Explanation How to Write a Prescription
A prescription is a significant therapeutics transaction or instruction between a patient and doctor. The prescriber can be a doctor, nurse, medical assistant and a paramedical worker. Similarly, a dispenser can be an assistant or a pharmacy technician. In other words, every state has some standards to minimize information in the prescription. There are laws that define if a drug requires a prescription or not and who can prescribe it.
Over the past few decades, many studies conclude that prescription errors can cause adverse events. A study in the Journal of Pharmaceutical and Biomedical Sciences classifies prescription errors into drug-related or physician related errors. The results of the study highlight low obedience issues concerning the procedural requirements of prescription writing.
Major Causes of Errors in Prescription Writing
Prescription errors occur when there is a discrepancy in written instructions or the pharmacy technician misinterprets drugs on the prescription. Commonly, these include
- Lapses, such as writing 50 mg instead of 5 mg
- Mistakes, such as writing 50 mg when prescriber does not know the exact dose is 10 mg
The frequency of prescription errors is difficult to find. However, knowing how dangerous mistakes can be, researchers define some major causes of prescription errors:
- Calculation errors
- Inadequate medicine knowledge
- Poor history knowledge of the patient
- Illegible handwriting
- Inadequate knowledge of patient’s clinical status
- Confusion in a drug name
Workload, stress, and fatigue can also contribute to unintentional lapses. However, it is important that the prescriber must have professional knowledge and is aware of the safety principles and the risks of negligence.
Considering the risks with prescription writing, here are some significant rules to explain ‘what does a prescription look like’:
How to Write a Prescription
Make sure you include all the essential information, including patient’s instructions, inscription, and subscription, in the prescription.
Basic Information of the Patient
The patient’s basic information starts with writing his/her clear identity in the prescription sample. To minimize confusion, you should include more than one identifier.
- Date of birth with patient’s full name is the common identifiers, in case two patients have the same name
- In settings outside of hospitals, you can use the address or phone numbers
- As a prescriber, providing your information is as important as providing the patient’s information. Make sure to list your name, contact information, and hospital or, the address of your medical practice.
- List your state’s Drug Enforcement Administration (DEA) contact number on the prescription.
- This information is printed on most prescription samples. However, if it is not, write it manually.
Prescription date refers to time-sensitive drugs. Providing a certain period for them is important even if the medication does not include in the time-sensitive drugs category. These are the general categories for the drugs:
- Drugs with a high risk of potential abuse are legally acceptable for medical use, such as Schedule I medicines.
- Drugs that have a high potential for abuse but have some legal acceptance for medical purposes, such as Schedule II
- Schedule III Medicines, that include drugs that have some risk of potential abuse and are acceptable for medical use
- Drugs that have a low risk for abuse and have the legal permission of medical use, such as Schedule IV drugs
- Drugs that have no risk of abuse and are legally accepted for the medical purposes
Prescriber’s Sign on the Written Prescription
- Your sign is a must-have part of the prescription. Your signature makes the prescription valid and reliable. You can use the bottom of the page to sign the prescription if there is no separate space or specific line for the signature.
- Make your signature the last part of your prescription writing practice. This ensures no one can misuse the blank and unfinished prescriptions.
The RX symbol is customarily a part of the prescription heading, commonly called ‘superscription’. Writing ‘RX’ on the prescription is important and you should write it before the instructions.
- You can also get it printed on the prescription paper.
- After RX symbol, add the inscription information, which includes the drug information
- Always use the non-proprietary name of the medicine instead of the brand name
- Adding brand name with the medicine will make it brand specific and maybe make the prescription potentially expensive for the patient
- If you think that it is important to prescribe a brand name, write ‘No Generic’ with the drug name.
Mention Medicine Strength
- This is one of the most important parts of prescribing medicines where you need to be Mention the medicine strength right after the medicine name.
- Use milligrams to indicate the strength amount of the medicines, such as suppositories and tablets. Similarly, use milliliters for prescribing fluids.
- Most importantly, avoid writing abbreviations that lead to misinterpretation. Use clear words and make sure to write correct spellings.
Write Prescription Amount
- A pharmacist must know the exact amount of prescription required to fill and pass to the patients.
- To avoid any confusion, always write an appropriate and clear heading ’disp’ or ‘dispense’, and how much.
- Indicate the number of tablets or bottle size while spelling the numbers clearlyto avoid any possible miscommunication.
Write the Number of Refills
- Writing prescriptions for chronic and acute conditions may require you to write a certain number of medicine refills for your patients.
- Allow additional refills only if your patient needs to take the same prescription multiple times. For example, if the prescribed oral contraceptives provide a monthly dose while you want your patient to continue it for a year, you can write ’11 Refills’ with it. It will indicate that the patient has the permission to buy 11 refills after fulfillment of the first dose.
- Inform your patient that he will have to obtain another prescription when the last refill runs out.
- In case there is no need for a refill, write ‘0 Refills’ to reduce the risk of tampering.
Directions for Patients
This refers to a specific method for taking the prescribed medication. You may use both Latin abbreviations and English terms for mentioning the route. Below are some common options:
- By mouth
- Topical (TP)
- Intra-peritoneal (IP)
- Intravenous (IV)
- Per rectum (PR)
- Buccal (BUCC)
- Intramuscular (IM)
- Intranasal (IN)
- Sublingual (SL)
Specify the Dosage Amount
You have to specify the dosage amount for the patient, depending on the medicine you prescribe. These instructions will be the part of the prescription label once the patient completes his first dosage. For instance, two capsules, 40 milligrams a day.
Frequency of Dosage
As is clear from the title, the frequency of the dosage indicates the number of times a day the patient must take the medicine. Avoid using abbreviations when it comes to indicating frequency.
- Mention medication, which requires ‘everyday’ dosage’, with complete spelling
- For others, you can use abbreviations but it is better to spell out them as well. You can pick some common prescription writing examples from this list,
- QWKfor every week
- QHSfor bedtime
- BIDfor twice a day
- QHSfor every bedtime
- Q4Hfor every 4 hours
- QIDfor 4 times a day
Inform Patient About ‘When To Stop Medicine’
It is important to tell your patient when to stop the medication. Ideally, they should discontinue it once the symptoms disappear.
Mention Diagnosis in Specific Cases
- It is for ‘needed basis’ medication. Writing a brief diagnosis along with the instructions will specify nature of ailment your patient is suffering from.
- You can use ‘PRN’ as an abbreviation. For instance, write ‘PRN pain’ as a statement for prescribing pain medication.
Write Special Instructions (If Needed)
There is always room for additional instructions on the prescription note (if your patient needs it). For example,
- Avoid alcohol
- Take medicine with food
- Shake before drink
- Keep it refrigerated
- Make sure that you use an indelible pen or ink to minimize tampering chance. You can type it for a safe side
- Make sure that you write prescriptions in legible writing to avoid errors
- Your registration with DEA is a must to practice prescription writing
Overall, writing a prescription requires you to pay attention to ensure the accuracy of correct drug references. With the above-mentioned guidelines, you can reduce the chances of errors, as well as risk associated with them.