In September 2018, the Uttarakhand High Court at Nainital directed all doctors whether in government, public or private clinics and hospitals to issue computer-generated prescriptions and not handwritten ones so that patients and their care givers understand them. Goel of Sitapur and Dr Ashish Saxena of Gonda district hospitals of UP on separate criminal cases for their poor and illegible handwriting.On April 21, 2017, the MCI directed the entire medical community in India to follow its October 2016 notification. Many times, the doctors themselves find it difficult to read their own handwriting at a later stage.Why illegible prescriptions?There may be many reasons, including busy work. As a result of this, the hospitals and community pharmacies initiated steps to invite highly qualified pharmacists with Pharm.Because of the quality of handwriting, she was dispensed a drug ‘Daonil,’ a medicine for diabetes, by the pharmacist in a pharmacy. Even those with miserable handwriting start writing prescriptions in a legible manner.As medical practice has become increasingly complex, the term prescription has broadened to include clinical assessments and investigation reports aimed at optimising safety or efficacy of medical treatment. If some Latin terms are used, pharmacists have to translate them into words understood by patients.Easy access to various patient data will also help in various types of studies and research which can lead to an overall improvement in the quality and effectiveness of healthcare.

It has a specified format and structure and requires the information about both prescriber and patient.A standard prescription has four parts namely superscription, inscription, subscription and signature. The court also suggested that such reports should be computer-typed. Till then, prescriptions were mainly retained as a reference book by the doctors and apothecaries.Doctors obey only court orders?While many doctors dare to ignore government and MCI directions, they seem to obey the court directions with fear and respect. Notification number MCI-211 (2)/2016 (Ethics)/131118 issued by the MCI in October 2016 directs the doctors to write prescriptions in capital or legible letters and prescribe medicines in generic names. Doctors and other healthcare professionals, including nurses and pharmacists, can quickly access the patient data without errors.Digitising the patient records and prescriptionsIn a country where digital India, e-governance, e-health and e-pharmacies are running at a pace, it is high time handwritten prescriptions are banned.The court also directed the home secretary, health secretary and the director of health services of UP to ensure that in future medico-legal reports are prepared in easy language and legible handwriting. They all pleaded that they were overburdened and hence erred in writing legible injury reports. The bench consisting of Justice Ajai Lamba and Justice Sanjay Harkauli considered their illegible handwriting as an obstruction to court work and admonished them and asked them to deposit Rs 5,000 each as penalty and deposit it in the library of the Bar Association within three weeks.Brand name or trade name is a proprietary, fancy, business name given by the manufacturers to distinguish their products from that of others. He also said that the doctors write prescriptions in such a way that the poor people do not understand their handwriting and they end up buying costly medicines while quality generics are available at lower costs.The court also directed the government to provide necessary infrastructure to government doctors in this regard. This is a grave cause of concern. When a patient is referred to a senior or specialty doctor, the latter has to go through all associated prescriptions and investigations.There are certain established conventions for prescription writing. The report estimated a national cost of 17 to 29 billion for the preventable adverse events in health care.In the 1960s, when there were many prescription errors in USA, the Ralph Nader movement helped the patients to take such litigation to consumer courts and the hospitals were forced to pay huge compensations.Good handwriting is an asset for any educated person, like good voice for a musician.Many doctors with bad handwriting at global level are now entering orders and note electronically suo motu and use even electronic signature. They must also furnish a complete and detailed prescription to ensure that there is no chance of incorrect treatment.K. However, a staff nurse could reveal that a doctor in Delhi had prescribed her ‘Duodil’ a drug for muscle spasm and resultant pain and discomfort. Many doctors have atrocious and illegible handwriting and it is a global problem irrespective of their specialty, position and designation. Many abbreviations, both popular and non-popular, approved and non-approved, often appear in prescriptions. In UK, about 30,000 British die every year due to medical errors. In case of an illegible hand-written prescription, the pharmacist or pharmacy technician must contact the prescriber for clarification before dispensing.The Lucknow bench of Allahabad High Court in the first week of October 2018 imposed a penalty of Rs 5,000 each on three doctors- Dr T.These doctors issued medico-legal reports of the victims in miserable handwriting and was not readable.It was John Morghan, the American apothecary who initiated prescriptions in the form of chit given to the patient in the 1750s in USA.Some typical prescriptionsIn the past, students and interns were made familiar with typical miserable prescriptions through textbooks and study papers only. In one case, a pregnant woman got aborted due to the wrong dispensing of medicines by a pharmacist in a pharmacy chain store at Vidyanagar in Hyderabad. She was taking it for a few days.

As medications became pre-packaged manufactured products, the prescriptions now refer to an order that a pharmacist has to dispense to a particular patient for specific medicines. A study conducted by the author and his team in Kerala could find some interesting brand name prescriptions written by male doctors even after the decision taken by the Government of India, MCI and High Court orders for legible generic prescriptions.Although a good move from MCI, this protocol is hardly being adhered to by certain practitioners as there is no monitoring mechanism to its adherence. Generic name being the scientific and official name, almost all countries follow the system of prescription writing and dispensing based on generic name of the medicines. Pharmacists may dispense wrong drugs. Because of WhatsApp and other electronic media for communication, such prescriptions now appear instantaneously in the media in these days.S. It revealed that 44,000 to 98,000 people die annually in USA from medical errors.Miserable prescriptionsPrime Minister Narendra Modi announced on April 17, 2017 that the Government of India intended to ensure that doctors prescribe medicines by generic name only as they are cheaper than the respective branded medicines. Being in an electronic age, they are smart enough to discuss such prescriptions using WhatsApp and other electronic media. It is to be considered that the medico-legal reports and postmortem reports are prepared to assist the persons involved in dispensation of criminal justice,” the court observed. Today USA is one of the countries where medication errors are minimum, medicine safety is high and innovations are made in prescription handling and dispensing.Compared to complicated chemical name, generic name is a shortened, popular, easy-to-recognise name in pharmaceutical sector. The reading of prescription will no longer be a challenge for the common man in Uttarakhand. It is an instruction manual for the patient or his/her family members/ caregivers. Citing a number of incidents, he brought to the notice of the court that pharmacists were giving wrong medicines to patients because of disastrous handwriting in prescriptions.Health insurance agencies, World Health Organisation, international, national and regional medicine procurement agencies all follow the generic system. Out of them, about 7,000 deaths are attributable to sloppy handwriting.“We will bring in a legal framework by which if a doctor writes a prescription, he has to write generic names in a legible manner,” he said. Such a grave consequence was mainly due to the illegible handwriting of the doctor who treated her in Delhi.P. Reading a doctor’s prescription has always been a challenge for the common man.Computer application and digitisation of patient records and prescriptions will help solve many medication-related problems, including illegible handwriting. The examination and investigations could not pinpoint a particular reason. Studies have shown that in rural India, only one in five doctors writes legible prescriptions and only half of the Indian doctors really sign the prescriptions written by them.From the perspective of patients, illegible handwriting in prescription writing is a nuisance, which could result in serious injuries, including death of the patients. “The medical reports are written in such a shabby handwriting that they are not readable and decipherable by Electronic lighter Suppliers advocates or judges. At that time, the MCI was not having any guidelines for prescription writing, though the state of Maharashtra had framed a model prescription format under the initiation of the then FDA commissioner Mahesh Zagade. In all academic activities, only generic name is used. Doctors, pharmacists and nurses are fully aware of the importance of all the four parts of the prescription, though some doctors make it a miserable document leaving to the interpretation of the pharmacists. Since we don’t have a perfect data bank or correct registry, the exact numbers are not known. Such illustrations were often pretty old or from other countries. Jaiswal of Unnao, Dr P. This caused a sudden fall in her blood sugar levels, leading to the convulsions.Even after 20 or 30 years of experience, my practising pharmacist friends are struggling hard to decipher certain prescriptions written by some doctors.It is also found that doctors handwriting is no better at home than in the hospital.Some studies have shown that male doctors are having far worse handwriting than their female counterparts. Prescription itself is a health care programme implemented by the physician or other health care practitioners for a patient. In March 2018, the Ministry of Health and Prevention of UAE banned handwritten prescriptions and said prescriptions have to be in electronic or printed format. In January 2017, the Bangladesh High Court ordered the government to issue a circular asking doctors to write prescriptions clearly in block letters or print the prescriptions. Prescriptions have to be written with permanent ink avoiding decimal points and other ambiguities. A division bench consisting of acting chief justice Rajiv Sharma and justice Manoj Kumar Tiwari issued the order while hearing a review petition based on the August 14 order for generic prescriptions by doctors. It may compel patients to take wrong medicine and wrong dosage and can also lead to unnecessary tests and discomfort.D and M.In the past, prescriptions often included detailed instructions regarding compounding of medications.Illegible handwriting in medical records too have caused adverse medico-legal implications. Various state medical councils, including the Travancore-Cochin Medical Council of Kerala, endorsed the decision and directed the practitioners to comply with the same.A few years ago, the daughter-in-law of the former editor of a leading publication in Assam was admitted to GNRC hospital in Guwahati as she was suffering from convulsions. Illegible prescriptions do take a fair share of it. Directions should be used in full English.Chilukuri Paramathma, a pharmacist from Andhra Pradesh, approached the High Court of Hyderabad in 2014 against the prescription writing style leading to confusion in pharmacists through a public interest litigation.It may also be noted that through its order dated August 14, 2018 the High Court of Uttarakhand directed all doctors in the state to prescribe only generic medicines and not force patients to buy costly branded medicines.For the dispensing pharmacists, deciphering the handwritten prescriptions for certain branded medicines often requires the assistance of colleagues. It is a documentation of drug requirement for the pharmacists and a track record of the patients’ past and present medication and disease conditions for other doctors and healthcare professionals.The very next day, the Union Ministry of Health and Family Welfare wrote to the additional chief secretaries/ principal secretaries of health and family welfare of all states and Union Territories calling their attention to the October 2016 MCI notification mandating prescribing drugs with generic names legibly and preferably in capital letters. Units like teaspoons or tablespoons have to be avoided.What is a prescription?A prescription is not merely a chit for the patients to buy some items from a pharmacy or other store. These hospitals are 100 to 200 kilometres apart, but their doctors have a common style of writing. Pharmacy qualifications to handle prescriptions and related professional activities.

Megosztás a facebookon