Rational Prescribing

Thus it can be best described by the 6 Rights of prescribing, which highlight the importance of getting

1)    The right Drug

2)    For the right diagnosis

3)    To the right patient

4)    At the right time

5)    And via the right route

This is important to note that “not all aspects of this decision are pharmacological” and one should not underestimate the importance of history, examination and diagnosis as part of process.

Why Prescriber Prescribes

The prescriber always needs to have a therapeutic aim in mind while prescribing an individual patient.

The components of aims are as under.

(i)               Alleviate symptoms (e.g. Diclofenac for pain)

(ii)            Replacing deficiency (Thyroxine for hypothyroidism)

(iii)          Preventing disease (Low dose aspirin for MI)

(iv)          Curing disease (e.g. Primaquin for cure of Plasmodium vivax malaria)

Sometimes, the reason for treatment does not fit neatly into one of the four categories so prescribing may also be due to the following reason as well.

1. Prescriber may have tactical reason for prescribing (placebo)
2. to gain time while waiting for another intervention (surgery, physiotherapy, psychotherapy)
3. To monitor a patient condition when they present themselves for the repeat prescription
4. for the therapeutic trial to help diagnosis
5. to respond to patient expectation and maintain Doctor-patient relationship.

Rational prescribing should meet certain criteria like appropriate diagnosis, indication, drug, patient, dosage, duration, route of administration information and monitoring.

Lectures By Dr. Bashir

Courtesy:

Compiled and Shared By: Habib Anwar 

habib.anwar@hotmail.com