Prescription writing: Time to revisit!
Correspondence Address: Source of Support: None, Conflict of Interest: None DOI: 10.4103/0028-3886.190248
Source of Support: None, Conflict of Interest: None
The skills achieved by medical students with regard to patient examination and therapeutics are learned from immediate seniors or faculty members. The art of writing a prescription is usually imbibed by medical students during their tenure in Pharmacology (MBBS/BDS). It has been observed that undergraduates attain the skill of writing prescriptions in the second professional year (may be, out of fear of the examinations); however, the moment they move to clinics, de-learning ensues. Is it because of work pressure, patient overload, casual attitude, aping their seniors, lack of awareness, or, no fear of evaluation; the reason for this callousness needs to be deciphered.
A prescription is a written, or electronic order, from a practitioner or designated agent to a pharmacist for a particular medication for a specific patient. Prescription is a medicolegal document, hence utmost care is needed while writing a prescription. All components of a prescription should be complete. There is no global standard for the prescriptions and every country has its own regulations.
The most important requirement is that a prescription should be legible and should indicate precisely what should be given. Although, till date, no standard format for prescription has been agreed upon or thought of, recently, the Medical Council of India has proposed a format for the prescription [Figure 1]. Medication errors due to an error in the act of writing (prescription errors) have resulted in morbidity and mortality.
Elements of a prescription
Superscription (Prescriber's details)
Inscription (Name of drug, amount, duration and frequency)
Subscription (Direction to the Pharmacist; [Figure 2])
Signa (Instruction to patient)
Signature of prescriber.
Common prescribing errors
Wrong/Inappropriate drug (e.g., drugs that sound similar)
Failure to take account of drug interactions
Two drugs from the same class
Wrong/Multiple routes (IV/SC/PO)
Calculation errors (important in pediatrics)
Infusions with not enough details of diluent, rate, etc.
Significance of date in the prescription
Important part of the medical record
It can assist the pharmacist in recognizing potential problems
Compliance behavior can be estimated using date of filling and refilling
Duration of therapy.
All the orders for controlled substances be dated and signed on the day issued.
Steps or instructions for a good prescription
Write legibly (use block letters)
Sign and date the prescription (it is a legal document!)
Never abbreviate drug names
Never use proprietary names; always use generic names
Use plain English for dosing directions
Be careful with lookalike/sound alike names e.g., Clotrimazole/Co-trimoxazole, Carbamazapine/carbimazole
Do not guess (check the name or the dose of the drug)
Avoid 10-fold dosing errors; write 1 mg instead of 1.0 mg
Do not allow patient to prescribe for you.
What can be done to inculcate the practice of writing a sound prescription
In the government setup, due to patient overload, lack of manpower, and financial issues, the use of a prescription writing software is a far-fetched idea. However, it is the will to change one's attitude that is required at this point of time. Simply writing in block letters  (the name of the drugs), the use of symbols (for dose frequency), the use of generic names as far as possible (brand names for combinations only), and the appropriate instructions to the patients in the prescription will suffice for a beginning.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
[Figure 1], [Figure 2]