A PRESCRIPTION is a written instruction from a physician or dentist to a pharmacist concerning the form and dosage of a drug to be dispensed to a patient. Prescription has different parts, including name, age, gender and weight of patient, his/her symptoms and diagnosis, name of medicines prescribed, frequency and dose of medicines, instructions to the pharmacist or the patient, and name, address and signature of the prescriber.

According to international guidelines, a written prescription for drugs must be clear, understandable, legible, printed or typed. Besides, it is also compulsory to use a zero before a number less than one, for example, 0.5mg, and never terminal zero (e.g. 5.0mg).

Studies in different countries, including Pakistan, have shown that drug-induced morbidity is an important problem in ambulatory care patients and one of its major factors is prescription error.

A study published in the Pakistan Journal of Medical Sciences, titled ‘Prescription patterns of general practitioners in Peshawar’, showed that out of 1,097 prescriptions in six major hospitals and pharmacies, no prescription contained all the essential components of a prescription. Legibility was poor in 58.5 per cent prescriptions; prescriber name and registration number were not mentioned in 89pc and 98.2pc prescriptions respectively.

Over 78pc prescriptions did not have diagnosis or indication mentioned. Dosage, duration of use, signature of physician and directions for taking medicines were not mentioned in 63.8pc, 55.4pc and 10.9pc of prescriptions respectively.

A similar study in Yemen indicated that only 0.87pc of prescriptions were considered to be of good quality. Writing errors relating to patients and prescribed medications were the most common errors.

Preventing prescription-writing errors is important to ensure the safety of patients. Printed or electronic prescription can minimise chances of such errors. It is the due right of patients to get prescriptions in legible format as they pay consultation and lab fee.

On the other hand, pharmacies in Pakistan do not have trained pharmacists and professionals which worsens the situation. Thus in many cases the patients are unable to get the required medications.

Legislations must be amended on a war footing to bring qualified and skilled individuals to pharmacy stores, and unethical promotions, unwanted visits of pharmaceutical representatives to physicians must be discouraged.

There is a need for developing SOPs for prescription-writing and record-keeping in the health system. A uniform standard prescription format should be introduced and these SOPs must be included in training by, say, the College of Physicians and Surgeons Pakistan. All these initiatives will benefit the patients both in terms of cost-effectiveness and quality of healthcare.

Ihsan Ullah

General Secretary,

Young Pharmacist Community, Pakistan

Peshawar

Published in Dawn, February 12th, 2021