Current Scenario of Prescription Writing

 

Mr. Rahul D. Khaire*, Mayur Bhosale, Dheeraj Chechare

PRES College of Pharmacy (D. Pharm), Chincholi- Mohu, Tal-Sinnar, Dist-Nashik.

*Corresponding Author E-mail: rahuldkhaire@gmail.com

 

ABSTRACT:

Prescription writing is one of the difficult tasks performed by the health professionals. A prescription is an instruction from prescriber to a patient as well as pharmacist. Use of proper format for prescription writing ensures appropriate use of drug and helps in minimizing errors. Health professionals must take account of appropriateness, effectiveness, side effects, contraindications and cost when prescribing any medicine. Special care and precautions are needed in prescribing the drugs with abuse potentials to avoid their misuse and to write proper prescription as per format. Every country has its own standards and regulations for prescription writing. This article presents current scenario prescription writing. It may benefit the readers, especially the budding students to ensure the correct format in prescription writing and other relevant aspects.

 

KEY WORDS: Prescription, Components of prescription, prescribing errors.

 

 


INTRODUCTION:

The prescription is one of the most important therapeutic transactions between physician and patient.1 The word ‘prescrip­tion’, derives from ‘pre’ (before) and ‘script’ (writing, written), which denotes that it is an order that must be written down before or for the preparation and administration of a drug. Commonly, the term prescrip­tion is used to mean an order to take certain medications.1–3

 

A prescription is defined as a health-care program implemented by a physician in the form of instructions that govern the plan of care for an individual patient. The fact that a prescription instructs some­one to ‘take’ rather than ‘give’, makes it clear that it is directed at the patient, and is not directly an instruction to anyone else. Prescription writing is a crucial task and suggests prescriber’s responsibility towards the clinical care and the safe monitoring of the patient thus also carries legal implica­tions.1,3,4–7

 

It is a written order for the medi­cation to be used for diagnosis, prevention and treatment of specific patient directed by physician.8, 9

 

The art of prescription writing is ancient in origin and had complex prescriptions which were in Latin, recently, it is being greatly replaced by English and the con­temporary practices are more simplified and systematic.1–4 the prescription symbol () currently in use is an ancient symbol which was established centuries ago. It sig­nifies the specific Latin verb recipe of the medication and the directions for taking it.1–4,8,9 Many historic stories are associated with prescription symbol which note its similarity to the Eye of Horus or to the symbol of Zeus or for Jupiter and to vari­ous gods.1,10

 

FORMAT OF PRESCRIPTION WRITING1,4,7-9,11

The document on which prescriptions are written is called as prescription order or prescription pad or pre­scription blank.8,9 Prescription order is a legal docu­ment. It should be clear, concise, accurate and legible. It should include complete information and be written in indelible ink pen especially while prescribing for Sched­ule II controlled substances that although has accepted medical use show high abuse potential. It includes drugs as amphetamine, cocaine, codeine, meperidine, methadone, methylphenidate, morphine, oxycodone, pentobarbital and secobarbital.3,9,13,14 At some of the places, prescriptions are regulated by state and federal laws and must be properly written with specific infor­mation included to avoid the errors and to prevent mis­use of prescription information.3

 

The written prescription order's main parts15-19:

 

1.      The superscription which consists of the heading where the symbol Rx (an abbreviation for recipe, the Latin for take thou) is found. The RX symbol comes before the inscription.

2.      The inscription is also called the body of the prescription, and provides the names and quantities of the chief ingredients of the prescription. Also in the inscription you find the dose and dosage form, such as tablet, suspension, capsule, syrup.

3.      The subscription, which gives specific directions for the pharmacist on how to compound the medication. These directions to the pharmacist are usually expressed in contracted Latin or may consist of a short sentence such as: "make a solution," "mix and place into 10 capsules," or "dispense 10 tablets." However, that was in the old days. Today... doctors just name the pill!

4.      The signatura (also called sig, or transcription), gives instructions to the patient on how, how much, when, and how long the drug is to be taken. These instructions are preceded by the symbol “S” or “Sig.” from the Latin, meaning "mark."

5.      Below the signatura line is room for special instructions, such as the number of times the prescription may be refilled, if any. You will also find the purpose of the prescription, special instructions, warnings followed by the signature of the prescriber.

 

RESULTS:

Study of 100 prescriptions was done and the % of prescriber writes the information which is to be essential on the prescription is check and the following results were obtained as shown in Table 1 and Figure 1.

 

Table 1- Prescription date of 100 prescriptions

Sr. No.

Particulars

No of Prescriptions written the information per 100 prescription

Percentage

1

Date

97

97%

2

Name

92

92%

3

Age

14

14%

4

Sex

10

10%

5

Address

05

05%

6

Superscription

09

09%

7

Inscription (Ingredients)

100

100%

8

Subscription (Direction)

08

08%

9

Signature

53

53%

10

Renewal instructions

50

50%

11

Registration No.

78

78%

 

Fig 1- Prescription date of 100 prescriptions.

 

Following Commoner mistakes and observations found in prescription writing20-21:

·     Proper format of prescription writing not followed.

·     No clarity in writing or Spelling mistakes that causes  con­fusion and because of that pharmacist may give wrong    

·     Drug.

·     Not readable to the patient.

·     •Insufficient information or ambiguous directions to patient or a pharmacist. .

·     Purpose or diagnosis for which prescription is written is always missing.

·     May not be economic, no consideration is given to the cost.

·     Lack in patient`s detail, poor history taking or prescribed without examining patient.

·     Unsigned or not prescribed on prescription order.

 

CONCLUSION:

Prescription writing is a fundamental task performed by health professionals but above study reflects the present scenario of prescription writing. Only Date, name and Superscription is mostly written on the prescriptions but there is a need to write all the information on the prescription so that patient will get more information about the dosage form, dosing frequency.  Prescription becomes useless unless it gives clear information to patient and the pharmacists.

 

ACKNOWLEDGEMENT:

Authors are thankful to Staff, Principal and management of PRES College of Pharmacy (D. Pharm) for providing necessary facilities for work.

 

REFERENCES:

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4.       Mercy ships bringing hope and healing. An essential medicines dosing guide based on the WHO model formulary 2008-Prescription writing guidelines.

5.       Proposed guidelines for prescription writing & handling for drugs having misuse or abuse potential, proposed by FDA, Goa at the stakeholders meeting held on 23rd September, 2009.

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8.       Benet LZ. Goodman and Gilman’s Principles of Prescription order Writing and Patient Compliance Instructions. The pharmacological basis of therapeutics. In: Gilman AG, Rall TW, Nies AS, Taylor P. 8th ed, vol II, New York: Pergamon press, 1991, 1640–49.

9.       Lewis VA. Prescription writing and Drug regulation. Pharmacology and Therapeutics for dentistry. In: Yogiela JA, Dowd FJ, Neidle EA. 5th ed., India: Mosby Publishers, 2005, 865–79.

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11.     Prescription Writing. Dept. of Pharmacology, GMC Amritsar, p1–19, 14th –17th June 2006.

12.     Prescription Writing. Dept. of Pharmacology, GMC Amritsar, p1–19, 14th – 17th June 2006.

13.     Guidelines for Complete, Safe, and Accurate Discharge and Outpatient Prescription Writing, PTNews Virtual Hospital.htm, P&T News: August 2003.

14.     Torrey T. Why Do Prescription Drug Errors Occur? About.com Guide Updated April, 2010.

15.     Manchikanti L. National Drug Control Policy and Prescription. Drug Abuse: Facts and Fallacies. Pain Physician 2007; 10:399–424.

16.     Teichman PG, Caffee AE. “Prescription writing to maximize patient safety”. Fam Pract Manag 2002; 9:27–30.

17.     Mikota SK, Plumb DC. Elephant Formulary. Abbreviations Used in Prescription Writing, Published by Elephant Care International - http://www. elephantcare.org, 2003–06.

18.     University of Florida College of medicine Jacksonville resident Manual. Prescription writing guidelines, reviewed 04/2007.

19.     Aronson JK. Medication errors: what they are, how they happen, and how to avoid them. QJM 2009; 102, 8:513–52.

20.     Shtrestha S. Irrational prescription: A hurdle to quality health. The Lancet 2013.

21.     Kadam A. Rational Drug Use A Concern for Healthcare Professionals. Pharmainfo.net, 2009; 7: 4.

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Received on 15.05.2017       Accepted on 24.06.2017     

© Asian Pharma Press All Right Reserved

Asian J. Pharm. Tech.  2017; 7 (3): 144-146.

DOI: 10.5958/2231-5713.2017.00023.X