Story: I had a prescription sent in to my pharmacy today for a 10 year old patient for naltrexone tabs. Naltrexone! Having never seen this prescribed to a peds patient before, I called this doctor's office to 1) confirm the medication was correct and 2) ask for a diagnosis code and medical reason for this patient to document it in our medical record. The medical assistant who called back confirmed they did want this medication but said the doctor was refusing to disclose the medical reason/need for naltrexone, to "just go ahead and it would be safe to fill it", and to simply call the mom (who has no medical background) for questions about the medication. Why would that be? For context, this is a "performance, sports medicine, and metabolism" clinic, and NOT a pediatrician's office.
What would be the reason, if any, you would want to withhold medical information about a patient to the pharmacy that is dispensing their medication?
To put it in the perspective of the pharmacist, having ICD-10 codes provide some insight to pharmacies and context as to why certain medications are being used in different populations, like when Flomax is used in women for kidney stones, or cis-men getting estrogen patches to help with chemo side effects. In addition, my state board of pharmacy actually requires medical diagnoses and ICD-10 codes to be noted in a patient's record when filling scripts. You can actually get "ding'd" in a board inspection for failing to do so (i.e., giving insulin to a patient but not having diabetes listed on the file, inhalers to a patient but no asthma/COPD diagnosis, etc). I am sure that many pharmacists will tell you they do not like filling scripts blindly or without cause, and since many retail/community pharmacies do not have access to provider chart notes, a simple medical diagnosis is a quick way to check if a medication may or may not be appropriate for the patient.
I am posting this to the medicine subreddit to see if any providers might have any input for me. I will say that 99% of the providers I have worked with have had no problem discussing medical treatment of a patient with the pharmacy.
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