Ever wondered what goes on behind the pharmacy counter while patients wait for their medicines?
At first glance, it is easy to assume that this process is simple and straightforward.
But in reality, several important steps need to be completed before the medicine reaches the patient.
This process is intended to reduce the risk of errors before medicines are supplied.
Understanding what goes on behind the scenes can help assure patients that pharmacists do their best to ensure the medicines dispensed are safe and right for the patient.
Verifying information
The process begins when the pharmacy receives a prescription at the counter.
At this stage, the pharmacy staff will first check the patient’s identity by obtaining information such as the patient’s name and identification card number, and matching it with the details on the prescription.
Patients are also required to provide accurate information and inform pharmacy staff if any details on the prescription are incorrect.
This verification is an important safety measure to prevent patient identification errors and ensure that the prescribed medicine is supplied to the correct patient.
Patients should also provide relevant medical information when asked, such as any known allergies, other medicines or supplements they are currently taking, and any health conditions that may affect their treatment.
Once all of this has been verified, the patient receives a queue number to be kept until the medicines are collected.
Screening and filling
Once the prescription has been received, a pharmacist will carefully screen it to ensure that the prescribed medicines are appropriate and safe for the patient.
This involves reviewing several key aspects, including the patient’s details; the medicine prescribed; the dose, frequency and route of administration; duration of treatment; and the possibility of medicine interactions.
If any information is unclear or requires clarification, the pharmacist will take the necessary steps to resolve the issue before the medicine is supplied.
This may involve clarifying the prescription with the doctor or making appropriate recommendations.
After the prescription has been screened and any necessary interventions taken, the pharmacy team will calculate the required quantity and prepare the medicines.
Each item is then labelled with important information such as the patient’s name, the name and strength of the medicine, the dose, and instructions on how and when it should be taken or used.
Clear and accurate labelling helps patients use their medicines correctly and safely.
Then, a cross-check is carried out to ensure that the patient and medicine details correspond with the prescription, including checking the type and strength of medicine, quantity supplied, dose, and instructions for use.
This additional safety step helps reduce the risk of medication errors before the medicine reaches the patient.
If an error is identified during the cross-check, it must be corrected and the medicine may need to be re-prepared and verified again.
Dispensing to patients
Once filling, preparation and cross-checking are complete, the medicines are supplied to the patient through the dispensing process at the pharmacy counter.
Before the medicines are handed over, the patient’s identity will be verified using at least two identifiers to ensure that they are given to the correct person.
If the medicine is being collected on behalf of someone else, the pharmacy staff will verify the patient’s name.
Patients are commonly asked to state their name and present the queue number issued earlier.
At some facilities, they may also be asked to provide the last four digits of their identification card number as an additional verification measure.
These details are then matched against the dispensing record and medicine labels.
After the patient’s identity is confirmed, the pharmacist will explain important information about the medicines supplied.
This includes the indication, the dose, how and when it should be taken or used, and any specific instructions that need to be followed.
Additional information, such as how to store the medicine or what to do if a dose is missed, will also be provided when relevant.
At this stage, patients are encouraged to pay close attention to the instructions and review their medicines, even if they have been taking the same treatment previously.
Any differences in appearance, name, quantity or instructions for use should be brought to the attention of the pharmacist immediately.
The duration of treatment varies according to the medical condition and the patient’s treatment plan.
Some medicines are only required for a short period or when needed, such as medicines used to relieve fever or cold symptoms.
In contrast, medicines for chronic conditions such as diabetes and hypertension (high blood pressure) usually need to be taken continuously.
As part of the Health Ministry’s (MOH) initiative to optimise medication use by patients, prescriptions exceeding one month are provided in partial refills (staggered supply).
For example, a patient with a three-month prescription duration may initially receive a one-month supply and is required to collect the remaining balance in subsequent months.
Supplying medicines in stages helps patients manage their medicine supply at home more systematically and helps maintain medicine quality during storage.
It can also reduce wastage if treatment is stopped or changed, e.g. because of side effects, allergies or changes to the treatment plan.
Patients should therefore know when and how to obtain their remaining supply, and should collect it before their current medicines run out.
It is also important for them to inform the pharmacy of any existing home stock to prevent unnecessary oversupply.
To enhance convenience, patients of MOH facilities can utilise various Pharmacy Value-Added Services (VAS) such as Medicines by Post, Medicine Locker and Pharmacy Drive-Through services, for hassle-free partial supply medicine collection.
The services available may vary between MOH healthcare facilities.
Patients are also encouraged to ask questions and seek clarification before leaving the pharmacy counter if there is anything they do not understand.
This helps ensure that they know how to use their medicines correctly and manage their medicine supply safely.
For added safety, each step such as screening, filling and preparing, cross-checking, and dispensing, is usually carried out by different pharmacy personnel.
This multi-step verification serves as an extra layer of protection against errors.
Medication counselling
Beyond the concise instructions given at the dispensing counter, certain patients may benefit from a more comprehensive medication-counselling session.
This may be offered to patients who are starting treatment for the first time, experiencing difficulty adhering to their treatment, having problems using their medicines, or requiring medicine delivery devices such as insulin pens and inhalers.
Counselling may also be provided when patients experience side effects, have changes to their treatment or require further explanation about their medicines.
Medication counselling provides more detailed guidance on treatment, including how to take or use medicines, techniques for using medicine delivery devices, proper storage, possible side effects and what to do if problems arise during treatment.
For medicines that require a particular administration technique, such as insulin pens and inhalers, the pharmacist will demonstrate the correct method of use.
Supporting materials such as leaflets, diagrams or videos may also be used to reinforce the patient’s understanding.
This session is a great opportunity for patients to discuss their treatment, share any concerns and clear up any doubts about their medication.
Patients will also have the opportunity to practise the technique with the pharmacist present.
This allows any errors to be adjusted together before the patient uses the medicine at home.
Overall, every stage of the medicine supply process is carried out according to established procedures to ensure patient safety.
Although these steps may take some time, every minute spent is important in reducing the risk of medication errors and ensuring that the right medicine reaches the right patient.
Understanding why these steps are necessary and providing the appropriate cooperation can help the process run smoothly.
At the same time, clear communication between patients and pharmacy staff can help ensure that medicines are used correctly and safely.
Mohd Shahiri Abd Ghapar is a pharmacist at the Pharmacy Practice and Development Division. This article is courtesy of the Health Ministry’s Pharmacy Practice and Development Division. For more information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only, and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this article. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
