A prescription is a paper document; handwritten, typed or computer generated detailing medicine(s) to be dispensed for an individually named patient & issued by an authorized prescriber.
A prescription may contain one or more medicines. In addition to medicines, a prescription may also contain other items needed for treatment like;
· Wound dressings
· Elastic hosiery
· Blood glucose monitoring
· Needles
· Syringes
· Nutritionally complete food
· Gluten free food
Electronic prescriptions would be routine in community & hospitals. It has same legal force (value) as prescription signed in writing & will replace paper prescriptions.
Benefits of electronic prescription include
1. Patient convenience
2. Easier ordering of repeat prescription
3. More detailed information
4. End to incomplete & illegible prescription
Though electronic prescription may become routine practice in National Health Service, private prescription will remain as paper document for appreciable future time.
In UK & Pakistan, there are two providers of healthcare, the private sector & National Health Service (UK) & govt. sector (PK) i.e. health ministry (basic health units, tehsil & dist. headquarter hospitals & teaching hospitals).
Types of prescription: -
There are two types of prescriptions:
1. Private prescription
2. Hospital prescription
Private prescription forms: -
There are two types of private prescriptions
1. Private prescription form from UK
2. Outpatient private prescription form from USA
Prescription sample 1
| (1) John B. Doe, MD(2) 1234 South Northwest Dr. (3) West City, Ca94999 (234)555-6789(4) | |||||
| For(5) | Date(6) | ||||
| Address(7) | |||||
| Rx Drug Name(8) & Strength (9) Quantity (10)
Sig (11) | |||||
| Warning(14) | __________________(15), MD | ||||
| AD1234567 (16) STATE LICENCE (17) | |||||
Common form of Outpatient Prescription – USA
| Dr. I. Diller BDS Dental Surgeon Mediton Dental Mediton Rx Sodium fluoride tabs 500mg Take one tablet daily Send 56 IDiller 14.2.08 Send 5 Miss Isabel Featherstone Molesworth Manor Mediton |
Prescription sample 2
A typical private prescription from UK
Elements of prescription: -
The sequence or pattern may vary from country to country but contents /elements of prescription are almost identical all over the globe.
Lets describe the outpatient prescription from USA
Prescriber’s identity:
The first four numerals 1,2,3,4 of prescription form (fig) establish the identity of the prescriber,
1. Name
2. License
3. Full address
4. Office tel #
The pharmacist must establish the prescriber’s bonafidies so that he should be able to contact prescriber by telephone if any question arises at the time of dispensing prescription.
THE DATE: -
5 It is the date at which prescription is written.
Significance
· It helps in maintaining medical records.
· Date is of great value for refill & termination of therapy.
· Date is useful in discouraging the misuse of prescribed drugs by another person who might have similar symptoms.
The states law necessitates that prescription containing NARCOTIC ingredients must be dated as the day of issuance of prescription (according to Dangerous Drugs Act)
Name & address of patient: -
6&7 identify the patient by name & address.
Name & full address of patient is written on prescription form clearly for serving the following purpose.
· This information is necessary to expedite the handling of prescription
· To eliminate the confusion with medication intended for someone else.
· To provide the pharmacist more accurate mean for checking medications.
· Sometimes it is mandatory to write name & address of patient by laws of the state.
NARCOTIC PRESCRIPTION also requires by law to contain name & address of patient & this info must appear on the label, which contain prescribed medications.
Superscription: - (Âx)
It is traditional symbol of pharmacy, which adorns every prescription. This symbol represents an abbreviation of Latin word RECEIPE, which means, “TAKE THOU”.
The earlier time pharmacists believe this symbol to be a hold over or ancient custom of invoking the blessings of their gods for sick people.
Inscription: -
8,9,10. This is the heart of prescription because this part contain
NAMES
STRENGTH
QUANTITY
STRENGTH
QUANTITY
To be dispensed of each ingredient (drug) prescribed. The dosage form of medication & complete direction for use are also mentioned. When writing the drug names, either generic or brand names can be used. Strength should be carefully mentioned in metric units. However both the prescriber & the pharmacist should be familiar with the both system used now- a- days i.e. metric & apothecary.
Originally Latin was used was universal language for prescription as it was easy for the pharmacist to interpret it anywhere in the world. But now ever-increasing appearance of branded medication in today’s prescriptions has resulted in gradual decline of the Latin language in prescription. Now- a- days in many countries prescribers make good use of their native languages to facilitate the pharmacist in particular patient to understand the dispensing & proper use of medication respectively.
The most important point is that pharmacist should never dispense any prescription if he is in doubt about the name, strength & quantity of the drug or about any of abbreviation appearing in the prescription. If there is any query pharmacist must contact prescriber for clarification.
Subscription: -
11 (a) Directions for the pharmacist
It is the direction for the pharmacist regarding preparation of dosage form, quantity & other information that has to be placed on the label. In earlier times, the pharmacist used to have big task, in order to dispense the prescription, relating to dosage form & quantity of each item prescribed. In present era of commercially prepared medicinal all types, directions for pharmacist has been reduced to minimum.
Signatura: -
11 (b) Directions/instructions for patients
The ultimate efficacy of prescribed therapy largely depends on the adherence to utilization & dosage schedule as indicated by prescriber thus it is important that patient fully understands & follows the directions as prescribed. The instructions about taking the medicines
i.e. when & how,
Duration of therapy&
Purpose of medication,
Must be explained to each patient by physician & pharmacist.
“ Neither should assume that other would do.”
The same instructions should be written on label. Simply writing “take as directed” may save the time but it often may lead to non- compliance, patient confusion & medication errors.
Most of the time, patient non-compliance is the major cause of failure of achieving the therapeutic success.
Refill Information (12)
In order to avoid the need for calling of the prescriber, the physician should clearly indicate his decision on each original prescription for refilling. This may be indicated as refill certain number of times or until such date or don’t refill (the prescriber may authorize pharmacist to refill on telephone).
Section (13)
Indicates waiver of requirements for child proof container.
Warning (14)
This is additional lab instructions like “may cause drowsiness” of “Don’t drink alcohol” or “Don’t drive” or “Don’t work on a machine that requires alertness.”
Prescriber’s Signatures and Identification data (15, 16 & 17)
15-17 are the signature of the prescriber and the other identification data of the prescriber.
Hospital Prescription Forms
For prescribing for In-patients or Indoor patient, there is no standard form and the real format and design of form depends on the individual hospital form. Thus for convenience, most hospitals forms are divided into three separate areas i.e. Area1 is meant for medicines to be administered on regular basis, Area2 for medicines to be administered once daily and Area3 for medicines to be administered on as-required basis.
Some forms may also have area for medicines that can be administered by nursing staff at their own discretion. Such medicines may include simple analgesics, sore throat lozenges, laxatives etc. All hospital prescription forms have space for identification of patient and important details about him like allergies.
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