The Pharmaceutical Journal
Vol 268 No 7198 p683-685
18 May 2002

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Letters to the Editor

The Profession

Reasons why labels should not be abandoned

From Mr J. M. Allan, MRPharmS

David Kaye asks "Why do we label everything?" (PJ, 4 May, p612). Although I have never been impressed by the instructions "Take as directed" or "As before", the following reasons may be sufficiently relevant for us to retain this apparently quaint British practice.

It identifies the patient for whom the preparation has been prescribed. This is surely not unimportant in a household occupied by more than one person, in residential homes and in schools. It also identifies the supplier and gives the date of supply, both potentially important in any audit trail

The dosage indicated serves as a reminder to those with less than total memory recall and provides printed evidence in the event of incorrect administration of any medicament. Verbal instructions given in either the consulting room or pharmacy, when the patient may be under stress, can be misinterpreted and may not be retained for more than a short time. The person collecting the prescribed items may not be the patient. To discuss treatment with anyone other than the patient without his or her consent would be a breach of confidentiality. Even with the agreement of the patient there could be no guarantee that the verbal directions would be accurately conveyed to the patient. When travelling abroad, the fact that medicines are clearly labelled gives some indication that they have been prescribed for the specific individual.

While on the subject of labelling, a plea to prescribers to express dosage in terms of intervals of hours rather than "times per day", thus eliminating the ambiguity of the waking day as opposed to the 24-hour day.

By all means emphasise and clarify written instructions, where appropriate, through effective verbal communication. However to abandon labels, I suspect, would result in our keeping not a few lawyers in comfort for some time, while conversely providing discomfort to patients and pharmacists alike.

Malcolm Allan
Glasgow

Suffering from a “reality complex”

From Mr P. Williams

I would like to reassure Chi Cheung (PJ, 11 May, p648) that I do not suffer from an "inferiority complex" regarding the pharmacy profession, nor did I wish to offend community pharmacists or community pharmacy in my letter (PJ, 27 April, p572).

Perhaps, however, I suffer from a "reality complex" regarding the profession, a complex fuelled by numerous letters published in The Journal from practising pharmacists week in week out. Flanking Mr Cheung's letter was a letter entitled "driving nails into community pharmacy's coffin", in which Steve Bullock believes "our Society has in recent years sat back and watched as nail after nail was driven into community pharmacy's coffin" (PJ, 11 May, p648). John Macmillan (PJ, 13 April, p495) asks "when will I ever start my extended role?", a role that Mr Cheung suggests all pharmacy students find "mouth-watering".

These letters, and the views of Sittal Patel (PJ, 30 March, p431), reinforce fears that my chosen career, a career that has forced students into thousands of pounds of debt, may not ride the waves of time, unless we act today to ask "for more now before it is too late". I hope that community pharmacy is a stable career base for Mr Cheung and me, so that we can participate in the proposed changes that, apparently, lie ahead. But forgive me if my mouth is decidedly dry at this moment in time and I am asking where is the pharmacy voice fighting for our survival?

Paul Williams
Final Year Pharmacy Student
University of Nottingham

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