Final answer:
A physician can prevent therapeutic substitution by providing clear instructions, using technology for tracking, and ensuring collaboration with pharmacy staff. DOT may be helpful but is not always practical. Education and monitoring are also key to adherence.
Step-by-step explanation:
A physician aiming to prevent therapeutic substitution in a nursing home can employ strategies to ensure the specific prescription is followed. One such strategy could include providing detailed explanations and directives on the prescription, indicating that no substitutions should be made without approval, utilizing technology to track medication administration, or collaborating closely with the nursing home's pharmacy and medical staff to ensure compliance. Additionally, implementing policies such as Directly Observed Therapy (DOT), where medications are supervised when administered to a patient, may be helpful in certain situations, but may not be practical for all medications like antibiotics due to the increased costs and logistical challenges. Continuous education for healthcare providers on the importance of adhering to the prescribed drugs and monitoring patient outcomes could also play a vital role in preventing unauthorized substitutions.