Do Clinical Indications Reduce Prescribing Errors?

What is the argument?

A clinical indication adds the reason for a medicine to the prescription in three or four words. The site’s FAQ 5 argues that indication labelling “ensures the correct drug is issued for the correct condition” and can “provide simple safety to health staff and patients to reduce the risk of mistakes”.

The point is that the prescriber is not the only check. In the FAQ’s words, prescribing errors will be reduced if all those involved are informed and advised, “especially patients, carers, pharmacists and other health staff – we simply cannot rely on the prescriber and the ‘intelligent’ computer to prevent medication errors.”

Which mix-ups does the site use as examples?

Five, all from FAQ 5. They are examples, not measured results.

• Similar names. Carbimazole is prescribed for thyrotoxicosis and carbamazepine for epilepsy. With the condition written beside the drug, prescribing one in error for the other “is less likely to happen”.
• One drug, several uses. Atenolol may be prescribed “to lower blood pressure”, “to prevent palpitations”, “to prevent angina” or “to prevent heart attacks”. Saying which “helps other health staff to link the correct illness with the use of the drug”.
• Inhalers. The wide range of asthma inhalers can lead to confusion, so the FAQ suggests adding the colour: salbutamol inhaler “to relieve asthma symptoms (blue inhaler)”.
• Dosing. Some drugs need a specific phrase, such as methotrexate “take four tablets ONCE weekly”.
• Interactions. “Avoid erythromycin” is recorded on all simvastatin scripts, as the two drugs can interact to cause a serious myopathy.

For other safety messages, such as monitoring and stop dates, see how to write a good indication.

Who else can spot an error?

The site names several people further along the chain:

• Pharmacists. FAQ 7 suggests indications can help health workers balance the risk and benefit of a medicine for each patient, and that this is “particularly helpful to dispensing pharmacists”.
• Nurses and pharmacists who prescribe. FAQ 5 notes that non-medical prescribers have a limited list of indications, so linking each item to its use “would enhance safety”.
• Carers. Feedback at the pilot practice included: “For carers, etc, it would be another check that the right drug was being used for the right complaint” (FAQ 14).

In 2004 the Health Minister, Dr Stephen Ladyman, said: “With clearer information on prescriptions, the chances of mistakes happening will be greatly reduced.” That was an expectation, not a measurement.

What does the research show?

The studies on the evidence page report these findings:

• UK hospitals, 2019. Only 4 of 64 trusts required an indication for all medicines. Pharmacists called indications “helpful” or “useful”, but the authors warn that “systems that force prescribers through mandatory fields to document clinical indications may be counterproductive” (Shemilt et al., Clinical Pharmacist).
• A New Zealand hospital, 2025. Making the indication field compulsory raised the share of medicines with an indication from 29% to 76%, “with only a small increase in ‘rubbish text’”, and the authors found “no change in medicine use” (Pairman et al., Br J Clin Pharmacol).
• A systematic review, 2026. Its title covers effects on documentation, medicines use and clinical outcomes. Of 24 studies, 16 covered antimicrobials and “only one study examined prescriptions for all medicines” (Pairman et al., Int J Med Inform). Its published summary reports better recording of indications in three studies, prescriptions more appropriate for the recorded indication in four, more deprescribing in two and less overuse of antimicrobials and blood products in ten; it does not mention prescribing errors.

The site’s own statin study looked at adherence, not errors, and its authors say prospective studies with controls are needed.

So what can be said?

That a clinical indication gives everyone who handles a medicine the reason for it, and that the GMC’s prescribing guidance advises: “As well, you should consider including clinical indications on your prescriptions” (paragraph 13; see what the GMC says). None of the findings summarised here is a measured change in error rates. Dr Masters knows of no study that measured prescribing or dispensing errors before and after indications were added.

If you have questions about your medicines, ask your GP practice or pharmacist.