CPD: Hot topics in prescribing – part 2

Case study 1 – Miss A

Miss A is a two-year-old girl who is brought in by her mother as she has a runny nose and a cough. You notice that this is the seventh such presentation in the last year and that each time she has been given appropriate advice for a viral upper respiratory tract infection and a prescription for paracetamol. Examining Miss A there is nothing of concern to find and you explain, again, about the self-limiting nature of viral infections. Before she leaves, Miss A’s mother asks you for a prescription of paracetamol. You explain that it is available over the counter and she looks surprised to be asked to buy it, asking why she can’t have a prescription, which would be free, given that she pays her taxes. You feel that the phrase ‘and I pay your salary’ may not be far from her lips.

Which of the following is true about the prescribing of medicines that are available over the counter?

• If a product is available over the counter, then it should never be prescribed
• NHS England advise that a prescription for the treatment of coughs and colds should not generally be offered in primary care
• If a GP recommends a medicine but does not prescribe it, they are in breach of their contract to provide medical services for the NHS
• Patients who get free prescriptions should not be expected to buy medicines over the counter

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