Drugs: too many acronyms and abbreviations, illegible recipes even written on the PC

Fedaisf editorial staff

January 11, 2018

Once it was the doctor's often illegible handwriting that made prescriptions difficult to understand for patients

Edited by AdnKronos – 11 gennaio 2018

“FarmacoX 1 cp die for 5 days, aerosol with drugY ½ fl, drugZ Xgtt, drugW 3gtt for 2 for 5 days. Prognosis: dd. work 7 days clin 7 . 7 sc“.

It was once there handwriting often illegible of the doctor to make the recipes hardly understandable to patients. Today, despite the computer and the printed prescriptions, what creates difficulties are the many acronyms, abbreviations and extreme synthesis often present in the communications of the hospital doctor directed to the patient, as in the example shown, faithfully taken (without indicating the medicines) from a discharge sheet from a large Roman hospital.

“It is a frequent situation. In the pharmacy we very often have requests for clarification of prescriptions after discharge from the emergency room or hospitalization“, he explains toAdnKronos Greetings Achille Gallina Toschi, president of Federfarma Emilia Romagna, who underlines how the problem affects all patients. Not only the elderly, but also the young and the more educated.

“Together with family doctors - points out - we often find ourselves having to interpret initialed, abbreviated or very synthetic indications, delivered to the patient quickly upon discharge. Furthermore, we frequently have requests for explanations on the way in which prescribed medicines are used, in particular those to be used with innovative devices. The biggest misunderstandings are those on the methods of administration. An example are sachets for local use, but mistakenly taken by mouth. Another case is that of injectable heparin, often prescribed after fractures which require immobility. A drug that involves injections into the belly and which, instead, some patients think of injecting intramuscularly or into a vein, with consequent damage“.

Indeed, in the hospitaldue to overcrowding and staff reduction in recent years – observes Gallina Toschi – it is not always possible to devote sufficient time to patients who would need more indications and explanations. Furthermore, the fact that in most cases there is no direct and long-lasting relationship between the hospital doctor and the patient, as is the case with family doctors and pharmacists, does not allow the patient to ask all the questions he would like“. The 'dematerialized' prescription – in reality still not completely widespread in all regions in hospital services – in addition to saving money, it has certainly reduced the margin of error as regards the identification of drugs, "but there are still prescriptions written by hand or with abbreviations that do not help the patient to understand and 'manage' his treatment“.

“There have been many improvements in clarity in direct-to-patient prescribing in recent years – confirms Mario Falconi, president of the Tribunal of the rights and duties of doctors, former president of the Order of Doctors of Rome and with a long experience as a family doctor – However, it is still necessary to avoid acronyms and abbreviations which may be unclear. In this sense, the dematerialized prescription, which arrives directly at the pharmacy, has been a great step forward for the prescription of medicines. But very few are still used in hospitals, perhaps less than 20%“.

A 'lack' also linked to the difficult conditions in which emergency doctors and hospital doctors are often forced to operate, Falconi points out. With the blocking of turnover, the reduction of operators and the cuts of recent years, "hospital structures have to deal with a growing demand to be managed with limited resources. In this way the time to be dedicated to the individual patient is necessarily reduced“, concludes Falconi.