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Prescribing medications with indications: time to flip the script
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  • Published on:
    Prescribing medications with indications: the script has been flipped
    • Casper Bollen, Pediatric Intensive Care consultant University Medical Center Utrecht

    In the editorial authored by G.D. Schiff, B. L. Lambert, and A. Wright, the concept of "indication-based prescribing" is explored. This involves clearly documenting the reason, or indication, for prescribing a medication and linking it to the prescription itself. Despite recommendations and evidence supporting its potential to enhance medication safety and patient comprehension, this essential piece of information is frequently absent from current practices.

    The authors advocate for a drastic reimagining of the prescription process. Rather than treating the indication as a supplementary detail, it should serve as the inception point. Under this proposed model, the prescriber would initially enter the medical condition to be addressed. The electronic prescribing system would then recommend the most appropriate and evidence-based medication for the patient. This suggestion, although raising issues about autonomy and trust, is posited to elevate prescription safety, patient education, medication reconciliation, deprescribing, and efficiency in prior authorization processes.

    A further innovative proposal places the prescriber in full control. We have developed clinical decision support software enabling the prescriber to begin with either a) an indication, b) a medication, or c) the administration route. The software then filters the remaining pertinent options. As the combination of these three elements, along with the patient's specific context,...

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    Conflict of Interest:
    None declared.