4.1.2: Writing of Prescriptions

The writing of prescriptions should follow these general guidelines.

• No prescription should be issued for a patient in the absence of a documented and established licensee-patient relationship. A licensee-patient relationship should be based on an appropriate history and physical examination in addition to overall care that is consistent with the standards of acceptable and prevailing medical practice. Limited exceptions for prescribing outside an established licensee-patient relationship are specified in the Board’s Position Statement titled “Contact with Patients Before Prescribing.”

• Prescriptions written by licensees for their personal or family use should comply with the Board’s position statement on “Self-Treatment and Treatment of Family Members.” As noted in that position statement and contained in the Board’s regulations, it is prohibited for licensees to write prescriptions for controlled substances for themselves, their family members, or persons with whom they are living or in a sexual relationship.

• The practice of pre-signing prescriptions, either written or electronic, is unacceptable.

• It is the responsibility of licensees who prescribe controlled substances to be aware of and fully comply with applicable federal and state laws and regulations, including evolving standards and regulations regarding e-prescribing.

• The prescriber should document each medication prescribed in the patient’s medical record.

• Physicians who supervise other providers (physician assistants and nurse practitioners) who prescribe controlled substances must possess a valid DEA registration that includes the same schedule(s) of controlled substances as the supervised health professional.

• Licensees should not write prescriptions for professional colleagues or other coworkers in the absence of a documented and established licensee-patient relationship. In addition, advance practice providers are prohibited from writing prescriptions for controlled substances for supervising physicians pursuant to Rules 21 NCAC 32S .0212 and 32M .0109.

• A frequent source of complaints to the Board regarding prescribing involves miscommunication or misunderstandings between pharmacists and prescribers. It should be recognized that the pharmacist has a corresponding responsibility with the prescriber for assuring the medication is dispensed properly. When appropriate, licensees are encouraged to discuss prescribing issues or problems with the pharmacist.