Please, please, please write the indication on the prescription

Fluid communication between different healthcare professionals is essential for providing high-quality care to patients. But an element of this communication, although necessary, is almost systematically absent from a prescription, namely the indication for treatment. In practice this week, I checked an antibiotic prescription for a patient. Without having the official indication listed, my technician wrote “flu” behind the prescription, according to what the patient told her at the counter. I scratch my head and wonder about the dosage which resembles neither that for pneumonia nor that for another respiratory tract infection. Read: Teamwork makes the dream work The patient is a lady who speaks little French and is not able to tell me exactly why she consulted with the doctor. To complicate matters, it's a Friday evening and the medical clinic is closed, so it's impossible to contact the prescriber. I ask her if she's had blood tests or other tests done recently and she tells me she doesn't know. Her Quebec health file doesn't help me either, since no laboratory values allowing me to judge kidney function can be found there. When a pharmacist adjusts or modifies a prescription, they are required to explicitly notify the prescriber. This is part of the aim of keeping all providers up to date with regard to therapeutic modifications made to the patient file. Just like the prescriber, the pharmacist is a professional who enjoys independence and a capacity for clinical judgment giving him full autonomy in the actions he is legally authorized to perform. Read: Are team-based healthcare clinics that serve one geographic area the answer? Thus, if the pharmacist is autonomous and independent, I question the principle that they are the only one who must justify and communicate their reasoning to the others. Indeed, why not ask prescribers to inform the pharmacist about the therapeutic indication of the prescriptions given to the patient? The flow of information should not be unidirectional in a philosophy of collaboration for the benefit of the patient. I remember, as a student at school, when we had to take the course entitled “Collaboration in Health Sciences” every year. It emphasized the importance of cooperating to optimize care. Workshops were held there between students in pharmacy, medicine, physiotherapy, psychology, etc., to inspire us to work as a team. This multidisciplinary philosophy must be illustrated in—and on—prescriptions. Some will say that the work of analyzing the treatment has already been carried out by the prescriber and that the pharmacist must stick to dispensing the prescription as recorded. In fact, it is precisely because the pharmacist is the safety net and the last verification point that they must evaluate the effectiveness and safety of the chosen treatment. We are all human and it's normal that mistakes occur. Just yesterday, I received a prescription for itraconazole prescribed by a dermatologist for a patient on rivaroxaban and, a little later in the evening, a prescription for amoxicillin for a patient with history of anaphylactic shock to penicillin. The process of verifying the prescriptions issued is therefore an essential step before providing pharmaceutical treatment, and writing the indication on the prescription is one of the important elements to have in order to carry out this work. My question is simple, what are we waiting for to improve teamwork between professionals? If the pharmacist must inform the prescriber of changes made to the patient file when adjusting or modifying a prescription, is it not natural for the prescriber to inform the pharmacist of the therapeutic intention? This article was translated from French and originally ran in our sister publication Profession Santé.

Please, please, please write the indication on the prescription

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