Appendix D – management: prescribing

Management 4: Prescribing (b) Interpersonal

The doctor issues prescriptions on a ‘take it or leave it’ basis, without obtaining informed agreement, warning of side effects, or instructions about use.					The doctor involves the patient in defining the aims of treatment, arrangements for follow-up, and further treatment. He/she uses follow-up to check the effectiveness and cost of his/her prescribing, including repeat prescriptions.
1	2	3	4	5	6	7	8	9	10
Has little understanding of this.		Attempts to do this but is not yet skilful and sometimes runs into difficulty.				Attempts to do this and is usually successful but recognises his/her limitations.			Perfect

The doctor:

Rarely

Occas
ionally

Fairly
frequently

Often

Usually

(a)

Advises the patient of dosage and duration of drug treatment.

(b)

Advises the patient about possible side effects.

(c)

Advises the patient about specific precautions. (eg, driving, alcohol).

(d)

Involves the patient in defining the aims of the treatment.

(e)

Makes adequate arrangements for feedback.

(f)

Checks response before further treatment.

(g)

Checks side effects, and notifies them (yellow card) where necessary.

(h)

Checks the effectiveness of the treatment.

(i)

Considers the cost of prescriptions.

(j)

Makes sound decisions about starting repeat prescribing.

(k)

Initiates or uses proper methods of monitoring repeat prescriptions.

This area of behaviour is best assessed in case discussion (eg ‘what did you tell the patient about. ..?” , ‘what did you warn him about…?”)