Targeting Drug Waste at the Level of the Prescriber
Dear Editor,
Professor Blackburn and colleagues make an excellent point regarding the reduction of drug waste, especially given the current financial difficulties within the NHS, as well as the current state of the Earth’s climate going past the point of no return.
To expand on a point mentioned briefly in the article, I feel there is another significant contributor to the waste of drugs at the level of the prescriber. Specifically through lack of education and experience which leads to situations where drugs may be prescribed, prepared, and then promptly discarded. A drug may have been prescribed via the incorrect method of administration, or a dose that matches the BNF but not the reality on the ward or for that specific patient. I say this as I myself have contributed to this drug wastage. For example, prescribing insulin to be administered via needles, before being informed that the standard practice on the ward is to prescribe an auto-injector. The prescription was cancelled, and the already prepared vial of insulin was unceremoniously discarded. Another example includes changing fluid prescriptions that result in bags of fluid (and therefore money) going down the drain. Unfortunately, junior doctor induction into new wards often do not have time to provide key information about the specialty such as common drugs used and their standard formulations. For new FY1s and FY2s such as myself, we may not have the experience required to integrate the difference between the BNF and reality.
I agree with Professor Blackburn that given a significant number of prescriptions are completed by junior doctors, especially FY1s and FY2s, drug waste at this level is important to target. A way to potentially address this may come in the form of better education from individual departments. For example, teaching sessions on what specific drugs are most commonly used and their standard forms for that speciality. A barrier to this type of training is of course time and resources, especially given that junior trainees move on after 4 months, but it may represent a valuable place to begin when targeting drug wastage of this kind.
Kind regards,
Rokaiba Afrin
Competing interests:
No competing interests
10 September 2024
Rokaiba Afrin
FY2 Doctor
The Royal Wolverhampton Trust
The Royal Wolverhampton Trust, New Cross Hospital, Wolverhampton, WV10 0QP
Rapid Response:
Targeting Drug Waste at the Level of the Prescriber
Dear Editor,
Professor Blackburn and colleagues make an excellent point regarding the reduction of drug waste, especially given the current financial difficulties within the NHS, as well as the current state of the Earth’s climate going past the point of no return.
To expand on a point mentioned briefly in the article, I feel there is another significant contributor to the waste of drugs at the level of the prescriber. Specifically through lack of education and experience which leads to situations where drugs may be prescribed, prepared, and then promptly discarded. A drug may have been prescribed via the incorrect method of administration, or a dose that matches the BNF but not the reality on the ward or for that specific patient. I say this as I myself have contributed to this drug wastage. For example, prescribing insulin to be administered via needles, before being informed that the standard practice on the ward is to prescribe an auto-injector. The prescription was cancelled, and the already prepared vial of insulin was unceremoniously discarded. Another example includes changing fluid prescriptions that result in bags of fluid (and therefore money) going down the drain. Unfortunately, junior doctor induction into new wards often do not have time to provide key information about the specialty such as common drugs used and their standard formulations. For new FY1s and FY2s such as myself, we may not have the experience required to integrate the difference between the BNF and reality.
I agree with Professor Blackburn that given a significant number of prescriptions are completed by junior doctors, especially FY1s and FY2s, drug waste at this level is important to target. A way to potentially address this may come in the form of better education from individual departments. For example, teaching sessions on what specific drugs are most commonly used and their standard forms for that speciality. A barrier to this type of training is of course time and resources, especially given that junior trainees move on after 4 months, but it may represent a valuable place to begin when targeting drug wastage of this kind.
Kind regards,
Rokaiba Afrin
Competing interests: No competing interests