How ROJoson Prescribes Medicines to Patients

How ROJoson Prescribes Medicines to Patients - ROJoson's Way(s)

ROJoson's Patient-care Management Strategies

1. Patient-care Management Strategy One: AVOID WASTAGE OF DRUGS AND MONEY

I usually make a prescription that includes an instruction to patients not to buy the whole amount placed in my prescription and to buy by installment, especially if the prescription of medicine is for the first time as patients may be allergic to the medicines or the medicines do not show response that I have to change right away. This way patients can return the medicines not used (or leftover) and change to another drug within one week of purchase without wasting their money.

First case in point:

I prescribed Quadtab to a patient. I told her to buy an initial supply good for 3 days only (15 tablets). If no allergic reactions occur during the first 3 days of intake, she should go back to the drugstore to buy the rest of the supply (200 tablets) as prescribed (which is good for at least 30 days).

After the first day of intake of Quadtab, she reported whole body itchiness. I told her to stop the medicine. I prescribed to her another medicine (Myrin Forte), again with the same procedures, initially buying only a supply good for 3 days and if with no adverse reaction, buy the rest.

She got her new prescription within 24 hours she reported to me the itchiness. She was able to return the leftover of 10 Quadtab to the drugstore and change them to Myrin Forte.

No wastage of medicine and money.

Note: I did not spell out the chemical names of the 4 drugs anymore (too long) - INH, PZA, ethambutol; rifampicin)

Second case in point:

Antibiotics are usually prescribed for a one week duration.

Example: Antibiotic ZZZ at one tab 3x a day; patients need a total of 21 tabs. I usually ask patients to buy an initial supply good for 3 days only (9 tablets). If there are no allergic reactions and there seems to be improvement in the infection, then I ask the patients to go back to the drugstore to buy the rest (12 tablets) to complete the course of treatment.

At times, I give a back-up antibiotic prescription so that patients will not have to go back to me for the prescription.

2. Patient-care Management Strategy One: ANALGESIC - AVOID WASTAGE OF DRUGS AND MONEY; PROMOTE RATIONAL USE; MINIMIZE EXPENSE

Analgesics or any medicine for that matter are usually given on the watch and wait basis or trial basis, meaning watching and waiting to see if the medicines are effective or not at the same time, monitoring for adverse reactions.

I usually prescribe analgesics, again on a staggered amount of buying or procurement from the drugstore on the part of the patients - initially 3 day supply, then more if needed.

I also usually prescribe two kinds of analgesics (not to be bought at the same time). One reason is for back-up purpose - if one analgesic is not effective or has adverse reaction, then the patient should stop and then procure the second analgesic.

Second reason is for scale-down purpose - if the pain has decreased tremendously after taking the stronger analgesic first, then the second less strong analgesic is procured and taken until there is not need to take analgesic anymore. The second analgesic usually has less adverse reactions and cheaper.

3. Patient-care Management Strategy One: MINIMIZE EXPENSE / PROMOTE VALUE-BASED (EFFECTIVE AT THE CHEAPEST COST)

I usually prescribe cost-effective medicines - effective at the cheapest cost (value-based).

I use generic medicines as long as they are not proven to be ineffective.

Sample of my instructions to a patient on Tamoxifen:

"OK. Here is the prescription. Buy Tamoxen brand - cheapest. Do not buy substitute from Mercury. If not available in Mercury, go to Watson and Southstar."

ROJ@20may8;20may20