Rational Rational Prescribing & Prescribing & Prescription Prescription

WritingWritingOnce a patient with a clinical Once a patient with a clinical problem has been evaluated and a problem has been evaluated and a diagnosis has been reached, the diagnosis has been reached, the

practitioner can often select from practitioner can often select from a variety of therapeutic a variety of therapeutic

approaches. approaches.

Medication, Surgery, Psychiatric Medication, Surgery, Psychiatric treatment, radiation, physical treatment, radiation, physical therapy, health education, therapy, health education, counseling, further consultation and counseling, further consultation and no therapy are some of the options no therapy are some of the options are available., of these options, drug are available., of these options, drug therapy is by far the most frequently therapy is by far the most frequently chosen. In most cases ,this requires chosen. In most cases ,this requires the writing of a prescription. the writing of a prescription.

A written prescription is the A written prescription is the prescriber’s order to prepare or prescriber’s order to prepare or dispense a specific treatment dispense a specific treatment usually medication for a specific usually medication for a specific patient.patient.

Rational Prescribing :Rational Prescribing : Like any other process in healthcare, Like any other process in healthcare,

writing a prescription should be writing a prescription should be based on a series of rational steps.based on a series of rational steps.

1. Make a specific diagnosis1. Make a specific diagnosis 2. Consider the pathophysiologic 2. Consider the pathophysiologic

implication of diagnosisimplication of diagnosis 3.Select a specific therapeutic object3.Select a specific therapeutic object

4. Select a drug of choice4. Select a drug of choice 5.Determine the appropriate dosing 5.Determine the appropriate dosing

regimenregimen 6.Devise a plan for monitoring the 6.Devise a plan for monitoring the

drug’s action drug’s action and determine an end point for and determine an end point for

therapytherapy 7.Plan a program of patient education7.Plan a program of patient education

Elements of the prescription:Elements of the prescription: 1.Name of the prescriber 1.Name of the prescriber 2.Professional degree2.Professional degree 3.Address3.Address 4.Office telephone #4.Office telephone # 5.Date of prescription5.Date of prescription 6.Name of the patient6.Name of the patient 7.Address of the patient7.Address of the patient

8.Drug name 8.Drug name 9.Strength of drugs9.Strength of drugs 10.Quantity of drugs10.Quantity of drugs 11.Signature (directions of medicine to 11.Signature (directions of medicine to

be used)be used) 12.Refill (repeat prescription)----Times 12.Refill (repeat prescription)----Times

or untilor until 13.Child proof container13.Child proof container 14.Warning (eg. May cause sedation, 14.Warning (eg. May cause sedation,

don’t take alcohol etc.don’t take alcohol etc.

15. prescriber’s signature15. prescriber’s signature 16. License no./ Registration no.16. License no./ Registration no.

Common prescribing errors :Common prescribing errors : a. Omission of needed informationa. Omission of needed information b. Poor prescription writingb. Poor prescription writing c. Inappropriate drug prescription c. Inappropriate drug prescription

COMPLIANCE/ NON COMPLIANCECOMPLIANCE/ NON COMPLIANCE Four types of non compliance leading to medication Four types of non compliance leading to medication

error error 1. The patient fails to obtain medication1. The patient fails to obtain medication 2.The patient fails to take medication2.The patient fails to take medication 3.The patient prematurely discontinues 3.The patient prematurely discontinues medicationmedication 4. The patient ( or another person) takes medication 4. The patient ( or another person) takes medication inappropriately .For example, the patient share a inappropriately .For example, the patient share a

medication medication with others for any of several reasons .with others for any of several reasons . ..