Can Patients Formulate Their Own Prescriptions?
No, patients should never formulate their own prescriptions based on their clinical history and laboratory investigations—this practice is fundamentally unsafe and contradicts established medical standards for medication safety.
Why Patient Self-Prescribing Is Dangerous
Prescribing is a complex intellectual task requiring specialized medical training to formulate appropriate treatment regimens while accounting for infinite patient variation 1. Even trained medical professionals struggle with this responsibility:
- Medical students consistently report that prescribing is the clinical skill for which they feel least prepared upon graduation 2
- Junior doctors make a significant proportion of medication errors despite their medical education 2
- Prescribing requires integration of patient examination, medication history, laboratory investigations, and scientific drug information—not just reviewing one's own labs 2
The Critical Components Patients Cannot Adequately Perform
Accurate Medication History Assessment
Patients cannot objectively evaluate their own medication histories with the rigor required for safe prescribing 2, 3. A proper medication history requires:
- Documentation of all prescription medications, over-the-counter drugs, and herbal/alternative remedies 2
- Detailed exploration of drug allergies, including dose, reaction type, temporal relationship, and susceptibility factors 2
- Assessment of adherence patterns that patients may not accurately self-report 2
- Recognition that pharmacists obtain better medication histories than physicians, highlighting the specialized skill required 2
Complex Drug Selection and Monitoring
Rational prescribing demands systematic evaluation that patients cannot self-administer 1:
- Making an accurate diagnosis (not just reviewing lab results)
- Estimating prognosis
- Establishing appropriate treatment goals
- Selecting optimal therapy from thousands of options
- Monitoring treatment effects and adjusting accordingly 1
Risk Assessment and Drug Interactions
Computerized prescribing systems exist specifically because human cognition—even among trained clinicians—cannot adequately screen for 4:
- Drug-drug interactions
- Drug-laboratory value interactions
- Drug-disease interactions
- Appropriate dosing calculations based on patient-specific factors (weight, renal function, hepatic function) 4
The Evidence on Medication Errors
Medication history errors are common even among healthcare professionals and frequently have potential to harm patients 3. Key findings include:
- 67% of medication histories taken by medical professionals contain at least one prescribing error 2
- Errors include drug duplication, unintended discontinuation, missed drug-related pathology, and loss of therapeutic efficacy 2
- Polypharmacy increases error rates substantially 3
The Proper Standard of Care
The established medical standard requires that prescriptions be written by licensed clinicians who integrate multiple data sources 2, 1:
- Patient examination findings
- Complete medication history (not self-reported)
- Laboratory investigations interpreted in clinical context
- Scientific drug information databases
- Patient-specific factors (weight, organ function) 4
Common Pitfall to Avoid
Patients may believe that having access to their laboratory results and medical records through patient portals qualifies them to make prescribing decisions. However, laboratory values must be interpreted within the complete clinical context, and even experienced clinicians require systematic approaches and decision support to prescribe safely 1, 4.
The recommendation is unequivocal: patients must work with licensed healthcare providers for all prescription medication decisions to ensure safety and optimize outcomes.