Making prescriptions simple

Strap: Illegible handwriting and use of too many acronyms in a prescription can cost a patient dearly

Pushpa Girimaji

Last fortnight, my neighbourhood chemist dispensed a wrong painkiller for my neck pain. I had some adverse reactions from the medication. When I reported it to the doctor, he checked my medication and said this was not the drug prescribed by him. In this case, I don’t blame the chemist because the doctor’s handwriting was totally illegible. This is not the first time this has happened and I am worried. How do I resolve the issue?

In the last couple of years, the Medical Council of India has addressed this issue of medication errors caused by the poor handwriting of doctors and similar sounding drug names by mandating that (a) doctors write the generic name of the drug and (b) that they write legibly and, as far as possible, use capital letters. Use of the generic name will not only eliminate confusion caused by similar sounding brand names, but will also give consumers a wide choice in terms of the medicine, given the difference in price between generic and branded drugs and also between various branded drugs. The Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, says: “Every physician should prescribe drugs with generic names legibly and preferably in capital letters and he/she shall ensure that there is a rational prescription and use of drugs.”

So please ask your doctor to write the generic name and in capitals, so that there are no grave errors while buying the prescribed medication. Also read the name prescribed by the doctor, spell it and ask him if you are getting it right. This way you can avoid such mistakes.

I must also mention that in order to overcome the problem of indecipherable prescriptions, many countries around the world have shifted to electronic prescriptions and we also need to move in that direction, particularly because e-prescriptions facilitate the use of local languages and also help us do away with incomprehensible Latin acronyms used by doctors. However, the software should be such that the process is faster and less time consuming than writing out a prescription.

And till we move towards that perfect solution, consumers need to exercise their right to information and clarify any doubts about the generic name of the drug, its purpose, dosage, how and when it should be taken and the side effects, if any. You should also check whether it interferes with any of the medicines that you may be taking at present. In Dr VK Ghodekar Vs Sumitra Prahlad Korgaonkar (RP NO 1727 of 2002), the apex consumer court has upheld the patients’ right to all vital information about the prescribed drug.

The doctor also uses certain short forms to indicate how often the medicine should be taken in a day and I find that too very difficult to comprehend. What should I do?

These are all short forms of Latin words and obviously it is difficult for a lay person to understand this. ‘QD’, for example, means ‘quaque die’ in Latin, meaning once a day. While ‘qid’ means ‘Quarter in die’ or four times a day. Yes, even if you understood the abbreviations, if you got the alphabets wrong because of the poor handwriting of the doctor and mistook ‘qd’ for ‘qid’ and took a tablet four times a day instead of once, it could be well be disastrous. The letters ‘bid’ stand for ‘bis in die’ in Latin, meaning twice a day and ‘tid’ ‘ter in die’ for thrice a day.

It’s time we stopped clinging to these outmoded, unintelligible acronyms and adopted a simple, easily understood way of conveying crucial information. Besides standardising simple English and its abbreviations, the Medical Council of India (MCI) should recommend pictorial representations, as a sizeable number of patients in India do not follow English. Some doctors, for example, indicate the number of times a medicine has to be taken, with dots or small zeroes. One zero for once a day, two zeroes with a space between them for twice a day, etc. This is easily understood by everyone and even if a patient forgets the doctor’s oral instructions, he or she can always look at the prescription to confirm the number of times a medication has to be taken. It’s time to implement such reforms.