e-Profile Login and ID Quick Search
Ohio News: Does the Prescriber Really Need to Sign that Piece of Paper
Published in the May 2007 Ohio State Board of Pharmacy Newsletter
Due to the number of pharmacists and prescribers calling the Board office about prescription format, signatures on written prescriptions, and the actual content of the prescriptions, it is time to review the requirements for a legal prescription. The requirements may be found on the Board’s Web site, www.pharmacy.ohio.gov by clicking on the box labeled “Laws & Rules” and, on the next screen, clicking on “Administrative Code Rules.” If you are printing out the rules to send to a physician’s office, the two most important rules are 4729-5-13 – Prescription format, and 4729-5-30 – Manner of issuance of a prescription. If you are looking for the rule relating to the duties of the pharmacist when filling a prescription, the rule to review is 4729-5-21 – Manner of processing a prescription. All three of these rules contain requirements that, if followed, will improve the communication between the prescriber and the pharmacist, will improve the safety of the patient, and will help to ensure the security of the transaction. In addition, if these rules are followed, there should be less need for telephone conversations between prescribers and pharmacists. With the workload in many pharmacies and prescribers’ offices, anything that reduces time spent on the telephone should be welcomed by all parties.
One of the most frequent questions received in the Board office deals with the signature of the prescriber. Rule 4729-5- 30, paragraph B(14), says:
For prescriptions issued to a patient by a prescriber, be:
(a) Manually signed on the day issued by the prescriber in the same manner as he/she would sign a check or legal document.
(b) Issued in compliance with rule 4729-5-13 of the Administrative Code.
The rule requires that written prescriptions given to the patient be “manually signed…by the prescriber.” That means the prescriber takes pen in hand and physically signs the prescription. Rubber stamps, signature by a nurse or other office personnel for the prescriber, and computer-generated signatures are all examples of illegal signatures. A hard copy prescription given to the patient that is “signed” in one of these ways is an illegal prescription and may not be filled as presented. If the prescription is for anything except a Schedule II controlled substance, the pharmacist may, of course, take a verbal order from the prescriber. Under no circumstances should a prescription presented to the pharmacist by a patient that has one of the illegal signatures above be filled without contacting the prescriber for a valid authorization. A Schedule II prescription with an illegal signature is not valid and must be rewritten by the prescriber. This signature requirement applies to all paper prescriptions given to a patient or written and then faxed to the pharmacy by a prescriber, whether handwritten, typed, or computer generated. The prescriber must physically sign these prescriptions.
On the other hand, prescriptions that are generated by a Board of Pharmacy-approved electronic prescribing system and are transmitted from the prescriber’s computer to the pharmacy fax machine or computer will not have a manual signature. No paper prescription is generated by the prescriber, so there is nothing to sign. Depending on the Board-approved prescribing system used by the prescriber, the electronic prescriptions may have a computer-generated signature, a statement that no signature is required, or a printed name where the signature would be. The pharmacist needs to know that the electronic prescription has been issued from a Board-approved system or the electronic prescription is not valid and may not be filled without a valid prescriber’s signature.
The other requirement in rule 4729-5-30 (B)(14) is that the prescription is issued in compliance with rule 4729-5-13. That means, among other things, that paper prescriptions issued to a patient may contain no more than three (3) prescriptions on a blank for non-controlled substances and no more than one (1) prescription on a blank for controlled substance prescriptions; that controlled substances and non-controlled substances are not written on the same blank; that a preprinted prescription form that has multiple drug names and strengths listed has only one choice selected; and that the quantity on a controlled substance prescription is written alpha and numeric (eg, 10 – ten). Please note that these requirements are not necessary for Board-approved electronic prescribing systems since the patient has no opportunity to manipulate the prescription.
For a list of Board-approved electronic prescribing systems, please visit the Board’s Web site, click on the box labeled “Frequently Asked Questions” and then click on the document titled “Electronic Prescription Transmission Systems.” The list is at the bottom of the article. This list is revised each time a new system is approved by the Board.
