Abstracts

Diastat^[reg] (diazepam rectal gel), a seizure rescue medication that can be administered by nonmedical caregivers without the need for hospitalization, is currently provided in fixed unit-dose devices. However, a new delivery system (AcuDial[trade]) that features a prefilled, adjustable-dose device will meet the diverse dosage needs of individual patients via a single delivery system. Once the prescribed dose has been set or [ldquo]dialed in[rdquo] by a pharmacist, the device is locked to prevent further changes. The purpose of this study was to measure the ability of pharmacy staff to understand dose-setting and syringe-locking instructions affixed to the new delivery system and to properly fill a new diazepam rectal gel prescription. Participants were selected by pharmacy managers from Southern California retail pharmacy locations to test their ability to properly fill a prescription for the new diazepam rectal gel delivery system (12.5 mg dose). Selected pharmacists or technicians were provided with a delivery system twin pack and a field study sheet with instructions on preparing the prescription and dispensing the materials. All study materials were collected after the prescription was filled. Results were scored in 3 categories: prescription filled correctly (correct adjustment to prescribed dose and locking of both syringes), prescription filled incorrectly (failure to adjust to prescribed dose and/or lock both syringes), and unable to dispense (incomplete syringe dose setting or locking of syringe, but would not have dispensed without consulting the manufacturer or pharmacy manager). Unable to dispense is not considered a test failure. The field study participants were 50 pharmacy staff members (pharmacists, n=26; pharmacy technicians, n=23; intern, n=1) at 26 Vons retail pharmacies located in 3 Southern California counties (Orange, Riverside, and San Diego Counties). Of the 50 participants, 46 filled the prescription with no errors, 2 filled the prescription incorrectly, and 2 were unable to dispense. The overall number of properly filled prescriptions was 46/48 (96%). The 2 dispensing errors involved the final locking of the syringes at 1 pharmacy and failure to prepare the second syringe in the twin pack at another pharmacy. The high overall success rate demonstrates that pharmacy staff can follow dose-setting and syringe-locking instructions to properly fill a prescription for diazepam rectal gel dispensed via the new delivery system. (Supported by Valeant Pharmaceuticals.)