The socio-economic level of the population was valued through the perceptions of the pharmacists in charge, by means of a 5-point Likert-like response scale ranging from «very low» to «very high». The items were grouped in 5 topics: prescription practice of the doctors 3 items ; pharmacist's qualification to prescribe 3 items ; responsibility of the pharmacist about dispensed drugs 5 items ; clients' qualification for self-medication 2 itemsand pharmacists' perception of their work 3 items.
Prescription requirement was considered for 5 drugs and two types of client: well-known customers habitual customers and unknown customers.
So, the variable ranges from 0 the pharmacist does not demand any prescription for any of the 5 drugs, either for well-known or unknown customers to 10 the pharmacist demands a prescription for the 5 drugs for all customers. We measured the effect that each of the opinions exerts on the variable requirement through linear regression. We adjusted the multiple linear regression models for the variables: age of the pharmacist, work status, specialty, number of prescription without a doctors prescription in the pharmacy and perception of socio-economic level of the population.
There variable were associated with the quality of dispensing in previous studies 6.
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SPSS package was used to analyze the data. Of the pharmacies sampled, 4 were excluded due to vacation closing. Out of the remaining pharmacies, prescriptkon Of the pharmacists, participated in the study Table 1 shows the characteristics of the participants.
The mean age of the pharmacists was Table 2 shows the proportion of pharmacists that demanded a prescription for dispensing the five drugs considered, according to the prescription without a doctors prescription of client.
Table 3 shows the variables in the multivariate model for the dependent variable requirement. Age of the pharmacist, work status, specialty, number of pharmacists in the pharmacy, and perception of socio-economic level of the population, were associated to the quality of dispensing. Pharmacists who have a heavier workload and who underestimate the physicians' qualification to prescribe but overestimate their own qualification to prescribe required medical prescriptions less often.
Those pharmacists who stress the importance of source duty in rationalizing the consumption of drugs demanded medical prescriptions more often.
According to our model, the dispensing practice of the pharmacists is associated with their opinions on the prescription practice of the physicians, on the qualification of the pharmacist to prescribe, and on the perception of the pharmacist's responsibility toward the rational use of drugs.
Prescription practice of the doctors. The association between pharmacists' perception of the quality of the medical prescription and prescription requirement table 4, items 1 and 2 reflects the doubts that pharmacists raise on the adequacy of the diagnosis and prescription by the prescriltion.
The pharmacist who is not convinced by the adequacy of the physician's diagnosis will be more flexible towards the mandatory character of the prescription demand. These results are consistent with those found in Nepal in a study of excessive prescription and quality of dispensing doctofs.
The similarity of the results of these studies that were carried out in very different cultural environment prescruption with different methodologies suggests that the relation between those variables is causal Furthermore, the high degree of agreement of the pharmacists with the third affirmation «doctors do not stop enough to give explanations to their patients», mean, 6.
Pharmacists' qualification to prescribe. We analyzed this determinant of the quality of dispensing by means of 3 items.
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The items 5 and 6, in which the level of knowledge of the patient is assessed, are also negatively associated with witgout variable requirementalthough this association is not statistically significant. These results show that the opinions of the pharmacists about their qualification to prescribe translate into dispensing practice 6. This practice is facilitated by their large autonomy and the scarce control that exists over dispensing in Spain To improve the quality of dispensing, it is necessary to implement a stricter administrative control over dispensing.
Pharmacist's prescription could be accepted only for over-the-counter drugs and continuation of treatments initially prescribed by a physician Responsibility on dispensed drugs. Those pharmacists who perceive as important their role in the rationalization of the consumption of drugs dispense in a stricter manner and demand every legal contro 15, The higher degree of agreement with the remaining items 9, 10 and 11 is correlated positively but not statistically significantly with the variable requirement.
According to the proposed model, the interaction of the pharmacists with their environment will modify their dispensing practice. Our source measured two aspects: pharmacists' perception of their work and opinion on the qualification of the customer for self-medication. The pharmacist's perception of the customers' qualification for self-medication is not significantly associated with prescription requirement.
However, both items 1 and 2 show a negative correlation with prescription without a doctors prescription prescription requirement: those pharmacists who consider that «a drug prospectus can be understood by patients» and that «the population makes a rational use of medicines» tend to require the medical prescription less often.
In relation to pharmacists' perception of their work, previous studies associated a large number of customers with less pharmaceutical advice 10, Other studies demonstrated dodtors existence of a relation between large dispensing loads and the number of dispensing mistakes This could be explained by the fact that those pharmacies with excessive workload function in prwscription more commercial way, reducing prescription without a doctors prescription time a pharmacist spends with each customer and exerting less control over prescriptions 6.
Previous studies found that a low degree of pharmaceutical advice is related to a high cultural degree of the population attended 11,18 ; a similar relation exists between medical prescriptions and the level of autonomy of the patient Four possible limitations to this study have to be considered.
First, since the withoit analysis prescription without a doctors prescription based on cross-sectional data, the validity of the conclusions could be limited by the difficulty in differentiating between cause and effect. However, in our study, those factors that are associated with quality dispensing are variables that are unlikely to change during the period of time in which the dependent variable is measured.
A cross-sectional analysis provides then results that are close to those of a longitudinal one Second, the questionnaire has not been validated. Third, the measure of the prescription requirement of the pharmacist could be biased by the pharmacist's tendency to provide answers that are legally acceptable.
The indicators are then probably too optimistic as far as it concerns the evaluation of the quality of dispensing. Finally, the quality of dispensing is assessed only by the aithout requirement. There are probably other indicators the measure of which was not feasible in our study In conclusion, our results suggest that, in order to increase the quality of dispensing, it is necessary: a to stress the importance of the duty pgescription the pharmacists in controlling the consumption of medicines; b to optimize the pharmacies workload, and c to improve the perception of the prescription practice of the physicians among pharmacists.
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It is also necessary to restrict drug prescription witthout the pharmacist to over-the-counter drugs and to continuation of treatments initially prescribed by a physician. Rawlin MD. Extending the role of the community pharmacist. Rupp MT. Value of community pharmacists' interventions to correct prescribing errors. Ann Pharmacother. Expanding the roles of outpatient pharmacists: effects on health services utilisation, costs, and patient outcomes. Cochrane Database Syst Rev.
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Going to the doctor's office for your medication can be an inconvenience, especially if you just need a prescription for a minor illness or condition. You may be wondering if you can get a prescription without consulting with a doctor. The answer is no –. canadarxdrugservices.com › news › can-i-get-a-prescription-without-seeing-a-doctor.