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Similar
studies conducted in the USA & UK arrive at the same conclusions.
Patient confidentiality is always cited as a reason why this cannot
be done.
Often the concept of 'diagnosis' is confused with 'indication'
but in the study consumers saw many advantages in the purpose
for the medication being on the label and their consent can always
be sought.
There are many advantages in considering this initiative.
For General Practitioners it is an additional method that ensures
the intended drug is communicated.
With computerised prescribing there have been many instances where
a computer error has seen a drug ordered wrongly. Mostly where
spelling is close and the wrong drug has been keyed in.
There have been cases where the dose supplied has been wrongly
ordered with fatal consequences. If the 'indication' had been
noted this could have been prevented.
Having an 'indication' on the script raises suspicion for the
dispenser and alerts a potential medication error.
In the USA because of this safety angle the inclusion of purpose
for use is often recommended.
In hospitals the diagnosis is well known to pharmacists - there
is no difference for prescriptions written in the community.
For the pharmacist there are obvious advantages.
If a prescription can be viewed as a referral to another professional
for pharmacological therapy then the purpose for which the therapy
is indicated should be made known. Otherwise pharmacists are 'flying
in the dark' and our duty of care must be limited as a consequence.
As a safety check for reasons already discussed it is becoming
an imperative.
As counseling is mandatory for each prescription the purpose for
the prescription must be known for meaningful information to be
given.
For most drugs we counsel on the obvious purpose e.g. an antibiotic
for an infection, pain reliever for pain etc.
But there are countless drugs where multiple indications exist
and a slip of the tongue on the pharmacist's part can result in
alarm or even refusal to take the drug.
I am sure this has occurred to a majority of pharmacists.
There are increasing numbers of drugs available now where many
indications for use exist. Anti epileptics are good examples as
are many antidepressants.
For pharmacists conducting Home medication reviews I would think
that at a glance the "indication' would gain time and communicate
immeasurably to the review.
The referring GP for a review in many cases does not write all
the scripts a patients takes and it is necessary to be informed
when conducting a review of the diagnosis.
Where this is not supplied then the 'indication' on the label
would help.
For the consumer with multiple medications the advantages are
many for having the 'indication' on the label. It would be unthinkable
on an OTC product not to have this obviously written.
Why with potent prescription drugs do we keep this a mystery?
I would be very interested to hear what pharmacist colleagues
think of a move to initiate the 'indication' being commonly applied
to prescriptions.
There are arguments for and against.
On balance and with progress and a move to universal computerisation
this surely must be one of the next steps adopted in the Quality
of Medicines evolution.
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