Friday, 19 June 2015

Pharmacist's prescription for docs, write in capital letters to save lives

Reporter: Prabeerkumar Sikdar (Hyderabad)
A one-man campaign that started in the sleepy town of Nalgonda in 2012 is on its way to rewrite (literally) medical history -making it mandatory for doctors to write prescriptions in CAPITAL letters so as to make these legible.Prescriptions, the way they are written now, have taken lives.
While a formal gazette notification by the Union health ministry is round the corner, the Medical Council of India (MCI) is circulating a prescription format to be used by doctors to all state medical councils across the country . The letter, which TOI has a copy of, says doctors must write the name of medicines, dosage, strength, duration and total quantity in “capital letters only“.
From his run-down pharmacy in Nalgonda, 47-year-old Chilkuri Paramathma used the Right to Information Act, filed PILs and wrote innumerable letters to the Union health ministry, the Medical Council of India (MCI), the Drugs Controller General of India (DCGI) and the Director-General of Health Services (DGHS) to enforce his 'prescription' for prescriptions.
“In my 25 years of practice as a pharmacist, names of medicines always fascinated me.There are several similarly spelt drugs that can stump a pharmacist as one single letter or even a hypen can sometimes be the only difference between two completely opposing drugs.Imagine the havoc it can cause,“ said Paramathma.
And havoc it often caused.
On February 22, 2012, Para mathma got to know of a Hyderabad-based pregnant woman who was advised Microgest 200 mg (used for fetus growth). “So illegible was the writing in the prescription that the pharmacist mistook Microgest for Misoprotol -which is used for abortion. The woman lost her baby ,“ he recounted.
In July 2013, a patient died in Hyderabad after he was administered a wrong injection by a pharmacy . The drug control administration later shut down the pharmacy .
Paramathma cites a plethora of drugs that spell and sound almost the same, but have quite different effects on the body .“Consider L-CIT and L-COT, KARDIA and KARDIN, JUCAN and JUGAM, IKA and IKKA, IDEBEN and IDIBEND, NEPOMOX and NEPOTOX, NIFDEC and NIFEDINE, OCUVIT and OCUWET, E-PRIN and EPRIL...The list is endless,“ he says.
Following several missives to various departments and a hearing at the Andhra Pradesh high court, a division bench in 2014 directed MCI to look into the aspect of illegible handwriting of doctors. Following this, the Union health ministry directed MCI to look into the case.
Now with formal notification on the way , doctors and MCI have welcomed the move.“This man's move has catapulted the MCI into action. Once it's a law, the responsibility will also lie with the pharmacy council as well as drug control administration,“ MCI member K Ramesh Reddy told TOI.
A few corporate hospitals in Hyderabad already got the cue and have started giving typedout prescriptions to their patients. “All our in-patients are given typed prescription so there is no chance of any prescription error. We are working towards implementing the same shortly for our out-patients too,“ said Hari Krishna, chief executive officer, Maxcure Hospitals, Hyderabad. True to his name, Nalgonda's Paramathma, has just given a boon of life to many in this country .