The Art of Writing Prescription

Abstract

Introduction: The prescription is our single most important communication. It reflects our personality, ability to communicate, sensitivity, and knowledge. Unfortunately, most psychiatric training programs do not pay much emphasis on it. There are a few studies on the appropriate use of drugs, proper use of guidelines as well on prescription errors.

Aims and objects: This paper discusses the strengths and deficiencies of individual prescriptions by trained psychiatrists on the following parameters. Is the drug use rational? Is the prescription economical? Has the prescription been individualized? Should fixed drug combinations used? Does the prescription reflect the psychosocial needs of the patient?

Material and methods: This subjective study is based on the author’s experience of practicing psychiatry for over 50 years. Many patients in psychiatry shift from one clinician to another as the illnesses are usually chronic and relapsing.

Observations: Treat the individual with the disease-the focus of treatment is often on the disease and not the patient. We plan to treat schizophrenia or depression and lose sight of each patient’s specific need. Each patient suffering from an illness receives a similar prescription. The prescription must be individualized. Does the patient need an injectable medicine or an orally administrable medicine? The quality of life-treatment goals should be clear. Often, the goal is to treat the illness and reduce the chances of recurrence. We often do not consider the effect of the medicines on the patient’s quality of life. Sometimes we may have to reduce medicines or use medicines that help patients’ quality of life despite having symptoms. A hallucinating patient who is working is a better choice than a non-hallucinating, dull person living at home and doing nothing.

Conclusion: This paper has highlighted some of the issues related to prescription writing in India. Unfortunately, there has not been any study that analyses prescription errors in this country. There seems to be an urgent need to start prescription audits in some form to improve practice in our country.