[Legal format and costs of prescriptions at the Central Hospital in Yaounde, Cameroon].

Prescribing treatment is the last act of a medical visit. A prescription is a written document that engages the medical and legal responsibility not only of the physician but of all those subsequently involved in its execution. In countries with weaker economies and more limited health care insurance the costs of filling a prescription can place a heavy financial burden on the families. In the present study we analyzed 285 prescriptions written in the Emergency Room and Outpatient Clinic of Central Hospital in Yaounde, Cameroon. In most cases prescribers were in compliance with legal requirements regarding their identity, but in 20 to 30% of cases neither the name nor function of the prescriber was mentioned. Most prescriptions were written legibly and coherently for both paramedical personnel and the patient. The number of products prescribed ranged from 2 to 5 depending on the issuing department. Practitioners in the outpatient clinic prescribed few brand-name products from the public outlet of the hospital pharmacy (16% of the prescriptions). In 68% of the cases a generic replacement was available. Practitioners in the emergency room were more apt to prescribe brand-name products (73% of the prescriptions). Five classes of drugs accounted for two thirds of prescriptions, i.e. analgesics-antipyretics, usual antibiotics, antimalarials, non-steroid anti-inflammatory drugs, and vitamins. Lawfully required information (drug presentation, route of administration, dose unit, directions and duration of treatment) was stated on 85% of prescriptions from the outpatient clinic and 50% from the emergency room. Although there were large variations, the mean cost of filling a prescription at the town pharmacy was identical in the two groups, i.e. 9500 CFA francs. The cost was 50% lower at the hospital pharmacy. All prescribers and in particular medical students should receive instruction in prescription writing. Careful selection of brand and non-brand-name drugs in agreement with practitioners should achieve further reductions in the cost of filling a prescription in hospital pharmacy.