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Saturday, March 27, 2010

How prescriptions are written matter to you

In India, it is common for doctors to write prescriptions for drugs based on the brand name and not the generic drug name. So a doctor will write a prescription for Metacin, Crocin etc. and not Paracetemol, Aspirin etc.

To understand why this is important for your health read on….

On the way back from work the other day I decided to stop over at a friend's place in Goregaon. She told me that she was sick and the doctor had prescribed the "Hilfas Kit" for her. She asked me if I could pick it up from a chemist near Goregaon station on my way to her home. I visited about 10 chemists and no one had even heard of the "Hilfas Kit" (I don't know why there need to be 10 different chemists near the station and that too only on the East side, but I’ll address the reasons in another blog).

I found it strange that none of the 10 chemists had even heard of the Hilfas Kit. So I asked my friend if she had her old medicines and if she could send me the drug names and their dosage. Luckily, she did. The Hilfas Kit, it turns out, consists of 2 fluconazole tablets 150mg, 1 azithromycin tablet 1g and 1 secnidazole tablet 1g. I asked a few of the chemists if they had the a similar "combo kit". They all did but yet they had not heard of Hilfas. That's because Hilfas is the name of one of over 10 companies that manufacturers the exact same kit.

Here’s the problem: suppose you have been taking the Hilfas Kit for a while now and the underlying problem is not going away, you decide to consult another doctor or a specialist. You show your prescription to the doctor and she doesn’t know what the Hilfas Kit is. How can she make the right diagnosis? How about if you wanted to get a second opinion from a doctor in another country say the USA? How will the doctor figure out what drugs you have been taking?

One way to fix this problem is for you to add the prescription to your Electronic Health Record (EHR). When you do that you will realize that the Hilfas Kit does not exist and you can call your doctor to understand what the underlying drug is. Of course, the best way would be if all doctors just entered the generic drug name and not the brand name. As EHRs gain more acceptance and are used more frequently this will become the norm.

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