The Pharmaceutical Journal
Vol 280 No 7503 p625
24 May 2008

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• New professional body
• Fitness to practise
• Medicines use reviews (MURs)
• Workload
• Disciplinary procedures
• Ergocalciferol
• Furosemide
• Ophthalmology

Letters to the Editor

Ophthalmology

Confusion over hospital prescriptions

From Mrs C. J. C. Gilbert, MRPharmS

Captain Blanch (PJ, 17 May 2008, p594) highlights the confusion over prescriptions for eye drops, which emanate from hospitals. His is not the only hospital department that issues prescriptions that can be interpreted by pharmacists in different ways.

It is a common problem with handwritten prescriptions. Will there ever come a time when hospitals routinely issue prescriptions generated on computers that have built-in checks to ensure that all information is present?

Pharmacists have enough to do without having to calculate the number of bottles of eye drops to dispense, requiring us to calculate (number of drops per dose x number of eyes x times per day x treatment length in days) divided by (drops/ml x ml per bottle).

Using Captain Blanch’s example — one drop in each eye every hour for 14 days — I calculate the Prescription Pricing Authority should pay me for a quantity of 7 x 5ml bottles. But is this really the quantity intended? I believe the PPA suggests 16–17 drops/ml and it would be unrealistic to expect that the eye drops would be used every hour.

This type of situation occurs less often with GP prescriptions, because most are computer generated. The British National Formulary states that computer-issued prescriptions “must be printed in English without abbreviation. The dose must be in numbers, frequency in words, and quantity in numbers in brackets”.

Handwritten prescriptions should preferably be in English without abbreviation but “it is recognised that some Latin abbreviations are used”. I imagine many pharmacists are unfamiliar with the examples of abbreviations that Captain Blanch uses for every hour and every two hours.

I am more familiar with the notations of qh and q2h. Might I suggest that Captain Blanch refamiliarise himself with the sections in the BNF on prescription writing and Latin abbreviations and any pharmacist unsure of how much to supply against a prescription contact the PPA for assistance.

Christine Gilbert
King’s Lynn, Norfolk

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