Kerala Doctors Slammed for 'Repeat All' Prescription Practice

Concerns have been mounting over a shortcut frequently used in medical prescriptions, where doctors simply write “Repeat All” instead of listing out individual medicines. This shorthand, intended to save time, has sparked widespread criticism after it was discovered that some prescriptions issued years ago—up to five years—are still being repeated without updates.

The problem was first highlighted by the Kerala Government Pharmacists Association. In a formal letter to the Health Department of the state, the association expressed alarm over the ongoing practice of using unclear instructions in prescriptions. According to them, such practices are a danger to patient safety, particularly when pharmacists have to interpret earlier medication history with little or no direction.

In response to the growing outcry, the Kerala Health Department has asked all District Medical Officers (DMOs) to provide their feedback on the matter. The directive was issued following multiple reports that some doctors, particularly in government hospitals, continue to rely on the “Repeat All” phrase, instead of clearly writing the required medications each time.

The association noted that many patients with chronic conditions such as diabetes, hypertension, and those enrolled in mental health programs often receive the same medication every month. These patients usually maintain a treatment logbook, which doctors reference during follow-up visits. If no changes are reported in the patient’s condition, doctors often skip writing out the entire list and opt for a simple “Repeat All.” This puts the responsibility on the pharmacist to flip through older prescriptions to determine the exact medications.

This practice, however, was originally allowed as a temporary measure during the COVID-19 pandemic, when regular consultations were disrupted. Patients were permitted to collect their routine medicines directly from pharmacies without fresh prescriptions. Although this measure was meant to ensure continuity of care during the crisis, pharmacists say it has unfortunately continued in several hospitals even after the pandemic subsided.

Dr. MC Tomichen, former Resident Medical Officer of Kottayam Medical College, stressed the importance of clarity in prescriptions. According to him, the correct and safest approach is to write down the names of medicines each time to avoid confusion or unintended consequences. He also emphasized that pharmacists must exercise extra caution when handling vague prescriptions.

Similarly, the Pathanamthitta District Prescription Audit Committee issued a directive last month urging doctors to stop using “Repeat All” in their prescriptions. The committee cited concerns about the delay in dispensing medicines and the risk of incorrect drug administration that can arise from such shorthand methods.

The Pharmacists Association letter also detailed why this is such a bad practice, particularly when prescriptions written years earlier are being reused. Given the possibility of patient health change, available medication, or dosing guidelines, reusing outdated prescriptions may create severe health issues.

Not all medical professionals are in favor of this short cut. Dr. KA Sreevivas, State President of the Indian Medical Association (IMA), said that all medicines prescribed must be written in full, no exceptions. Although he conceded that some doctors might take the "Repeat All" route because of their workload, he insisted that it must not become a norm. Clearly writing out prescriptions protects pharmacists from being placed in a situation where they could misinterpret a physician's intention.

(Input from various sources)

(Rehash/Sai Sindhuja K/MSM)