DOI: 10.1097/MLR.0b013e3181c18aeb

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Issn Print: 0025-7079

Publication Date: 2009/11/01


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Prescription Standards are Necessary to Improve Health Literacy and Medication Safety

Amanda G. Kennedy; Mark A. DiParlo

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We applaud the recent article by Dr. Wolf and colleagues regarding Variability in Pharmacy Interpretations of Physician Prescriptions.1 The results of this paper and others suggest standardizing prescriptions and container labels are needed.2 We believe prescription and container label standards for FDA-approved indications included as part of medication package inserts warrants further attention. Simulation studies could assist with understanding the health literacy and medication safety standards of new prescriptions. The standards could be fed to electronic prescribing systems and therefore substantially reduce the variability associated with prescriptions and container labels. Clearly this is the promise that electronic prescribing holds.
The authors note that indication on the prescription label varied from 20–56%. Prescription indication is important to medication safety, and alerting the pharmacist of the prescription indication should be a legal requirement.3 However, including the indication on a container label has important patient confidentiality concerns that cannot be ignored. Understanding the balance among literacy, safety, and patient confidentiality with container labels must be studied before standards regarding prescription indication are created.
Lastly, the scope of the pharmacist goes well beyond that of translating prescriptions, and some of the variability in the container label may reflect the pharmacology knowledge of the pharmacist. For example, it was suggested that the “optimal dosage timing” of atorvasatin is bedtime. While bedtime may be an optimal dosage timing for other medications within the class, such as simvastatin, this is simply not true for atorvastatin.4–5 Ideally the pharmacist would counsel the patient to determine the optimal timing for the patient to maximize adherence.
Despite our criticisms, we wholeheartedly support this paper. The purpose of this letter is to continue the discussion and highlight the importance of investigating the health literacy and medication safety of outpatient prescriptions.
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