Rational Prescribing Prescription Writing Collected and Prepared By

Rational Prescribing & Prescription Writing Collected and Prepared By S. Bohlooli, Pharm. D, Ph. D

Introduction • After reaching to the Diagnosis, the practitioner can often select from variety of therapeutic approaches. – – – – Drug therapy Surgery Psychiatric treatment Radiation Physical therapy Health education Counseling No therapy

Rational Prescribing 1. 2. 3. 4. 5. 6. Make a specific diagnosis Consider the pathophysiologic implications Select a specific therapeutic objective Select a drug of choice Determine the appropriate dosing regimen Devise a plan for monitoring the drug’s action and determine an end point for therapy 7. Plan a program of patient education

The Prescription

Elements of the Prescription 1. Identity of prescriber • 2. 3. 4. Date Name and address of patient Body of prescription • • 5. 6. Name, license classification, address, office telephone number Medication, the strength, quantity Dosage and complete directions for use Refill information , waiver for child proof and additional labeling instructions Prescriber Signature and other Identification Data

Abbreviation Used in Prescriptions & Chart Orders

Prescriptions should be legible, unambiguous, dated and timed Prescribing Errors • Omission of Information As needed (prn) • Poor Prescription Writing Ø Illegible handwriting Ø Ambiguous decimal points • Inappropriate Drug Prescription Ø Failure to recognize contraindications by other disease Ø Failure to obtain information about other drugs Ø Failure to recognize possible physicochemical incompatibility

Compliance • The extent to which patients follow the treatment instructions • Types of noncompliance Ø The patient fail to obtain the medication Ø The patient fail to take the medication as prescribed: wrong dosage, wrong frequency of administration, improper timing, wrong route or technique of administration, taking medication for the wrong purpose Ø The patient prematurely discontinue the medication Ø The patient takes medication improperly.

Strategies to improve compliance • Enhanced communications • Assessment of personal, social and economic conditions • Development of a routine for taking the medications • Provision of systems to assist taking medications • Mailing of the refill reminders by pharmacist

Labeled and Unlabeled Uses of Drugs

Socioeconomic factors • Generic Prescribing ØIf the physician wants a particular brand of drug product dispensed handwriting instruction to “Dispense as written “ is required. • Other Cost Factors ØProfessional service fee

Good Luck