Pharmacy Record Analysis

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LNCtips.com: Pharmacy Record Analysis


As a new legal  nurse consultant, you may analyze the records of pharmacies that have filled prescriptions for the plaintiff.  The first time you review such records, you might think there's not very much to review - usually just lines of data.  So how do you analyze these types of records?

Obviously, identify the medications listed in the records.  But remember, in medical malpractice cases, not all medications are important to the case.

 Identify which meds, if any, validate the plaintiff's allegations.  For example, if the plaintiff is alleging emotional distress, are there medications prescribed that might counteract that distress such as anxiolytics or antidepressants?  (Of course, there are non-pharmaceutical ways of treating emotional distress as well.)

Determine if medications are consistent with allegations and damages.  For example, if the plaintiff complains of severe and unrelenting pain, does he or she obtain prescriptions for pain medications and regularly refill them?

If your review of one pharmacy's records shows no medications that relate to the plaintiff's allegations, the plaintiff may be using a different pharmacy.  Some defense firms subpoena the four or five largest pharmacies in the area, such as Walgreens, CVS, Wal-Mart, and Rite Aid, because it's common for patients to fill prescriptions at multiple pharmacies.

Review the dates that the pharmacy filled and refilled prescriptions.  If medication compliance is an important issue in the case, determine if the patient refilled prescriptions for scheduled medications every 30 days or if there were gaps.  And for a graphic way to show non-compliance, see my Medication Non-Compliance Calendar.

Identify each of the prescribers. Note the names of new prescribers to alert the attorney.  He or she may want to obtain the prescriber's medical records. Identify the specialty of new prescribers.  To determine the prescriber's specialty, type the prescriber's name in Google's search box or use the American Medical Association's DoctorFinder.  If the prescriber is an emergency medicine physician or a hospitalist, do the dates of the prescriptions correlate to an ER visit or recent hospitalization?  If not, your records may be incomplete.

Review the dates of the prescriptions.  Do the dates of prescriptions correlate to the dates of your medical records?  For example, let's say that you have medical records from 2004 through 2009 for Dr. Hanson.  But you notice that the pharmacy records list six prescriptions from 2010 and one from 2011.  In this case, you should inform the attorney who may want to obtain updated medical records from Dr. Hanson.

You've just turned lines of data into a meaningful analysis for your attorney.

Want to learn more about LNC skills for legal nurse consultants?  Check out the Archives.

...Katy Jones