Days’ Supply Chart to factor total units available and beyond use dating.
- Any clarification made to the directions needs to be documented with a clinical note AND be on the patient label directions.