While most prescribing takes place in the community, the quality use of medicines in hospitals should not be neglected. Doctors learn to prescribe in hospitals, and this has a big impact on how they prescribe afterward. Our large teaching hospitals care for the most complex patients. But their immediate therapeutic care is managed by our least experienced physicians, albeit under the supervision of experienced physicians. Unlike community prescribing, little information is available on drug use in hospitals due to a lack of coordination. And poorly developed information systems. So, we are going to discuss about ways to improve prescribing practices. Lets start.
What is Prescription
Prescription is the main approach to the treatment and prevention of disease in modern healthcare. While medications can improve health, they all have the potential to cause harm if used incorrectly. We recommend that healthcare professionals who prescribe medicines do so based on the following ten principles that underpin the safe and effective use of medicines.
- Prescribing errors are one of the most common reasons doctors seek advice from MDUs.
- Risk areas include long-term administration, dosage errors, and allergies.
- You are responsible for any prescriptions you sign.
It is your responsibility to understand the medication you are being prescribed. Including any possible side effects, contraindications, and the need for appropriate monitoring. You are responsible for the prescriptions you sign, even if they were created by non-clinical staff. You should be sure that the medicine and dosage are correct. The World Health Organization suggests a multi-step approach to prescribing that can help providers better target treatment intent. The guidelines were created in 2007 and are still valid today.
Now we are about to discuss ways to improve prescribing practices. So, keep your eyes open on this article.
- Assess and define the patient’s problem.
- Determine the therapeutic goal of pharmacotherapy.
- Choose the right medicine.
- Provide information, warnings, and instructions to patients.
- Monitor the patient regularly.
- Consider the cost of medications when prescribing.
- Use appropriate tools such as prescribing software and electronic drug references to reduce prescribing errors.
A major component of ethical prescribing is examining each patient’s individual needs and situation. Many ethical challenges from past decades are still present for clinicians today.
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Principles To Improve Prescribing Practices
- Be clear about the cause for prescribing.
- Consider the patient’s medication before prescribing.
- Consider other factors that can alter the benefits and harms of treatment.
- Consider the patient’s ideas, examine them, and expectations.
- Choose effective, safe, and cost-effective medicines tailored to the patient.
- Follow national guidelines and local forms where appropriate.
- Write clear legal regulations using proper documentation.
- Monitor treatment outcomes, both beneficial and adverse.
- Communicate and document prescribing resolutions and reasons for them.
- Prescribe within the restrictions of your knowledge, skills, and experience.
Each prescription has a prescription number on the label of the bottle or box. This number identifies your prescription so the pharmacy can refer to it for refills or answer questions.
Give Information Instructions and Warnings:
Physicians should educate patients about the intended use, expected results, and potential side effects of each drug prescribed. Although it is impossible to describe every side effect of a given drug. It is important to address the common and rare but serious ones. Physicians must describe how the drug should (and should not) be administered. Including all important relationships to food, time of day, and other medications the patient is taking.
Patients can demonstrate their understanding of medication by repeating relevant information. At the end of the visit, the prescriber should make sure the patient knows when to return for follow-up. And that treatment is continuing after this single prescription.
This is also good technique to improve prescribing practices.
Evaluate Therapy Regular:
Systematic drug review at each visit allows the prescriber to monitor the effectiveness of treatment and reduce problems, especially in elderly patients who are most prone to polypharmacy. A medication review may include reevaluating the diagnosis, evaluating possible side effects, looking for drug interactions, and discontinuing unnecessary medications.
The review also helps avoid a prescribing cascade, which involves adding additional drugs to a patient’s regimen to treat the side effects of other drugs.
Medication Name and Strength:
Medication errors can include the correct drug in the wrong dose, resulting in an overdose, underdose, or extra dose. Alternatively, the drug itself may be different from the one prescribed by your doctor. For example, a pharmacist might mistakenly give you “immediate-release” tablets rather than “extended-release” tablets.
To avoid medication errors, make a note of your prescribed medication, dosage, and dosing instructions when you are at your doctor’s office. Then check the prescription tag to make sure the medication and other information are correct.
Detector the Beneficial and Adverse Effects of Medicines:
Identify how the positive and negative effects of treatment can be assessed. Understand how to change your prescription based on this information. Know how to report adverse drug reactions.
Specify the Therapeutic Objective:
Specifying a therapeutic goal allows clinicians to direct prescribing toward a clear goal with expected outcomes. This can be illustrated using several clinical scenarios. Other common examples of nonspecific prescribing include the use of benzodiazepines to treat insomnia without investigating the cause and the use of analgesics without diagnosing the underlying source of pain. Establishing clear therapeutic goals is particularly important for conditions where treatment goals vary depending on risk factors.
Communicate and Document Prescribing Decisions:
Communicate clearly with patients, their careers, and colleagues. Provide patients with important information about how to take the drug, and what benefits may occur. Adverse effects (especially those that will require urgent review) and any necessary monitoring. Use the medical record and other means to accurately document prescribing decisions.
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Prevent or Reduce Prescribing Errors
- Preventing prescribing delusion is critical to improving patient safety.
- We developed an evidence review for policy to identify effective interventions to avoid or reduce prescribing errors.
- Four options were presented: support for educational events on prudent prescribing aimed at prescribers; incorporation of computerised alerting systems into clinical practice; introducing the use of tools to guide drug prescribing; and support of patient care by a multidisciplinary team with the participation of a pharmacist.
- These options can be incorporated into health systems separately or together, and therefore context needs to be considered.
Prescribing restrictions can effectively control drug use, but they can also shift practice in unpredictable ways. Therefore, physicians must engage in any interventions to change their prescribing.
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Multifaceted interventions targeting barriers to good prescribing are likely to have the greatest chance of success. Interactive learning sessions have more impact than didactic sessions. And individual learning visits are consistently effective. The implementation of guidelines should be supported by strategies such as a systematic audit. And feedback, active educational measures, and mechanisms to ensure that they are available at the time of prescribing.