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Points for Consideration by the Physician

When You Issue Prescriptions in Writing or by Telephone

• When prescribing for outpatient use, consider the advantage of including both the name of the drug and the therapeutic indication (the patient's disorder) on the prescription label. For example: Sinemet CR for Parkinson's. Putting the disorder on the label will help (1) reduce dispensing errors caused by "look-alike" and "soundalike" drug names, and (2) prevent confusion that often occurs during concurrent use of multiple drugs, especially among the elderly: mistaken identity of drug and purpose, mistakenly altered dosing schedules, etc.
• Respect your patients' wishes as to whether or not they want the name of the disorder written on the prescription label. If they prefer you not include it, recommend that they write it on the label themselves after the prescription is filled.
• Keep dosing schedules as simple as possible. Once-a-day dosing improves adherence.
• Alert the pharmacist to "look-alike" and "sound-alike" drug names. Print the drug name on written prescriptions. Spell the drug name when prescribing by telephone.

When Counseling Patients About Drug Therapy

• Briefly explain the nature of the patient's disorder and its treatment. Use language that is readily understood by the average person.
• Provide written information or references for educational materialabout the disorder. If the disorder is chronic in nature (diabetes, hypertension), explain the need to continue drug therapy indefinitely, possibly for life.
• Briefly explain the name and nature of the drugs you are prescribing. Stress the importance of strict adherence with the medicine. It is wise to tell the patient-in advance-about potential adverse effects. The patient who has such effects is more likely to be understanding and forgiving if they do not come as a surprise to them.
• To supplement your discussion, provide a printed document that summarizes the essential information the patient needs to use the drug(s) safely and effectively. This is comforting and will save you an amazing number of telephone calls. Be sure the patient knows what to do if a dose is missed. Look at an add-on program to your office management program that prints out relevant information for your patients to take home. Such services can provide detailed descriptions of drugs, general guidelines for drug use, and personalized instructions.
• Explain the need for follow-up visits to monitor the effects of drug treatment and the course of the disorder.
• Explain that drugs may not work in practice exactly as expected. Tell the patient to be alert to the possibility that a new symptom or sign may be drug related. If one of your patients does experience a novel adverse drug reaction.