Dispensing, Legislation and the Pharmacy Profession

The Dispensing Process

Dispensing is the act of preparing and issuing a medicine to a patient in accordance with a valid prescription. A systematic dispensing workflow is essential for patient safety. The process begins with receiving the prescription, followed by clinical screening (checking legibility, validity, dosing, interactions, allergies), labelling, preparation, final accuracy check, and patient counselling at the point of supply.

In New Zealand, the Medicines Act 1981 and Medicines Regulations 1984 govern the manufacture, sale, and supply of medicines. The Act classifies medicines into prescription medicines (Part I), restricted medicines (Part II), pharmacy-only medicines (Part III), and general sale medicines (Part IV). Pharmacists must only dispense prescription medicines when a valid prescription from an authorised prescriber is presented.

Controlled Drugs

Controlled drugs (CDs) are regulated under the Misuse of Drugs Act 1975 and fall into three classes based on harm potential: Class A (e.g., heroin, methamphetamine — highest harm), Class B (e.g., morphine, codeine), and Class C (e.g., benzodiazepines, anabolic steroids). Prescriptions for Class B CDs must be handwritten by the prescriber, include the patient's full name and address, and specify the quantity in both words and figures. Pharmacies must maintain a CD register recording all supplies and receipts.

Medication Errors

Medication errors are preventable events that may cause or lead to inappropriate medication use or patient harm. The "five rights" — right patient, right drug, right dose, right route, right time — provide a framework for error prevention. Common error types include wrong drug selection (look-alike, sound-alike names), calculation errors, transcription errors, and omission of a medicine. Near-miss reporting and root-cause analysis are essential for systemic improvement. Electronic prescribing systems and barcode scanning significantly reduce dispensing errors.

Patient Counselling

Effective patient counselling improves adherence and outcomes. Key counselling points include the name and purpose of the medicine, how and when to take it, common and serious side effects, storage requirements, what to do if a dose is missed, and when to seek further advice. Motivational interviewing techniques help address ambivalence and support behaviour change. The "show and tell" and "teach-back" methods confirm patient understanding.