Time frame for prescriptions needs to be fixed to stall medication mismanagement

New Delhi, March, 2016

Union Ministry of Health and Family Welfare needs to mandate prescription validity time frame to stall medication mismanagement, said Dr BR Jagashetty, Former National Advisor, (Drugs Control) to MoHFW and Project in-charge for the implementation of two schemes of Central Drugs Standards Control Organization (CDSCO). 
The government needs to take a cue from the Telangana government initiative to advise its doctors to mention expiry dates on prescriptions. In fact, many of the developed countries already have put in a system with details of drugs and the therapy duration. The move will enable prescription audit which is one of the cornerstones of good healthcare practices, after immediate patient attention, maintaining confidentiality and ensuring cordial relations with patients, he added.

In a similar manner all state governments need to ensure its healthcare facilities adopt medication safety particularly for drugs like antibiotics, hormones, vitamins, analgesics and antipyretic which have serious side-effects during over-consumption. But the first step to be made by the MoHWF is to look at including a directive on prescription validity by suitably amending the Drugs & Cosmetics Rules, he said.

Particularly for antibiotics, prescription validity may be fixed for 3-5 days. This will give ample time to change the drug by doctors in case of an adverse event and also prevent antibiotic resistance. Moreover, if the drug is not available to patients in far-flung villages, there is sufficient time to purchase the same from a town or district headquarters close to the village, he stated.In the case of life style disorders like diabetes, hypertension and cholesterol drugs, the doctor should provide a time frame for the drug therapy. These disorders can be reversed with lifestyle modification and there is every possibility to discontinue the medication or tweak the dosage, noted Dr Jagashetty.
To mandate prescription validity, the government will have to work closely with the Medical Council of India and Indian Medical Association to educate doctors. The medical practitioners are also required to provide in every prescription, date, MCI registration number, patient details with name-address and Rx symbol besides specifying duration of the treatment and dosage without fail as per D & C Rules, 1945. All retail license holders need to have prescribing doctor’s registration details updated to verify the authenticity of the registered medical practitioner before dispensing the prescription.
Currently, Rule 65 (9) and (10) of D & C Rules, 1945 provides details about the prescription format. Going by the transformations in pharmaceuticals and healthcare sector, together with growing consumer awareness, India needs to adopt systems to keep pace with the changing times. Moreover, registered pharmacists also needed to ensure that all drugs are dispensed with a prescription which must also bear their outlet seal and signature. This will put a stop to unethical over-the-counter supply of medicines. For all this the government needs to do is to introduce a sub-clause under Rule 65, said Dr Jagashetty. Express Pharma