CHEARS

While the healthcare sector struggles to cope with the repeated waves and variants of the Covid19 virus, a familiar problem seems to be emerging yet again, and may soon become a problem bigger than the pandemic itself. Prescription cloning among patients who contract the virus has become commonplace, and while its magnitude and seriousness may be underestimated, the effects of the same have already started to manifest themselves as some serious consequences.

What is Prescription cloning?

Prescription cloning is when a person suffering from a disease condition decides to follow the treatment regime prescribed to another patient with a same or similar disease condition by a medical practitioner, without consulting a medical practitioner themselves. This practice has been common with Over the counter (OTC) medications in the previous decades, but its usage for procurement of stronger medications like steroids has increased markedly during the pandemic.

What has led to this rise?

Covid19 being a new disease has led to mass panic and confusion, and this has led to different doctors prescribing various different drug regimens for symptomatic relief. In addition health services have been struggling to cope with the demand generated by the sudden increase in cases, and many doctors are refusing to see patients for fear of contracting the virus. Above factors when coupled with the fear, economic burden and social stigma of the disease lead many patients to try and bypass the doctor consultation part altogether and instead follow the treatment that may have worked for another person who previously contracted the virus.

What are the risks?

Prescription cloning is to be discouraged for many reasons. Firstly, different patients often present with different symptoms, such as fever, rashes, diarrhoea, body aches and so on. They may even have contracted a different strain altogether, which may cause an infection of a different severity level. Thus, symptomatic or effective treatment for one patient may not lead to relief for another, leading to unnecessary delay in appropriate treatment, which may result in further morbidity or even complications leading to death.

Second, stronger drugs often have undesirable side effects, and must not be taken without medical advice or supervision. These side effects, or Adverse Drug Reactions (ADRs), may range from mild effects such as nausea to life threatening conditions. One example is the now feared Mucormycosis, which has been found to affect several post-Covid patients and is being linked to steroid overuse. Steroids lead to weakening of the immune system, and their usage without medical supervision may lead to mucormycosis or other conditions commonly seen in immune-deficient patients.

The usage of antibiotics may lead to development of antibiotic resistance in bacteria previously susceptible to the same. Antibiotic resistance is already a major problem in all parts of the world, and developing nations like India are especially vulnerable to drug resistant strains of bacteria like M. tuberculosis, among others. Another factor that must be taken into consideration is the economic burden of the medications involved, and following unjustified regimens may in turn increase this economic stress on families that may already be struggling financially.

What can be done?

Prescription cloning and self-medication are issues that can be solved, and that firstly involves generating awareness amongst the masses regarding the risks of taking medications without proper consultation or supervision. Medical practitioners have a special responsibility in this regard as well, and they must advise their patients to not share their prescriptions with other patients, rather, advise them to seek consultation and get prescriptions tailored to their needs. Lastly, in times of crisis, health personnel can try to extend services in ways such as teleconsultation that may make them more approachable.