PEBC MCQ study guide: Prescription Intake, Verification & Drug Utilization Review (DUR)

Providing Care – Distribution

Therapeutic vs. technical checks, prescription validity, and computerized DUR alerts.

Therapeutic Check vs. Technical Check

These two checks are distinct and both required before a prescription reaches the patient, and mixing them up is a common exam trap:

Therapeutic (clinical) check: reviewing the prescription for clinical appropriateness — correct drug/dose/indication, interactions, allergies, duplication of therapy, contraindications. This is a pharmacist-only responsibility and cannot be delegated to a pharmacy technician.
Technical (dispensing) check: confirming the filled product physically matches what was entered — right drug, strength, quantity, patient, directions on the label. In most Canadian jurisdictions, a regulated pharmacy technician CAN perform the final technical check independently, freeing the pharmacist to focus on clinical verification — this technician-final-check model is a relatively recent, exam-relevant scope expansion.

A prescription is generally not considered complete/valid without: prescriber identification, patient identification, drug name/strength/dosage form, directions for use, quantity/duration, and date written. Missing elements may still be fillable after a clarifying call to the prescriber, documented appropriately, rather than being an automatic refusal.

Prescription Validity & Refills

Prescription validity periods and maximum refill periods are provincially regulated and vary — the exam tends to test the underlying PRINCIPLES rather than one province's exact numbers: a prescription is generally valid for a defined period from the date written (commonly around 1 year, but check local scope), refills cannot generally be authorized beyond that same window even if refills remain on the original order, and emergency/bridge supplies (e.g., a short-term supply for a patient who has run out and cannot immediately reach their prescriber) are permitted under defined, narrower conditions specific to each province's scope of practice regulations.

Forged or altered prescriptions: red flags include prescriptions for high-diversion-risk drugs (opioids, benzodiazepines, stimulants) written in unusually large quantities, doctor-shopping patterns (multiple prescribers/pharmacies identified via a provincial monitoring program), physically altered quantities/strengths, or prescriber information that doesn't match a verifiable license. Pharmacists have a professional and often a legal obligation to refuse to fill a prescription they reasonably believe is forged, and many jurisdictions require reporting suspected forgeries.

Computerized Drug Utilization Review (DUR)

DUR systems flag interactions, duplicate therapy, allergy conflicts, and dose-range concerns automatically at data entry — but the pharmacist retains professional responsibility to exercise clinical judgment on every alert, not to blindly override or blindly accept the system's flag. A key stewardship concept ("alert fatigue"): systems that generate excessive low-value alerts train staff to override warnings reflexively, which is a recognized patient-safety failure mode — clinically significant alerts can get missed among noise. Overriding an interaction alert should always be a documented, deliberate clinical decision (e.g., interaction is theoretical/low-risk for this specific patient, already being monitored), not a routine click-through.

High-yield points

Therapeutic check = pharmacist-only, clinical appropriateness. Technical check = can be delegated to a regulated technician in most provinces, confirms the physical product matches the order.
Forged prescription red flags: high-diversion drugs, unusual quantities, doctor-shopping pattern, altered document, unverifiable prescriber.
"Alert fatigue" from excessive low-value DUR alerts is a recognized safety failure mode — every override should be a deliberate, documented clinical decision.

Guideline references

NAPRA Model Standards of Practice for Canadian Pharmacy Technicians
Provincial College Scope of Practice Regulations (varies by province)