Practice
The research and guidance on clinical indications, in date order, from the first description in 2003 to a 2026 systematic review. Each entry links to the study or guidance itself.
The evidence on clinical indications runs from Dr Masters’ first descriptions to a 2026 systematic review. It includes a single-practice statin compliance study, audits, GMC guidance in 2013 and 2021, and hospital studies; the review found that only one of 24 studies looked at prescriptions for all medicines.
Dr Nigel Masters first described adding the clinical indication to repeat prescriptions, and Doctor newspaper ran a front-page story on clinical indications in everyday practice.
Masters N. A clinical indication on every repeat performance. Br J Gen Pract 2004;54(498):58-9 (read on PubMed Central). At Highfield Surgery, a departure audit in January 2004 found indication labelling on 89% of repeat prescriptions, and one in August 2004 on 100% (the audits).
The first Clinical Indications Directory was compiled at Highfield Surgery, and an expert cardiac patient group discussed its phrases on 18 October 2005 (the focus group).
At Highfield Surgery, where 85% of repeat prescriptions carried an indication, average statin compliance over a year was 93%, and 91% when repeated in January 2006. A residential home audit of Highfield Surgery patients found the indication on 47 of 52 medicine items (90%). The authors note that prospective, controlled studies would be needed to show the effect (the study).
The GMC’s prescribing guidance advised prescribers to consider adding clinical indications. Masters NJ. Add clinical indications to prescription instructions to avoid problems of polypharmacy. BMJ 2013;347:f7496 (PubMed).
Masters NJ. Always add indication labelling to all repeat prescriptions. Br J Gen Pract 2015;65(634):231 (read on PubMed Central): “Adding indication labelling to the drug instructions firmly links the drug with its clinical indication.”
Schiff GD, Seoane-Vazquez E, Wright A. Incorporating indications into medication ordering: time to enter the age of reason. N Engl J Med 2016;375(4):306-9 (PubMed). A commentary arguing for indication-based prescribing, supported by health information technology.
Shemilt K, Morecroft CW, Ford JL, Mackridge AJ, Green C. Impact of including clinical indications on inpatient prescriptions. Clinical Pharmacist 2019;11(1) (read the article). Only 4 of 64 trusts surveyed required an indication for all medicines; pharmacists found indications helpful on new prescriptions but harder to add to existing ones.
The GMC’s Good practice in proposing, prescribing, providing and managing medicines and devices came into effect, advising: “As well, you should consider including clinical indications on your prescriptions” (paragraph 13), with a footnote linking to this website. What the guidance says.
Pairman L, Chin P, Doogue M. Evaluating the effect of making the indication field compulsory in electronic prescriptions: a pre-post study in a hospital prescribing system. Br J Clin Pharmacol 2025;91(5):1370-81 (PubMed). In Christchurch, New Zealand, the share of medicines with an indication rose from 29% to 76% after the field became compulsory, with no change in medicine use.
Pairman L, Chin P, Doogue M. Indication-based prescribing and prescribing with indications, effects on documentation, medicines use, and clinical outcomes: a systematic review. Int J Med Inform 2026;207:106209 (PubMed). Of 24 studies, 16 covered antimicrobials and only one looked at prescriptions for all medicines; the authors call for agreed international standards.
Of 24 studies, 16 covered antimicrobials and only one looked at prescriptions for all medicines; the authors call for agreed international standards.
In Christchurch, New Zealand, the share of medicines with an indication rose from 29% to 76%, with no change in medicine use (indications in hospital).
Yes, in its 2013 prescribing guidance and again in the guidance in effect since 2021, paragraph 13 (what the guidance says).
Read the single-practice study in full.
The statin compliance study sets out its method, results and limits.
Last reviewed
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