Writing a Prescription: Guidelines
Writing a prescription is both a science and an art. With the recent notification of the government and the council, indeed many medical practitioners have been left confused on how to go about writing their prescriptions. Yet doctors also need to keep in mind that there are many essential, sometimes legal requirements that are mandated in a practitioner's prescription, and some very important points that we must remember, while undertaking this routine yet most significant task. While there are pointers for doctors to remember here and there, there are no set guidelines that medical practitioners in India can follow given by the government or the council.
Having said that the Voluntary Health Association of Goa, with inputs from various stakeholders has come out with Guidelines for prescription writing and handling of prescriptions and prescription medicines
A prescription has various parts; some of them "mandatory" (as per the Drugs & Cosmetics Act and Rules, or the Medical Council of India), and some of them though not mandatory, important for better understanding of the prescription by the pharmacist and the patient also. Here are some of the key elements that every prescription should contain as highlighted by the Voluntary Health Association Goa guidelines.
Details pertaining to DOCTORS
- Doctor's full name (printed on the letterhead)
- Doctor's details such as address, consultation timings, telephone/ contact numbers should printed on the letterhead.
- Doctor's Qualification should printed on the letterhead. This means ALL the degrees, especially the primary degree, namely, M.B.B.S./B.D. S./B.V.Sc.
- Doctor's registration number and the registering authority should be printed on the letterhead.
- Doctor's full signature and date, both in blue indelible ink. This is required to verify the authenticity of prescription in order to prevent misuse.
- Date of prescribing- Also a legal requirement
- Rx superscription- Not a legal requirement but most often used as a matter of practice. It comes from the Latin "Take Thou"
- Doctor's rubber stamp containing his full name, qualifications, and Reg. No. below his signature- More so to add to the authenticity of Prescriptions
Details pertaining to PATIENT
- Patient's Full Name
- Patient's age, weight
- Patient's address and telephone number (including Mobile No.)
- Patient's Sex
Details pertaining to MEDICINES
- Name of the medicine - write the GENERIC NAME IN CAPITAL, with the brand name/comp any name in brackets ( coming from recent interpretation of MCI notificiation by DMC, Read Here. ) Strictly avoid abbreviation s or scribbling the name of the medicine/s.
- Strength or potency of the medicine
- Dosage Form- E.g. DT or tablet, or syrup etc
- Dosage & dosing instructions
- Total Quantity
- Refill information- If the doctor wants the prescription to be filled/dispensed only once, he should clearly write that it "SHOULD NOT BE REFILLED" or "DO NOT DISPENSE MORE THAN ONCE" at the bottom of the prescription (or get it pre-printed on the prescription blank). If the doctor wants the prescription to be refilled, he should clearly write the number of times the prescription should be refilled. This is very important to deter patients from refilling (repurchasing) the same prescription again & again unless so directed by the doctor.
Besides giving the important key points, the guideline also lays down some important tips for doctors
Some Important Points to Remember ( Dos and Donts)
- Letterheads/prescription blanks should be kept secure to avoid misuse.
- Overwriting on a prescription should be avoided. In case of overwriting, doctor must initial each correction.
- Prescription may be typed/computer generated, but it has to be signed and dated by Doctor in blue indelible ink.
- It is illegal to allow nurses/assistants to write prescriptions/medication orders
- Doctors should always encourage pharmacies to call them up on telephone in case of any problems/ discrepancies/doubts/queries in their prescription.
- One should avoid having names of two or more doctors on the same prescription pad (even if it is a husband and wife team). More so if they belong to different specialties or systems of medicine.
- It is unethical for a doctor to prescribe medicines for his own use other than the simplest OTC medicines. Self medication as a concept is to be discouraged.
- A doctor should not use another doctor's prescription pad, even with his consent. Conversely a doctor should not allow another other doctor to use his/her prescription pad
- The doctor should not write s.o.s. against any medicine. It is not an accepted abbreviation. The doctor should use the correct abbreviation - p.r.n. (pro re nata) or the English equivalent – 'as and when required'. In such cases, the minimum dose interval, the maximum daily dose and maximum duration and the maximum quantities to be dispensed, should be specified.
- Avoid unnecessary use of units.
- Doctors should be extra careful in prescribing habit forming medicines or drugs with potential for misuse like sedati ves, hypnoti c s, codeine containing cough syrups, Pentazocine, Buprenorphine, etc. Prescribers should inform the patient about their potential for habit forming, as well as the dangers of long term and excessive use.
- Doctors should doubly careful in writing the potency & quantity of the drug/s. It is advisable to write the quantity in words also so that patients/clients do not manipulate the numbers.
- Write in bold "DO NOT DISPENSE MORE THAN ONCE", in the in the middle or bottom of the prescription (bearing in mind that sometimes what is written at the bottom is cut off by the patient).
- Always write the potency for single ingredient drugs even if no other potency is marketed. You never know, when a new potency (higher or lower) would be introduced in the market.
- In case of combination products, it is always advisable to write the potencies of all the individual components in order to eliminate any misinterpretation at the pharmacy.
- Alterations/overwriting in the prescription are best avoided, but if any are made, they should be clear and unambiguous. Doctors should make sure to add their initials against the altered items.
- Doctors should refrain from prescribing medicines of other systems of medicine.
To read the complete guideline click on the following link